Jeevanandam M, Young D H, Schiller W R
Trauma Center, St Joseph's Hospital and Medical Center, Phoenix, AZ 85013.
Metabolism. 1990 Feb;39(2):144-9. doi: 10.1016/0026-0495(90)90067-m.
Age-related changes in body composition may result in varied responses to acute accidental injury. Gaining fat as age advances is common and therefore the mobilization of fat fuel resources in traumatized geriatric patients needs closer examination. We have measured in six elderly (age, 60 to 74 years) and seven young (age, 18 to 46) traumatized, hypermetabolic, and highly catabolic patients, in the "flow phase" of the metabolic response to injury, the rates of whole-body lipolysis and net fat oxidation. This enabled us to calculate the rate of triglyceride/free fatty acid (TG/FFA) cycling in the whole body and to assess its contribution to energy expenditure. Energy metabolism in general and the fat metabolism in particular were found to be somewhat slowed in elderly trauma patients compared with equally injured young individuals, although the aged patients had more total body fat. The energy cost of TG/FFA cycling is significantly (P less than .025) lower in elderly trauma victims (0.28 +/- 0.06 kcal/kg/d) compared with young patients (0.63 +/- 0.1 kcal/kg/d). This can account for approximately 3% to 4% of the elevation in metabolic rate over that predicted in the uninjured state.
身体成分的年龄相关变化可能导致对急性意外伤害产生不同反应。随着年龄增长，脂肪增加很常见，因此在受伤的老年患者中脂肪燃料资源的动员需要更仔细的研究。我们测量了6名老年（年龄60至74岁）和7名年轻（年龄18至46岁）的创伤、高代谢和高分解代谢患者在损伤代谢反应的“流动期”全身脂肪分解率和净脂肪氧化率。这使我们能够计算全身甘油三酯/游离脂肪酸（TG/FFA）循环率，并评估其对能量消耗的贡献。与同样受伤的年轻个体相比，老年创伤患者的一般能量代谢，尤其是脂肪代谢有所减缓，尽管老年患者的全身脂肪更多。与年轻患者（0.63±0.1千卡/千克/天）相比，老年创伤受害者的TG/FFA循环能量成本显著降低（P＜0.025）（0.28±0.06千卡/千克/天）。这大约可占代谢率高于未受伤状态预测值的3%至4%。
