Paradoxical weight loss with extra energy expenditure at brown adipose tissue in adolescent patients with Duchenne muscular dystrophy

Citation
S. Satomura et al., Paradoxical weight loss with extra energy expenditure at brown adipose tissue in adolescent patients with Duchenne muscular dystrophy, METABOLISM, 50(10), 2001, pp. 1181-1185
Citations number
20
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Endocrinology, Nutrition & Metabolism
Journal title
METABOLISM-CLINICAL AND EXPERIMENTAL
ISSN journal
0026-0495 → ACNP
Volume
50
Issue
10
Year of publication
2001
Pages
1181 - 1185
Database
ISI
SICI code
0026-0495(200110)50:10<1181:PWLWEE>2.0.ZU;2-W
Abstract
We examined the energy expenditure in patients with Duchenne muscular dystr ophy(DMD) to evaluate the cause of the paradoxical weight loss observed in large numbers of adolescent patients before any obvious impairment of their swallowing function. In the morning, resting energy expenditure (REE)/m(2) was almost the same as that in normal controls despite a reduction in fat- free mass (FFM); thus, REE/m(2)/FFM was significantly increased in patients (median, 21.2 kcal/m(2)/FFM kg; range, 17.7 to 44.2, P = .012). A thermogr aphic examination in the morning showed an obvious elevation of the body su rface temperature on the back. This phenomenon was consistent with a parado xical fall in the low frequency (LF)/high frequency (HF) ratio at night ana lyzed using the inter-RR spectrum by 24-hour electrocardiogram, which indic ated relative activation of the sympathetic nervous system. The urinary sec retion of norepinephrine at night was also significantly greater in patient s (median, 0.119 mug/kg/h; range, 0.061 to 0.219, P = .011). These results suggest that paradoxical activation of the sympathetic nervous system may a ccelerate the production of heat in brown adipose tissue (BAT) and increase the level of energy consumption in patients, and that adolescent DMD patie nts may require greater caloric intake than expected to maintain body weigh t, which is important to improve the prognosis of their respiratory functio n. Copyright (C) 2001 by W.B. Saunders Company.