NIHR Biomedical Research Unit (Nutrition, Diet & Lifestyle) Institute of Human Nutrition University of Southampton, Southampton, UK.
J Pediatr Gastroenterol Nutr. 2012 Feb;54(2):271-6. doi: 10.1097/MPG.0b013e318236b19a.
Increased resting energy expenditure (REE) unmatched by dietary intake is implicated as a cause of poor nutrition in childhood inflammatory conditions. Adequate description of disease activity and correction of REE data for body composition are important to reach reliable conclusions about changes in REE associated with disease. The present study aimed to determine the effect of disease activity measured by clinical status, systemic and stool inflammatory markers on REE in children with Crohn disease using appropriate correction for confounding factors.
Sixty children with Crohn disease were recruited from the regional paediatric gastroenterology unit and studied on 1 occasion. REE was measured by indirect calorimetry. Fat-free mass (FFM) was estimated by skinfold thickness. Disease activity was measured using systemic (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR]) and faecal markers of inflammation (lactoferrin, calprotectin) and clinical scores (Paediatric Crohn Disease Activity Index).
Using a multiple regression model, there was no significant change in REE from active or inactive disease (β = 0.03, P = 0.7) nor from CRP (β = -0.05, P = 0.52), ESR (β = -0.07, P = 0.43), faecal calprotectin (β = -0.07, P = 0.38), and faecal lactoferrin (β = 0.01, P = 0.88). REE/kg FFM was not associated with the Paediatric Crohn Disease Activity Index (r = 0.1, P = 0.44), CRP (r = -0.3, P = 0.84) or ESR (r = 0.12, P = 0.4), faecal calprotectin (r = 0.04, P = 0.97), or faecal lactoferrin (r = 0.02, P = 0.87).
REE corrected for physiologically relevant confounders is not associated with degree of disease activity using clinical tools or systemic and local inflammatory markers, and therefore is an unlikely mechanism for poor nutritional state.
静息能量消耗（REE）增加而饮食摄入不增加与儿童炎症性疾病中的营养不良有关。充分描述疾病活动并对 REE 数据进行身体成分校正对于得出与疾病相关的 REE 变化的可靠结论非常重要。本研究旨在使用适当的混杂因素校正来确定通过临床状态、系统和粪便炎症标志物测量的疾病活动对克罗恩病儿童 REE 的影响。
从区域儿科胃肠病学单位招募了 60 名克罗恩病患儿，并在一次就诊时进行了研究。REE 通过间接热量法测量。通过皮褶厚度估计去脂体重（FFM）。疾病活动使用系统（C 反应蛋白 [CRP]、红细胞沉降率 [ESR]）和粪便炎症标志物（乳铁蛋白、钙卫蛋白）和临床评分（儿科克罗恩病活动指数）进行测量。
使用多元回归模型，REE 未因疾病活动或不活动而发生显著变化（β=0.03，P=0.7），也未因 CRP（β=-0.05，P=0.52）、ESR（β=-0.07，P=0.43）、粪便钙卫蛋白（β=-0.07，P=0.38）或粪便乳铁蛋白（β=0.01，P=0.88）而发生变化。REE/kg FFM 与儿科克罗恩病活动指数（r=0.1，P=0.44）、CRP（r=-0.3，P=0.84）或 ESR（r=0.12，P=0.4）、粪便钙卫蛋白（r=0.04，P=0.97）或粪便乳铁蛋白（r=0.02，P=0.87）无关。
对生理相关混杂因素进行校正后的 REE 与使用临床工具或系统和局部炎症标志物测量的疾病活动程度无关，因此不太可能是营养状态不佳的机制。
