Jésus Pierre, Achamrah Najate, Grigioni Sébastien, Charles Jocelyne, Rimbert Agnès, Folope Vanessa, Petit André, Déchelotte Pierre, Coëffier Moïse
INSERM Unit 1073, Rouen, France; Rouen University, Institute for Innovation and Biomedical Research, Rouen, France; Rouen University Hospital, Nutrition Unit, Rouen, France.
Rouen University Hospital, Nutrition Unit, Rouen, France.
Clin Nutr. 2015 Jun;34(3):529-35. doi: 10.1016/j.clnu.2014.06.009. Epub 2014 Jun 28.
BACKGROUND & AIMS: The resting energy expenditure (REE) predictive formulas are often used in clinical practice to adapt the nutritional intake of patients or to compare to REE measured by indirect calorimetry. We aimed to evaluate which predictive equations was the best alternative to REE measurements according to the BMI.
28 REE prediction equations were studied in a population of 1726 patients without acute or chronic high-grade inflammatory diseases followed in a Nutrition Unit for malnutrition, eating disorders or obesity. REE was measured by indirect calorimetry for 30 min after a fasting period of 12 h. Some formulas requiring fat mass and free-fat mass, body composition was measured by bioelectrical impedance analysis. The percentage of accurate prediction (±10%/REE measured) and Pearson r correlations were calculated.
Original Harris & Benedict equation provided 73.0% of accurate predictions in normal BMI group but only 39.3% and 62.4% in patients with BMI < 16 kg m(-2) and BMI ≥ 40 kg m(-2), respectively. In particularly, this equation overestimated the REE in 51.74% of patients with BMI < 16 kg m(-2). Huang equation involving body composition provided the highest percent of accurate prediction, 42.7% and 66.0% in patients with BMI < 16 and >40 kg m(-2), respectively.
Usual predictive equations of REE are not suitable for predicting REE in patients with extreme BMI, in particularly in patients with BMI <16 kg m(-2). Indirect Calorimetry may still be recommended for an accurate assessment of REE in this population until the development of an adapted predictive equation.
静息能量消耗（REE）预测公式在临床实践中常被用于调整患者的营养摄入量或与通过间接测热法测量的REE进行比较。我们旨在评估根据体重指数（BMI），哪种预测方程是REE测量的最佳替代方法。
在一家营养科对1726例无急性或慢性重度炎症性疾病的患者进行研究，这些患者因营养不良、饮食失调或肥胖而接受随访。在禁食12小时后，通过间接测热法测量REE 30分钟。一些公式需要脂肪量和去脂体重，通过生物电阻抗分析测量身体成分。计算准确预测的百分比（±10%/测量的REE）和皮尔逊r相关性。
原始的哈里斯-本尼迪克特方程在正常BMI组中提供了73.0%的准确预测，但在BMI<16 kg/m²和BMI≥40 kg/m²的患者中分别仅为39.3%和62.4%。特别是，该方程在51.74%的BMI<16 kg/m²的患者中高估了REE。涉及身体成分的黄方程提供了最高的准确预测百分比，在BMI<16和>40 kg/m²的患者中分别为42.7%和66.0%。
常用的REE预测方程不适用于预测极端BMI患者的REE，特别是BMI<16 kg/m²的患者。在开发出适用的预测方程之前，对于该人群REE的准确评估，仍可能推荐使用间接测热法。
