Division of Clinical Nutrition, Shiga University of Medical Science, Seta-Tsukinowa, Otsu 520-2192, Japan.
J Clin Biochem Nutr. 2010 Jan;46(1):68-72. doi: 10.3164/jcbn.09-55. Epub 2009 Dec 29.
We investigated energy expenditure in hospitalized patients with Crohn's disease (CD), and determined optimal energy requirements for nutritional therapy. Sixteen patients (5 women and 11 men, mean age 36 year old, mean BMI 18.7 kg/m(2)) and 8 healthy volunteers were enrolled in this study. Measured resting energy expenditure (mREE) levels were determined by indirect calorimetry. The mREEs in CD patients were significantly higher than those of healthy controls (24.4 +/- 2.4 kcal/kg/day vs 21.3 +/- 1.7 kcal/kg/day). However, mREEs in CD patients were significantly lower than predicted REEs (pREEs) calculated by the Harris-Benedict equation (26.4 +/- 2.5 kcal/kg/day). Furthermore, mREE/pREE values were lower in undernourished patients than in well-nourished patients. CD patients had hyper-metabolic statuses evaluated by mREE/body weight, but increased energy expenditure did not contribute to weight loss in these patients. In conclusion, nutritional therapy with 25-30 kcal/ideal body weight/day (calculated by mREE x active factor) may be optimal for active CD patients, while higher energy intake values pose the risk of overfeeding.
我们研究了住院克罗恩病（CD）患者的能量消耗，并确定了营养治疗的最佳能量需求。本研究纳入了 16 名患者（5 名女性和 11 名男性，平均年龄 36 岁，平均 BMI 18.7kg/m2）和 8 名健康志愿者。通过间接测热法测定静息能量消耗（REE）。CD 患者的 mREE 明显高于健康对照组（24.4±2.4kcal/kg/天 vs 21.3±1.7kcal/kg/天）。然而，CD 患者的 mREE 明显低于 Harris-Benedict 方程（26.4±2.5kcal/kg/天）计算的预测 REE（pREE）。此外，营养不良患者的 mREE/pREE 值低于营养良好的患者。CD 患者通过 mREE/体重评估存在高代谢状态，但能量消耗的增加并未导致这些患者体重减轻。总之，对于活动期 CD 患者，25-30kcal/理想体重/天（通过 mREEx 活动因子计算）的营养治疗可能是最佳的，而较高的能量摄入值有过度喂养的风险。
