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Parental diabetes influences resting energy expenditure in offspring without diabetes
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Adult offspring of parents with type 2 diabetes had lower resting energy expenditure vs. offspring of parents without diabetes that translated to a potential weight gain of 6 kg per year, increasing their risk for obesity and other cardiometabolic conditions, according to findings published in BMJ Open Diabetes Research & Care.
Type 2 diabetes and energy expenditure are inherited traits, and about 40% of the variance in energy expenditure may be explained by inherited characteristics, Ebenezer A. Nyenwe, MD, associate professor in the division of endocrinology, diabetes and metabolism at the University of Tennessee Health Sciences Center in Memphis, and colleagues wrote in the study background. Additionally, low resting energy expenditure is a positive predictor of future weight gain in adults and has been linked to the disparate prevalence of obesity in ethnic minority groups.
“Both impaired glucose tolerance and [type 2 diabetes] have been associated with higher [resting energy expenditure] compared with normoglycemic individuals,” the researchers wrote. “This may represent an early abnormality in the pathogenesis of [type 2 diabetes].”
Nyenwe and colleagues analyzed data from 87 healthy adults who had normal blood glucose readings after a 75-g oral glucose tolerance test and had at least one biological parent with type 2 diabetes, selected from the Pathobiology of Prediabetes in a Biracial Cohort, as well as 83 healthy adults with parents who did not have diabetes, matched by demography and anthropometry (mean age, 39 years; 57% women; 53% black; mean BMI, 28.5 kg/m²). Parental diabetes status was determined via questionnaire. Each participant underwent measurement of resting energy expenditure using indirect calorimetry and body composition via DXA and provided blood samples for measurement of plasma glucose and insulin. Researchers used multiple regression analysis to determine the independent effect of anthropometry, body composition, parental diabetes status and ethnicity on resting energy expenditure.
Researchers found that normalized resting energy expenditure was lower in the adult children of parents with type 2 diabetes vs. offspring of parents without the disease (mean, 1,364.4 kcal vs. 1,489.4 kcal; P = .0063). Resting energy expenditure per fat-free mass (FFM) was similarly lower in the offspring of parents with diabetes vs. the offspring of those without (mean, 29.2 kcal/kg of FFM per day vs. 31.9 kcal/kg of FFM per day; P = .002). In multiple regression analysis, parental history of diabetes was a strong independent predictor of resting energy expenditure (P = .0057), according to the researchers.
Researchers also found that race played a role in resting energy expenditure. Compared with white adults, black adults had a lower resting energy expenditure (mean, 1,362 kcal per day vs. 1,496 kcal per day; P = .0035) and lower resting energy expenditure per FFM (mean, 28.6 kcal/kg of FFM per day vs. 32.6 kcal/kg of FFM per day; P < .0001). Black adults with parental type 2 diabetes had the lowest resting energy expenditure per FFM (mean, 27.9 kcal/kg of FFM per day), according to researchers.
In multiple regression models, independent predictors of resting energy expenditure were ethnicity (P < .0001), parental diabetes status (P = .006) and FFM (P = .0001).
The researchers noted that the lower resting energy expenditure among offspring of parents with diabetes would amount to an energy surplus of 2.7 kcal/kg of FFM per day. Considering a mean FFM of 53.8 kg, this translates to 53,020 kcal per year, or 6.9 kg weight gain per year, according to the researchers.
“Given the inverse association between low resting and exercise energy expenditure and weight gain, our findings of a lower [resting energy expenditure] in African-American offspring predicts increased risk of obesity and dysglycemia among these subjects,” the researchers wrote. “By the same token, the Caucasian offspring who had lower [resting energy expenditure] than Caucasians without parental diabetes would be at increased risk of obesity and dysglycemia.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.
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