Comparison of Measured and Predicted Energy Expenditure in Patients with Liver Cirrhosis

肝硬化患者能量消耗的实际测定值与估计值的比较

Arisa Teramoto ； Hisami Yamanaka-Okumura ； Eri Urano ； Taki Nakamura-Kutsuzawa ； Kohei Sugihara ； Takafumi Katayama ； Hidenori Miyake ； Satoru Imura ； Tohru Utsunomiya ； Mitsuo Shimada ； Eiji Takeda

《Asia Pacific Journal of Clinical Nutrition》 23卷2期 (2014/06) Pp. 197-204

https://doi.org/10.6133/apjcn.2014.23.2.12

摘要

肥胖是肝硬化患者引发肝癌的一个风险因子。为了预防过量饮食和肥胖，估计能量需求是不必可少的。但是对肝硬化患者能量消耗情况尚未充分了解。本研究旨在调查肝硬化患者的静息能量消耗（REE）以及能量摄取情况，从而制定能量摄取的标准。本横断面研究主要对日本488名肝硬化病人进行了间接热量测定，并将间接热量测定法（M-REE）测得的REE结果与Harris-Benedict方程计算的基础能量消耗（BEE）结果（H-BEE）以及日本膳食指南（DRI）推荐的标准（D-BEE）进行比较。M-REE的平均值（1256 kcal）显著低于H-BEE（1276 kcal）；但与DBEE（1254 kcal）相比差别不大。M-REE的均值与体重（BW; REE/kg BW）的关系为21.7 kcal/kg BW. BMI在第一和第二四分位数的病人的H-BEE显著高于MREE，而且BMI在最高和最低四分位数病人的D-BEE都与M-REE有明显差别。平均能量摄取量为30.5 kcal/kg BW，高于REE/kg BW 1.4倍。虽然DRI可以用来帮助估计BMI在第二和第三四分位数病人的REE，但M-REE则能够保证肝硬化病人得到足够的营养供应，即使BMI在最高四分位数和最低四分位数的病人也不例外。

關鍵字

间接能量测定 ； 静息能量消耗 ； 非蛋白呼吸商 ； 非酯化脂肪酸

並列摘要

Obesity is a risk factor for the onset of liver cancer in patients with cirrhosis. To prevent overfeeding and obesity, estimation of energy requirement is important, but energy expenditure in patients with liver cirrhosis has not been fully elucidated. This study aimed to investigate resting energy expenditure (REE) and energy intake in patients with cirrhosis and determine adequate energy intake criteria. In this cross-sectional study, indirect calorimetry measurement was conducted in 488 Japanese inpatients with cirrhosis. We compared REE measured by indirect calorimetry (M-REE) with basal energy expenditure (BEE) predicted by the Harris-Benedict equation (H-BEE) and Dietary Reference Intakes (DRI) for Japanese (D-BEE). Mean M-REE (1256 kcal) was significantly lower than H-BEE (1279 kcal); however, it was not significantly different from D-BEE (1254 kcal). Mean M-REE expressed in relation to body weight (BW; REE/kg BW) was 21.7 kcal/kg BW. H-BEE was significantly higher than M-REE in patients in the first and second quartiles of BMI, and D-BEE was significantly different from MREE in patients in the highest and lowest quartiles of BMI. Average energy intake was 30.5 kcal/kg BW, which was 1.4 times greater than REE/kg BW. Although DRI is a useful tool for the estimation of REE in patients in the second and third quartiles of BMI, M-REE is recommended to ensure the provision of adequate nutritional care to patients with cirrhosis, including those in the highest and lowest quartiles of BMI.

並列關鍵字

indirect calorimetry ； resting energy expenditure ； Harris-Benedict ； non-protein respiratory quotient ； non-esterified fatty acids

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