title: Influence of fat-free mass and functional status on resting energy expenditure in underweight elders.
abstract: BACKGROUND
  In underweight elders, resting energy expenditure (REE) and its relationship with fat-free mass (FFM) could be modified by sarcopenia, physical activity, and functional limitation. The aims of this study were to investigate REE and its relationship with quantity and metabolic activity of FFM and to evaluate the influence of functional status on REE in underweight elderly subjects.
  
  
  METHODS
  Forty-eight underweight elders (BMI < 20) and 54 normal weight elderly subjects (BMI 20-30) as a control group were selected. Body composition was determined by dual energy x-ray absorptiometry (DEXA). REE was measured by indirect calorimetry. Ability in activities of daily living (ADLs) was assessed by the Katz index.
  
  
  RESULTS
  Underweight elders had significantly lower FFM, FFM index (FFM/height(2)), and REE than healthy subjects. REE adjusted for FFM with analysis of covariance remained significantly lower in the underweight group (1287 +/- 85 vs 1715 +/- 139 kcal/day in men, and 1124 +/- 63 vs 1366 +/- 91 kcal/day in women). Katz index in the underweight group was inversely correlated with REE (r = -0.68; p <.001) even after removal of FFM, FM, and gender, by multiple regression analysis. In this model, FFM and Katz index together explained approximately 54% of REE variability.
  
  
  CONCLUSIONS
  Underweight elderly subjects show a hypometabolism due to a reduction of both FFM quantity and its metabolic activity. Functional status in ADLs comes out as an important predictor of REE independently from FFM. The limited physical activity might be the underlying determinant of this hypometabolism, but further investigations are necessary to confirm this issue.
authors: Department of Medical and Surgical Sciences, Division of Geriatrics, University of Padova, Italy. giuseppe.sergi@tin.it
authors: Giuseppe
authors: G
authors: Sergi
authors: Alessandra
authors: A
authors: Coin
authors: Mauro
authors: M
authors: Bussolotto
authors: Paolo
authors: P
authors: Benincà
authors: Giovanna
authors: G
authors: Tomasi
authors: Claudia
authors: C
authors: Pisent
authors: Silvia
authors: S
authors: Peruzza
authors: Emine M
authors: EM
authors: Inelmen
authors: Giuliano
authors: G
authors: Enzi
mesh_terms: D000203:Activities of Daily Living; D000273:Adipose Tissue / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001823:Body Composition; D001835:Body Weight; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D012016:Reference Values; D012146:Rest; D013851:Thinness / Q000473:pathology / Q000503:physiopathology*