Lipid oxidation assessed by indirect calorimetry predicts metabolic syndrome and type 2 diabetes

Diabetes has been linked to an impaired ability to oxidize fatty acids. Fat oxidation can be assessed clinically by a respiratory quotient measurementduring fasting. We hypothesized that a respiratory quotient might predictmetabolic syndrome and type 2 diabetes onset. Methods: In this longitudinal studywe used an existing database of 233 individuals who had complete nutritional and biochemical data at baseline and after 12-month follow-up. All participantsunderwent an indirect calorimetry to measure the respiratory quotient. Weexcluded participants with diabetes, metabolic syndrome, chronic diseases, andthose who had changed food habits in the previous 3 months. Only 88 subjects met the inclusion criteria. Results: Two individuals developed type 2 diabetes and 10metabolic syndrome after 1 year. Participants in the high respiratory quotientgroup (>0.91) had a higher incidence of metabolic syndrome/diabetes than those inthe low quotient group (25 vs. 8% p = 0.04). In this group, mean basalrespiratory quotient was 0.97 ± 0.04. In the high respiratory quotient group,Kaplan-Meier curves showed a greater probability of having metabolicsyndrome/diabetes than those in the low respiratoryquotient group (log Rankχ2-test = 8.44; p = 0.004). A multivariable Cox proportional hazards modeldemonstrated that energy expenditure and weight increase did not predictmetabolic syndrome/diabetes [HR (95% CI) = 1 (0.996-1.005), p = 0.86 and 3.9(0.407-38.061), p = 0.23, respectively). Conclusions: A greater probability ofmetabolic syndrome/diabetes was found in individuals with a basal respiratoryquotient of >0.91 than in those with a respiratoryquotient of ≤ 0.91 after 1year. In the short-term anthropometric measurements and their variation overtime were not correlated with metabolic syndrome/diabetes.