间歇性跛行和严重肢体缺血患者的静息能量消耗。

Resting energy expenditure in patients with intermittent claudication and critical limb ischemia.

机构信息

Children's Medical Research Institute, Diabetes and Metabolic Research Program, Harold Hamm Oklahoma Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, Okla 73117, USA.

出版信息

J Vasc Surg. 2010 Jun;51(6):1436-41. doi: 10.1016/j.jvs.2009.12.072. Epub 2010 Apr 10.

DOI:10.1016/j.jvs.2009.12.072

PMID:20382493

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2874602/

Abstract

OBJECTIVE

The primary aim of this study was to compare the resting energy expenditure of patients with intermittent claudication and critical limb ischemia. A secondary aim was to identify predictors of resting energy expenditure.

METHODS

One hundred patients limited by intermittent claudication and 40 patients with critical limb ischemia participated in this study. Patients were assessed on resting energy expenditure, body composition, ankle brachial index (ABI), and calf blood flow.

RESULTS

Patients with critical limb ischemia had a lower resting energy expenditure than patients with intermittent claudication (1429 +/- 190 kcal/day vs 1563 +/- 229 kcal/day; P = .004), and higher body fat percentage (34.8 +/- 7.8% vs 31.5 +/- 7.8%; P = .037), higher fat mass (30.0 +/- 9.3 kg vs 26.2 +/- 8.9 kg;P = .016), and lower ABI (0.31 +/- 0.11 vs 0.79 +/- 0.23; P < .001). Resting energy expenditure was predicted by fat free mass (P < .0001), age (P < .0001), ABI (P < .0001), ethnicity (P < .0001), calf blood flow (P = .005), and diabetes (P = .008). Resting energy expenditure remained lower in the patients with critical limb ischemia after adjusting for clinical characteristics plus fat free mass (1473 +/- 27.8 kcal/day [mean +/- SEM] vs 1527 +/- 19.3 kcal/day; P = .031), but it was no longer different between groups after further adjustment for ABI and calf blood flow (1494 +/- 25.2 kcal/day vs 1505 +/- 17.7 kcal/day; P = .269).

CONCLUSION

Resting energy expenditure is decreased with a progression in peripheral arterial disease (PAD) symptoms from intermittent claudication to critical limb ischemia. Furthermore, patients with critical limb ischemia who are most susceptible for decline in resting energy expenditure are older, African American patients with diabetes. The lower resting energy expenditure of patients with critical limb ischemia, combined with their sedentary lifestyle, suggests that they are at high risk for long-term positive energy balance and weight gain.

摘要

目的

本研究的主要目的是比较间歇性跛行和严重肢体缺血患者的静息能量消耗。次要目的是确定静息能量消耗的预测因素。

方法

本研究纳入了 100 例间歇性跛行患者和 40 例严重肢体缺血患者。评估患者的静息能量消耗、身体成分、踝肱指数（ABI）和小腿血流。

结果

严重肢体缺血患者的静息能量消耗低于间歇性跛行患者（1429±190 kcal/天 vs 1563±229 kcal/天；P=0.004），且体脂百分比较高（34.8±7.8% vs 31.5±7.8%；P=0.037）、脂肪量较高（30.0±9.3 kg vs 26.2±8.9 kg；P=0.016）和 ABI 较低（0.31±0.11 vs 0.79±0.23；P＜0.001）。静息能量消耗可由去脂体重（P＜0.0001）、年龄（P＜0.0001）、ABI（P＜0.0001）、种族（P＜0.0001）、小腿血流（P=0.005）和糖尿病（P=0.008）预测。调整临床特征加去脂体重后，严重肢体缺血患者的静息能量消耗仍较低（1473±27.8 kcal/天[平均值±SEM] vs 1527±19.3 kcal/天；P=0.031），但进一步调整 ABI 和小腿血流后，两组之间的差异不再存在（1494±25.2 kcal/天 vs 1505±17.7 kcal/天；P=0.269）。