Reviewer #3 (Public Review):
Sarver et al., propose that TcMAC21 mice are hypermetabolic and that this is the cause of their reduced weight. Unfortunately, the developmental defects of TcMAC21 mice make this a challenging question to definitively answer. The authors claim that TcMAC21 mice are hypermetabolic due to a futile calcium cycling in skeletal muscle, which is caused by up-regulation of SLN. However, all of the data that would go into the energy balance equation (food intake, energy absorption, and energy expenditure) have been improperly analyzed. TcMAC21 pups are 8.5 g lighter than euploid littermates. The body weight data and images in Fig. 3A indicate that TcMAC21 mice runted. This difference is primarily a result of lower lean mass (FIG. 2B). This is important as it sets up many concerns that need to be addressed. Specific comments are noted below.
Specific comments:
1) It is incorrect to normalize EE to lean mass if this parameter is different between groups. Normalizing the EE data to lean mass makes it appear as though TcMAC21 mice exhibited increased EE when in fact this is a mathematical artefact. EE data should simply be plotted as ml/h (or kcal/h) per mouse. Alternatively, ANCOVA can be applied using lean mass as a covariate. Excellent reviews on this topic have been written (PMID: 20103710; PMID: 22205519).
2) It makes no sense to normalize food intake to weight, as it makes no sense to divide metabolic rate by weight as well (see above). If food intake is not normalized, this will clearly show that TcMAC21 mice eat much less than controls, and if plotted as cumulative food intake will show that TcMAC21 are smaller and gain less weight on a high-fat diet because they simply eat less. This further indicates that the major tenet of this paper is not correct.
3) The authors have tried to address the smaller weight of TcMAC21 mice by including weight-matched wild-type mice. However, they only focus on analyzing surface temperature, which is not an indicator of thermogenesis. Moreover, there is no information on whether these weight-matched wild-type mice are similar in age or body composition to the TcMAC21 mice. Nevertheless, the increased surface temperature can also indicate increased heat conservation, which is opposite to thermogenesis. It would make sense that TcMAC21 mice with massive reductions in lean mass would activate compensatory mechanisms of heat conservation to offset increased heat dissipation to the environment. This does seem to be the case, based on the data shown in Fig. 6D (see below).
4) A more optimal method of testing whether increased heat dissipation plays a role in the EE of TcMAC21 mice, is to measure EE at thermoneutrality, where energy dissipation to the environment will be minimized. Here the authors have attempted this in Fig. 6D. Unfortunately, the authors normalized EE to lean mass, artefactually elevating TcMAC21 EE. Despite this mistake, it now looks as though the large differences in EE that were seen at room temp have been attenuated, and only significantly limited to the dark phase. This indicates that in addition to the normalization artefact, higher heat dissipation from smaller TcMAC21 mice may also contribute to the elevated EE at 22C.
5) In Fig. 6D, why is the hourly plot not shown here (like 2D and 4C)? The data clearly are not as striking as the EE data at 22C?
6) GTT was similar between TcMAC21 and controls (Fig. 3I). However, the smaller insulin response could be due to the fact that glucose was normalized to body weight. It would be better to normalize to lean mass, since that is different as well, or simply give all mice the same amount of glucose that the control group receives since this is how it is done in humans.
7) The fecal energy in Fig. 4B only measures the concentration of energy per gram of feces. However, this analysis has failed to take into account total fecal excretion, which should be used to multiply the energy density of the feces. Thus, these data are incomplete and not sufficient to exclude absorption differences between the groups. And it is now curious why if all other metabolic measurements (even though wrong), such as food intake and EE are normalized to body weight, why have the authors not normalized to body weight for the feces data? Is this because if this was done this would show massive elevating in fecal energy in TcMAC21 mice and thus falsify their hypothesis?
8) I cannot find any indication of sample size in any of the EE experiments, aside from the bar graph in Fig. 6D. In any case, this experiment only an n=4 to 5 per group. This is an extremely small number for these types of experiments, so how can the authors be sure of reproducibility with such a low sample size? Are all of the other EE experiments also of similarly small sample sizes?



