Food Science Post Graduation Program, Pharmacy School, Universidade Federal de Minas Gerais, Brazil.
Adult Health Post Graduation Program, Medical School, Universidade Federal de Minas Gerais, Brazil.
Clin Nutr. 2014 Dec;33(6):1147-52. doi: 10.1016/j.clnu.2013.12.015. Epub 2014 Jan 3.
Excessive weight gain in patients undergoing liver transplantation has been well documented. The etiology for this complication is not well defined, although it has a high prevalence in post-transplant patients. Reduced energy expenditure may be related to excessive weight gain. Thus, the assessment of the resting energy expenditure (REE) in this patient population is of utmost importance.
Therefore, patients who underwent liver transplantation had their REEs measured by indirect calorimetry (IC). These results were compared with the demographic, socioeconomic, clinical, anthropometric, dietary and lifestyle variables assessed by uni- and multivariate statistical analyses. The REEs were also compared to estimates using the Harris-Benedict formula, and the patients were classified as hypo-, normo- and hypermetabolic.
We evaluated 42 patients with an average of 6.5 years post-transplant and an REE of 1449.7 kcal/day (measured by IC) or 1404.5 kcal/day (predicted by the HB formula). There was great correlation between the methods, and the best predictors of REE were age, weight, amount of lean mass and amount of total body water. Excessive weight was observed in 57% of patients, and obesity was observed in 26.2%. Underreporting of energy intake was observed in 65.8% of patients, and most patients (92.7%) were classified as sedentary or less active. No patient was classified as hypometabolic.
These results indicate that hypometabolism should be discarded as cause of the high prevalence of overweight and obese patients in the population undergoing LT. However, energy consumption and low levels of physical activity may be risk factors.
接受肝移植的患者体重过度增加已得到充分证实。尽管该并发症在移植后患者中普遍存在，但其病因尚未明确。能量消耗减少可能与体重过度增加有关。因此，评估该患者人群的静息能量消耗（REE）非常重要。
因此，通过间接热量测定法（IC）测量接受肝移植的患者的 REE。通过单变量和多变量统计分析，将这些结果与人口统计学、社会经济学、临床、人体测量学、饮食和生活方式变量进行比较。REE 还与使用 Harris-Benedict 公式的估计值进行了比较，并将患者分为低代谢、正常代谢和高代谢。
我们评估了 42 名患者，平均移植后 6.5 年，REE 为 1449.7 kcal/天（通过 IC 测量）或 1404.5 kcal/天（通过 HB 公式预测）。两种方法之间相关性很好，REE 的最佳预测因子是年龄、体重、瘦体重量和全身水量。57%的患者体重过重，26.2%的患者肥胖。65.8%的患者存在能量摄入少报的情况，92.7%的患者被归类为久坐或活动量少。没有患者被归类为低代谢。
这些结果表明，低代谢不应作为 LT 后超重和肥胖患者高发的原因。然而，能量消耗和低水平的体力活动可能是风险因素。
