Gaillard C, Alix E, Salle A, Berrut G, Ritz P
Pôle de médecine interne et maladies métaboliques, Angers, France.
J Nutr Health Aging. 2008 Apr;12(4):277-80. doi: 10.1007/BF02982634.
Some prediction equations of resting energy expenditure (REE) are available and can be used in clinical wards to determine energy requirements of patients. The aim of the present study was to assess the accuracy of those equations in sick elderly patients, using the Bland and Altman methods with our database of 187 REE measurements.
The 3 equations tested were Harris and Benedict equation of 1919, WHO/FAO/UNU equation of 1985 and Fredrix et al. equation of 1990. In addition, three models developed from the present data were tested.
The present study shows that the Fredrix et al equation gave an accurate prediction of REE without significant bias along the whole range of REE. It also shows that under-weight sick elderly patients (BMI <or= 21 kg/m(2)) had a greater weight-adjusted REE than their normal weight counterparts.
A simple formula using a factor multiplying body weight, i.e. 22 kcal/kg/d in under-weight and 19 kcal/kg/d in normal weight sick elderly was accurate to predicting REE and bias was not influenced by the level of REE. This model included half of the group in the range of +/- 10% of the difference between predicted REE and measured REE, but the confidence interval of the bias was +/- 400 kcal/d. Conversely, the Harris and Benedict and WHO formulae did accurately predict REE.
已有一些静息能量消耗(REE)的预测方程,可用于临床病房以确定患者的能量需求。本研究的目的是使用Bland和Altman方法以及我们包含187次REE测量值的数据库,评估这些方程在患病老年患者中的准确性。
测试的3个方程分别是1919年的Harris和Benedict方程、1985年的WHO/FAO/UNU方程以及1990年的Fredrix等人的方程。此外,还测试了根据当前数据开发的3个模型。
本研究表明,Fredrix等人的方程在整个REE范围内对REE给出了准确的预测,且无显著偏差。研究还表明,体重过轻的患病老年患者(BMI≤21kg/m²)的体重调整后REE高于正常体重的患者。
一个简单的公式,即体重过轻的患者乘以系数22kcal/kg/d,正常体重的患病老年患者乘以系数19kcal/kg/d,可准确预测REE,且偏差不受REE水平的影响。该模型涵盖了预测REE与测量REE差值的±10%范围内一半的研究对象,但偏差的置信区间为±400kcal/d。相反,Harris和Benedict方程以及WHO公式并不能准确预测REE。