Teramoto Arisa, Yamanaka-Okumura Hisami, Urano Eri, Nakamura-Kutsuzawa Taki, Sugihara Kohei, Katayama Takafumi, Miyake Hidenori, Imura Satoru, Utsunomiya Tohru, Shimada Mitsuo, Takeda Eiji
Department of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School, 3-18-15, Kuramotocho, Tokushima 770-8503, Japan.
Asia Pac J Clin Nutr. 2014;23(2):197-204. doi: 10.6133/apjcn.2014.23.2.12.
Obesity is a risk factor for the onset of liver cancer in patients with cirrhosis. To prevent overfeeding and obesity, estimation of energy requirement is important, but energy expenditure in patients with liver cirrhosis has not been fully elucidated. This study aimed to investigate resting energy expenditure (REE) and energy intake in patients with cirrhosis and determine adequate energy intake criteria. In this cross-sectional study, indirect calorimetry measurement was conducted in 488 Japanese inpatients with cirrhosis. We compared REE measured by indirect calorimetry (M-REE) with basal energy expenditure (BEE) predicted by the Harris-Benedict equation (H-BEE) and Dietary Reference Intakes (DRI) for Japanese (D-BEE). Mean M-REE (1256 kcal) was significantly lower than H-BEE (1279 kcal); however, it was not significantly different from D-BEE (1254 kcal). Mean M-REE expressed in relation to body weight (BW; REE/kg BW) was 21.7 kcal/kg BW. H-BEE was significantly higher than M-REE in patients in the first and second quartiles of BMI, and D-BEE was significantly different from MREE in patients in the highest and lowest quartiles of BMI. Average energy intake was 30.5 kcal/kg BW, which was 1.4 times greater than REE/kg BW. Although DRI is a useful tool for the estimation of REE in patients in the second and third quartiles of BMI, M-REE is recommended to ensure the provision of adequate nutritional care to patients with cirrhosis, including those in the highest and lowest quartiles of BMI.
肥胖是肝硬化患者发生肝癌的一个风险因素。为预防过度喂养和肥胖，估算能量需求很重要，但肝硬化患者的能量消耗尚未完全阐明。本研究旨在调查肝硬化患者的静息能量消耗（REE）和能量摄入，并确定适当的能量摄入标准。在这项横断面研究中，对488名日本肝硬化住院患者进行了间接测热法测量。我们将通过间接测热法测得的REE（M-REE）与用哈里斯-本尼迪克特方程（H-BEE）预测的基础能量消耗（BEE）以及日本的膳食参考摄入量（DRI，D-BEE）进行了比较。平均M-REE（1256千卡）显著低于H-BEE（1279千卡）；然而，它与D-BEE（1254千卡）没有显著差异。以体重（BW；REE/kg BW）表示的平均M-REE为21.7千卡/千克体重。在BMI处于第一和第二四分位数的患者中，H-BEE显著高于M-REE，在BMI处于最高和最低四分位数的患者中，D-BEE与M-REE有显著差异。平均能量摄入量为30.5千卡/千克体重，是REE/kg BW的1.4倍。虽然DRI是估算BMI处于第二和第三四分位数患者REE的有用工具，但建议采用M-REE来确保为肝硬化患者，包括BMI处于最高和最低四分位数的患者提供充足的营养护理。
