Marugán de Miguelsanz J M, Redondo del Río Ma P, Alonso-Franch M, Calvo Romero C, Torres Hinojal Ma del C
Sección de Gastroenterología y Nutrición Infantil, Hospital Clínico Universitario de Valladolid, Valladolid, España.
Nutr Hosp. 2011 May-Jun;26(3):589-93. doi: 10.1590/S0212-16112011000300023.
BACKGROUND/OBJECTIVES: To compare the resting energy expenditure (REE) and the REE/Fat-free-mass (FFM) quotient in children with constitutional leanness (CL) and children with normal body weight, and to describe the within-family clustering of CL.
SUBJECTS/METHODS: We have studied 18 children and teenagers with CL, 10 girls and 8 boys, and 18 gender and age matched normal controls, with the same pubertal stage. All were recruited from the outpatient pediatric clinic nutrition unit. None of the children with CL showed symptoms of chronic illness, they had normal laboratory results, they had a normal caloric food intake, and they did not agree with the DSM-IV-TR criteria for anorexia nervosa. We describe the body mass index (BMI) of children and their parents. The children were classified according to Cole's recently published BMI cut-offs for thinness: under 18.5 points in CL group, stable at least in the last year, and between 18.5 and 25 cutt-offs in the control group. The body composition was calculated by anthropometric methods (skinfold thickness measurements). In addition REE was measured using fasting indirect calorimetry.
The CL group had a higher mean percentage of FFM, and a mean FM significantly less, relative to controls (p < 0.001). The average absolute REE was significantly lower in the CL group (1,106.55 ± 240.72 kcal) than the control group (1,353.33 ± 270.01 kcal/dia) (p < 0.01). However, the REE adjusted for FFM showed a mean significantly greater in the CL group (41.39 ± 2.26 kcal/kg FFM) (Mean confidence interval (CI) 95 %: 40.33-42.45) than the controls (37.37 ± 3.06 kcal/kg FFM) (Mean CI 95 %: 35.93-38.81) (p < 0.001). Finally, in the family study, the mean BMI of fathers of CL group was significantly lower (p < 0.01), but there were not any differences in the mean BMI of mothers. Among parents with BMI known, 8 of 35 parents of CL group had an BMI lower 18.5, and only 2 of 36 parents in the control group (p < 0.05).
This increased energy expenditure-to-FFM ratio differentiates between CL and controls. These metabolic differences are probably genetically determined.
背景/目的：比较体质性消瘦（CL）儿童与正常体重儿童的静息能量消耗（REE）及REE/去脂体重（FFM）商，并描述CL在家族内的聚集情况。
对象/方法：我们研究了18名CL儿童及青少年，其中10名女孩、8名男孩，以及18名年龄和性别匹配、处于相同青春期阶段的正常对照者。所有研究对象均来自儿科门诊营养科。CL儿童均无慢性病症状，实验室检查结果正常，热量摄入正常，且不符合精神疾病诊断与统计手册第四版修订版（DSM-IV-TR）中神经性厌食症的标准。我们描述了儿童及其父母的体重指数（BMI）。根据Cole最近公布的消瘦BMI切点对儿童进行分类：CL组BMI低于18.5，且至少在过去一年保持稳定，对照组BMI在18.5至25之间。通过人体测量法（皮褶厚度测量）计算身体成分。此外，采用空腹间接测热法测量REE。
相对于对照组，CL组的FFM平均百分比更高，平均脂肪量（FM）显著更低（p<0.001）。CL组的平均绝对REE（1106.55±240.72千卡）显著低于对照组（1353.33±270.01千卡/天）（p<0.01）。然而，校正FFM后的REE显示，CL组（41.39±2.26千卡/千克FFM）（平均95%置信区间（CI）：40.33 - 42.45）显著高于对照组（37.37±3.06千卡/千克FFM）（平均CI 95%：35.93 - 38.81）（p<0.001）。最后，在家族研究中，CL组父亲的平均BMI显著更低（p<0.01），但母亲的平均BMI无差异。在已知BMI的父母中，CL组35名父母中有8名BMI低于18.5，对照组36名父母中仅有2名（p<0.05）。
这种能量消耗与FFM比值的增加区分了CL儿童与对照组儿童。这些代谢差异可能由基因决定。
