Farooqi Nighat, Carlsson Maine, Håglin Lena, Sandström Thomas, Slinde Frode
Department of Public Health and Clinical Medicine, Respiratory Medicine and Allergy, Umeå University, Umeå, Sweden.
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
Clin Nutr ESPEN. 2018 Dec;28:171-178. doi: 10.1016/j.clnesp.2018.08.008. Epub 2018 Sep 14.
Many patients with chronic obstructive pulmonary disease (COPD) lose weight. Successful nutritional intervention is vital, thus assessment of energy requirement is required. The aim of this study was to present an improved possibility to assess energy requirement in patients with COPD.
Pub Med search was conducted for all the studies reporting total energy expenditure (TEE) measured by doubly labeled water (DLW) method in patients with COPD. Four studies were identified, whereof three were conducted in Sweden. The present analysis is based on these three studies of which the data was acquired.
There was a large variation in resting metabolic rate (RMR) and TEE. Body mass index decreased significantly with increase in disease severity (p < .001), and correlated significantly to forced expiratory volume in 1 s (FEV) % predicted (r = .627, p < .001). FEV% predicted had a significant correlation with RMR/kg body weight (BW)/day (r = -.503, p = .001), RMR/kg fat-free mass (FFM)/day (r = .338, p = .031), and TEE/kg FFM/day (r = .671, p < .001). Compared to men, women had a lower RMR and TEE/kg BW/day (p < .001 respectively p = .002), and higher RMR and TEE/kg FFM/day (p = .080 respectively p = .005). The correlates of: RMR/kg BW were gender and FEV1% predicted; of TEE/kg BW the correlates were age and gender, and of TEE/kg FFM the correlates were age and FEV1% predicted.
In this study, we have presented a possibility to assess energy requirement per kg BW/day and per kg FFM/day in patients with COPD in clinical settings. However, gender, age, and disease severity must be considered.
许多慢性阻塞性肺疾病（COPD）患者体重减轻。成功的营养干预至关重要，因此需要评估能量需求。本研究的目的是提出一种改进的方法来评估COPD患者的能量需求。
在PubMed上检索所有报告采用双标水（DLW）法测量COPD患者总能量消耗（TEE）的研究。共识别出四项研究，其中三项在瑞典进行。本分析基于这三项已获取数据的研究。
静息代谢率（RMR）和TEE存在很大差异。体重指数随疾病严重程度增加而显著下降（p <.001），并与预测的1秒用力呼气量（FEV）%显著相关（r =.627，p <.001）。预测的FEV%与RMR/千克体重（BW）/天（r = -.503，p =.001）、RMR/千克去脂体重（FFM）/天（r =.338，p =.031）以及TEE/千克FFM/天（r =.671，p <.001）显著相关。与男性相比，女性的RMR和TEE/千克BW/天较低（分别为p <.001和p =.002），而RMR和TEE/千克FFM/天较高（分别为p =.080和p =.005）。RMR/千克BW的相关因素为性别和预测的FEV1%；TEE/千克BW的相关因素为年龄和性别，TEE/千克FFM的相关因素为年龄和预测的FEV1%。
在本研究中，我们提出了一种在临床环境中评估COPD患者每千克BW/天和每千克FFM/天能量需求的方法。然而，必须考虑性别、年龄和疾病严重程度。
