Forman-Hoffman Valerie L, Ruffin Timothy, Schultz Susan K
Department of Respiratory Care, The University of Iowa, Roy J and Lucille A Carver College of Medicine, Iowa City, IA, USA.
Ann Clin Psychiatry. 2006 Apr-Jun;18(2):123-7. doi: 10.1080/10401230600614660.
The refeeding process is a particularly dangerous time for some anorexia nervosa (AN) patients. Great physiologicatress can occur from imposing a large caloric intake on a body dealing with the effects of long-term starvation. Accurate predictive equations of basal metabolic rate (BMR) are needed to ensure AN patients gain weight at a safe rate.
Patients with AN undergoing strictly controlled nutritional rehabilitation on an inpatient unit were examined for changes in BMR via indirect calorimetry. Seven female patients were assessed shortly after inpatient admission. Follow-up measures of weight and BMR were obtained after three weeks of refeeding treatment comprised of approximately 3500 kcal/day.
Body mass index (BMI) increased in all subjects from a median 13.7 kg/m2 at baseline to 15.2 kg/m2. BMR also increased from a median of 1000 kcal/day to 1220 kcal/day. The Owens and Mifflin equations were moderately accurate (within 10%) of predicted BMR at baseline and 3-week follow-up, and the Harris-Benedict equation was very accurate (within 2%) at 3-week follow-up only.
These results may guide nutritional therapies for AN by demonstrating the suppression of metabolism induced by calorie restriction as well as its relatively prompt rebound to expected values with weight gain. Derivation of accurate predictive equations for use during the early refeeding period is needed.
对于一些神经性厌食症（AN）患者来说，重新进食过程是一个特别危险的时期。给长期饥饿的身体强行摄入大量热量可能会导致巨大的生理压力。需要准确的基础代谢率（BMR）预测方程，以确保AN患者以安全的速度增加体重。
对在住院部接受严格控制营养康复治疗的AN患者，通过间接测热法检测其基础代谢率的变化。7名女性患者在入院后不久接受评估。在为期三周、每日热量约为3500千卡的重新进食治疗后，获取体重和基础代谢率的随访测量值。
所有受试者的体重指数（BMI）从基线时的中位数13.7kg/m²增至15.2kg/m²。基础代谢率也从中位数1000千卡/天增至1220千卡/天。欧文斯方程和米夫林方程在基线和3周随访时对基础代谢率预测值的准确性中等（误差在10%以内），而哈里斯-本尼迪克特方程仅在3周随访时非常准确（误差在2%以内）。
这些结果通过证明热量限制引起的代谢抑制以及随着体重增加其相对迅速反弹至预期值，可为AN的营养治疗提供指导。需要推导在重新进食早期使用的准确预测方程。
