Resting metabolic rate in healthy adults: relation to growth hormone status and leptin levels

Studies in patients with acromegaly and growth hormone (GH) deficiency, and administration of GH in normal and obese subjects and in patients with GH deficiency, suggest that GH increases resting metabolic rate (RMR) independently of changes in body composition. To test whether endogenous GH status determines RMR, we studied 38 healthy adults (18 women and 18 men) in two age groups (young, 30+/-0 years (n=18); older, 51+/-1 years [n=18]) with indirect calorimetry, deconvolution analysis of 24-hour GH secretion, arginin stimulation test, insulin-like growth factor-I (IGF-I) measurement, lean and fat tissue distribution (computed tomography [CT] and dual-energy x-ray absorptiometry), assessment of physical fitness (maximal oxygen consumption [VO2max]), thyroid status, and serum leptin levels. RMR was higher in men compared with women, whereas RMR per lean body mass (LBM) (kcal x 24 h(-1) x kg(-1)) was higher in women (30.0+/-0.5 v 33.0 2/3 0.8; P=.003). GH secretion was higher in women and in young people. Total-body fat (TBF) was higher in women, whereas LBM and abdominal fat were higher in men. Older people had significantly more TBF and abdominal fat as compared with younger people. VO2max was higher in younger people. Leptin levels were higher in women and in older people. Thyroid status was narrowly within the normal range in all subjects. RMR was strongly correlated with LBM (r=.90, P < .001). RMR/LBM correlated strongly with TBF (r=.49, P < .01) and leptin (r=.56, P < .001), but not with GH status. By multiple regression analysis, sex and TBF were the strongest predictors of RMR/LBM. However, in the young subgroup, GH production rate was a positive determinant of RMR/LBM. In the male subgroup, leptin was a stronger predictor than TBF of RMR/LBM (P < .001). Neither age, physical fitness, nor thyroid status contributed independently to predict RMR/LBM. In conclusion, (1) LBM was the most important determinant of RMR; (2) RMR/LBM was higher in women and depended strongly on TBF; (3) GH status in healthy adults was only weakly associated with RMR; and (4) in men, serum leptin levels were a strong positive determinant of RMR.