Ullah S, Arsalani-Zadeh R, MacFie J
Hull and East Yorkshire Hospitals NHS Trust, UK.
Ann R Coll Surg Engl. 2012 Mar;94(2):129-32. doi: 10.1308/003588412X13171221501988.
The accuracy of prediction equations for estimating resting energy expenditure (REE) in morbidly obese patients is unclear. The aim of this study was to compare the REE measured using bedside indirect calorimetry with commonly used prediction equations.
A total of 31 morbidly obese patients were studied. Pre-operative REE was measured with indirect calorimetry and compared with estimated REE using the Harris-Benedict and Schofield equations. All patients subsequently underwent a Roux-en-Y gastric bypass and measurements were repeated at six weeks and three months following surgery.
The mean age of the patients was 47 years. The mean pre-operative body mass index was 46 kg/m(2). The mean REE measured using indirect calorimetry was 1,980 kcal/day. The estimated REE using the Harris-Benedict and Schofield formulae was 2,195 and 2,129 kcal/day respectively. The equations overestimated REE by 10% and 7%. Body weight and body mass index reduced significantly following Roux-en-Y gastric bypass. There was no significant change in measured REE over the three-month period. After weight loss the difference between the estimated and measured REE reduced to 1-3%.
Prediction equations overestimate REE in morbidly obese patients. Their accuracy improved after surgery induced weight loss, confirming their validity for the normal weight population. Indirect calorimetry should be used in morbid obesity.
用于估算病态肥胖患者静息能量消耗（REE）的预测方程的准确性尚不清楚。本研究的目的是比较使用床边间接测热法测量的REE与常用的预测方程。
共研究了31例病态肥胖患者。术前使用间接测热法测量REE，并与使用哈里斯-本尼迪克特方程和斯科菲尔德方程估算的REE进行比较。所有患者随后均接受了 Roux-en-Y 胃旁路手术，并在术后六周和三个月重复测量。
患者的平均年龄为47岁。术前平均体重指数为46kg/m²。使用间接测热法测量的平均REE为1980千卡/天。使用哈里斯-本尼迪克特方程和斯科菲尔德方程估算的REE分别为2195千卡/天和2129千卡/天。这些方程将REE高估了10%和7%。Roux-en-Y胃旁路手术后体重和体重指数显著降低。在三个月期间，测量的REE没有显著变化。体重减轻后，估算的REE与测量的REE之间的差异降至1%-3%。
预测方程高估了病态肥胖患者的REE。手术导致体重减轻后，其准确性提高，证实了它们对正常体重人群的有效性。病态肥胖患者应使用间接测热法。
