Pinto Andressa S, Chedid Marcio F, Guerra Léa T, Álvares-DA-Silva Mario R, Araújo Alexandre de, Guimarães Luciano S, Leipnitz Ian, Chedid Aljamir D, Kruel Cleber R P, Grezzana-Filho Tomaz J M, Kruel Cleber D P
Postgraduate Program in Surgical Sciences.
Division of Gastrointestinal Surgery and Liver and Pancreas Transplantation.
Arq Bras Cir Dig. 2016 Jul-Sep;29(3):185-188. doi: 10.1590/0102-6720201600030013.
Reliable measurement of basal energy expenditure (BEE) in liver transplant (LT) recipients is necessary for adapting energy requirements, improving nutritional status and preventing weight gain. Indirect calorimetry (IC) is the gold standard for measuring BEE. However, BEE may be estimated through alternative methods, including electrical bioimpedance (BI), Harris-Benedict Equation (HBE), and Mifflin-St. Jeor Equation (MSJ) that carry easier applicability and lower cost.
To determine which of the three alternative methods for BEE estimation (HBE, BI and MSJ) would provide most reliable BEE estimation in LT recipients.
Prospective cross-sectional study including dyslipidemic LT recipients in follow-up at a 735-bed tertiary referral university hospital. Comparisons of BEE measured through IC to BEE estimated through each of the three alternative methods (HBE, BI and MSJ) were performed using Bland-Altman method and Wilcoxon Rank Sum test.
Forty-five patients were included, aged 58±10 years. BEE measured using IC was 1664±319 kcal for males, and 1409±221 kcal for females. Average difference between BEE measured by IC (1534±300 kcal) and BI (1584±377 kcal) was +50 kcal (p=0.0384). Average difference between the BEE measured using IC (1534±300 kcal) and MSJ (1479.6±375 kcal) was -55 kcal (p=0.16). Average difference between BEE values measured by IC (1534±300 kcal) and HBE (1521±283 kcal) was -13 kcal (p=0.326). Difference between BEE estimated through IC and HBE was less than 100 kcal for 39 of all 43patients.
Among the three alternative methods, HBE was the most reliable for estimating BEE in LT recipients.
准确测量肝移植（LT）受者的基础能量消耗（BEE）对于调整能量需求、改善营养状况和防止体重增加至关重要。间接测热法（IC）是测量BEE的金标准。然而，BEE也可通过其他方法估算，包括生物电阻抗法（BI）、哈里斯-本尼迪克特方程（HBE）和米夫林-圣乔尔方程（MSJ），这些方法应用更简便且成本更低。
确定三种BEE估算替代方法（HBE、BI和MSJ）中哪种在LT受者中能提供最可靠的BEE估算值。
在一家拥有735张床位的三级转诊大学医院，对随访中的血脂异常LT受者进行前瞻性横断面研究。使用布兰德-奥特曼方法和威尔科克森秩和检验，将通过IC测量的BEE与通过三种替代方法（HBE、BI和MSJ）各自估算的BEE进行比较。
纳入45例患者，年龄58±10岁。男性通过IC测量的BEE为1664±319千卡，女性为1409±221千卡。IC测量的BEE（1534±300千卡）与BI估算的BEE（1584±377千卡）的平均差值为+50千卡（p = 0.0384）。IC测量的BEE（1534±300千卡）与MSJ估算的BEE（1479.6±375千卡）的平均差值为-55千卡（p = 0.16）。IC测量的BEE值（1534±300千卡）与HBE估算的BEE（1521±283千卡）的平均差值为-13千卡（p = 0.326）。在全部43例患者中，有39例通过IC估算的BEE与HBE估算的BEE差值小于100千卡。
在这三种替代方法中，HBE在估算LT受者的BEE方面最为可靠。
