Stettler N, Schutz Y, Whitehead R, Jéquier E
Institute of Physiology, Faculty of Medicine, University of Lausanne, Switzerland.
Pediatr Res. 1992 Feb;31(2):102-6. doi: 10.1203/00006450-199202000-00002.
The aim of the present study was to measure the changes in resting energy expenditure (REE) induced by malaria and to assess to what extent they are related to fever and nutritional status. The REE of 19 Gambian children (mean age +/- SEM, 9 +/- 1 y; weight, 24 +/- 2 kg; expected weight for height 86 +/- 1%) were measured with a hood system at repeated intervals at the onset of malaria crisis (test A), 3 to 4 d after therapy (test B), and 14 to 21 d later (test C). Axillary temperature averaged 39.2 +/- 0.1, 36.6 +/- 0.1, and 36.7 +/- 0.1 degrees C in the tests A, B, and C, respectively. REE in test A was significantly higher than REE in test B (223 +/- 10 versus 174 +/- 8 kJ/kg.d, p less than 0.0001), but in test C (169 +/- 8 kJ/kg.d), it did not differ from that observed in test B. The percentage of increase in REE was significantly correlated with the difference in axillary temperature (r = 0.46, p less than 0.05); the slope of the regression line indicated an increase of 6.9% in REE/degree C of fever. Furthermore, the individual increase in REE/degree C was correlated to the percentage of weight for height of the children (r = 0.54, p less than 0.05), indicating that the child's nutritional status influences the magnitude of the hypermetabolism due to fever. We concluded that Gambian children suffering from an acute episode of malaria have an increase in REE averaging 30%; however, REE promptly returns to baseline value a few days after the beginning of therapy.
本研究的目的是测量疟疾引起的静息能量消耗（REE）变化，并评估这些变化与发热和营养状况的相关程度。对19名冈比亚儿童（平均年龄±标准误，9±1岁；体重，24±2 kg；身高预期体重86±1%）的REE进行测量，在疟疾发作时（测试A）、治疗后3至4天（测试B）以及14至21天后（测试C），使用面罩系统重复测量。测试A、B和C中腋温分别平均为39.2±0.1、36.6±0.1和36.7±0.1摄氏度。测试A中的REE显著高于测试B（223±10与174±8 kJ/kg·d，p<0.0001），但在测试C中（169±8 kJ/kg·d），与测试B中观察到的REE没有差异。REE增加的百分比与腋温差异显著相关（r = 0.46，p<0.05）；回归线斜率表明发热每升高1摄氏度，REE增加6.9%。此外，REE每升高1摄氏度的个体增加量与儿童身高体重百分比相关（r = 0.54，p<0.05），表明儿童的营养状况会影响发热引起的高代谢程度。我们得出结论，患有急性疟疾发作的冈比亚儿童的REE平均增加30%；然而，治疗开始几天后，REE迅速恢复到基线值。
