Buchholz Andrea C, McGillivray Colleen F, Pencharz Paul B
Department of Nutritional Sciences, University of Toronto, Ontario.
Am J Clin Nutr. 2003 Feb;77(2):371-8. doi: 10.1093/ajcn/77.2.371.
Little is known about the relation between body composition and energy metabolism in paraplegia.
We investigated the relation between body composition and energy metabolism in healthy paraplegics as compared with able-bodied control subjects. We hypothesized that paraplegics would have lower fat-free mass (FFM), body cell mass (BCM), resting metabolic rate (RMR), and thermic effect of feeding (TEF).
This cross-sectional study included 34 control subjects and 28 paraplegics (mean age: 29.1 +/- 7.6 and 33.9 +/- 9.2 y, respectively) with body mass indexes (in kg/m(2)) of 23.5 +/- 1.8 and 24.3 +/- 6.0, respectively. We measured RMR and TEF with indirect calorimetry, total body water with deuterium dilution, and extracellular water with corrected bromide space. We calculated FFM (total body water/0.732) and BCM [(total body water - extracellular water)/0.732)].
FFM was higher in control subjects than in paraplegics (77.2 +/- 7.2% and 69.2 +/- 8.7%, respectively; P = 0.0002), as were BCM (47.4 +/- 6.7% and 35.9 +/- 8.1%, respectively; P < 0.0001) and RMR (7016 +/- 935 and 6159 +/- 954 kJ/d, respectively; P = 0.0007). FFM was the single best predictor of RMR in both groups (r(2) = 0.83 for control subjects and 0.70 for paraplegics, P < 0.0001 for both). RMR adjusted for FFM did not differ significantly between control subjects and paraplegics (6670 +/- 504 and 6588 +/- 501 kJ/d, respectively). TEF also did not differ significantly between control subjects and paraplegics (6.25 +/- 2.2% and 5.53 +/- 1.8% of energy intake, respectively).
FFM, BCM, and RMR, but not obligatory TEF, are lower in paraplegics than in control subjects. RMR does not differ between control and paraplegic subjects after adjustment for FFM, indicating similar metabolic activity in the fat-free compartment of the body.
关于截瘫患者身体成分与能量代谢之间的关系，人们了解甚少。
我们研究了健康截瘫患者与健全对照者身体成分与能量代谢之间的关系。我们假设截瘫患者的去脂体重（FFM）、身体细胞质量（BCM）、静息代谢率（RMR）和进食热效应（TEF）较低。
这项横断面研究纳入了34名对照者和28名截瘫患者（平均年龄分别为29.1±7.6岁和33.9±9.2岁），体重指数（kg/m²）分别为23.5±1.8和24.3±6.0。我们用间接测热法测量RMR和TEF，用氘稀释法测量总体水，用校正溴空间法测量细胞外水。我们计算FFM（总体水/0.732）和BCM[（总体水-细胞外水）/0.732]。
对照者的FFM高于截瘫患者（分别为77.2±7.2%和69.2±8.7%；P = 0.0002），BCM（分别为47.4±6.7%和35.9±8.1%；P < 0.0001）和RMR（分别为7016±935和6159±954 kJ/d；P = 0.0007）也是如此。FFM是两组中RMR的最佳单一预测指标（对照者r² = 0.83，截瘫患者r² = 0.70，两者P均< 0.0001）。校正FFM后的RMR在对照者和截瘫患者之间无显著差异（分别为6670±504和6588±501 kJ/d）。对照者和截瘫患者之间的TEF也无显著差异（分别为能量摄入的6.25±2.2%和5.53±1.8%）。
截瘫患者的FFM、BCM和RMR低于对照者，但必需TEF无差异。校正FFM后，对照者和截瘫患者的RMR无差异，表明身体去脂部分的代谢活动相似。
