Comparision of measured resting energy expenditure by indirect calorimetry and predicted value in the obese

BACKGROUND: In order to treat obese individuals, control of caloric intake after determination of patient's energy expenditure and recommendation of exercise program with possible use of specific medication is advised. There are many limitations in measuring all individuals energy expenditure by calorimetry, thus estimation is made using many variables such as weight, height, age, and gender. But, commonly used equations to predict resting energy expenditure(REE) are thought to result in overestimation of energy expenditure for use with obese individuals. This study investigated difference between measured and predicted resting energy expenditure in obese individuals. METHODS: Subjects were 133 adults who were admitted either to Internal Medicine Department and ENT Department of Yeung Nam University Hospital and their resting energy expenditure was measured by indirect calorimetry. According to age, sex, smoking habits and body mass index, Measured REE by indirect calorimetry between groups was compared. Predicted REE estimated by 6 equations to measured REE was compared in the two groups by body mass index 27kg/m2 under 65 years old individuals. RESULTS: There was no significant difference of measured REE between groups according to smoking habits(p>0.05). In the older group(> or =65 years old), REE was lower compared to the younger groups(27kg/m2) measured REE was higher than the normal weight group(BMI<27kg/m2)(p<0.05). Among 108 individuals under 65 years old, other equation except for Fleish equation and Robertson and Reid equation were inaccurate when applied to the obese group. CONCLUSIONS: These commonly used prediction equations tend to overestimate the REE in obese individuals, and the best estimates for the obese seem to be derived from the Fleish and Robertson and Reid equations.

The effectiveness of glycosylated hemoglobin, fructosamine in the diagnosis of diabetes

BACKGROUND: With respect to the risk of developing diabetic vascular complications, the central purpose of most screening and detection program, is to identify people with diabetes at early stage so they might have advantages of early treatment to prevent complication of the disease. Oral glucose tolerence test(OGTT) is widely used for diagnosis of diabetes and impaired glucose tolerence, bit the performance of a complete OGTT is not only time consuming and expensive but physically demanding on the individual being tested. Determination of HbA1 and more recently of glycosylated total serum proteins(fructosamine) has been proposed as an alternative method of screening and diagnosis. The aim of our cross-sectional study is to compare the values of fructosamine and HbA1, for the ourpose of diabetes diagnosis with the OGTT as reference method. METHODS: In the study, from January 1996 to August 1996, we included 55 consecutive subjects in Kyeungssang Hospital. Blood samples for HbA1 and fructosamone determination were drawn at the same time as a fasting plasma glucose sample, and then all subjects underwent a standard 2-hour OGTT according to the World Health Organization recom-mandations, The subjects were classified according to the American Diabetes Association classification. RESULTS: In our study, we observed fasting plasma glucose of 145.32+/-75.00mg/deciliter, two-hour plasma glucose of 245.83+/-155.22mg/deciliter, HbA1 of 7.06+/-2.77%, and fructosamine of 308.77+/-128.23 micromol/liter. The correlation coefficient between FPG and HbA1 was 0.9098(p<.05), between FPG and fructosamine 0.7953(p