Department of Nutrition and Dietetics, Austin Health, Heidelberg, VIC, 3084, Australia.
Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, 3010, Australia.
Spinal Cord. 2019 Jul;57(7):562-570. doi: 10.1038/s41393-019-0253-9. Epub 2019 Feb 6.
Prospective, observational OBJECTIVES: To evaluate agreement between a reference method (doubly labelled water, DLW) of total energy expenditure (TEE) and published equations for estimating energy requirements in acute spinal cord injury (SCI).
Victoria, Australia METHODS: Twenty participants (18 male) within 8 weeks of traumatic SCI completed DLW, anthropometric and dietary intake assessments. Energy requirements were predicted using Harris-Benedict, Schofield, Henry, Nelson, Buchholz and Chun equations, multiplied by a combined activity and stress factor of 1.3, and the ratio method (kJ/kg body weight). Fat-free mass (FFM) and fat mass (FM) were calculated from TBW-derived DLW and from bioelectrical impedance spectroscopy (BIS).
Median time since injury was 41 days. Median TEE was 9.1 MJ. Fair agreement was found between TEE and predicted energy requirements for the Chun (r = 0.39), the Harris-Benedict equation (r = 0.30), the ratio method (r = 0.23) and the Buchholz (r = 0.31) and Nelson equations (r = 0.35), which incorporate measures of FFM and/or FM. Other equations showed weak concordance with DLW. When two hypermetabolic patients were removed, agreement between TEE and predicted energy requirements using the Buchholz equation increased to substantial (r = 0.72) and using the Nelson (r = 0.53) and Chun equations (r = 0.53) increased to moderate. The Buchholz equation had the smallest limits of agreement (-2.4-2.3 MJ/d).
The population-specific Buchholz equation that incorporates FFM, predicted from either BIS or DLW, demonstrated the best agreement in patients with acute SCI.
The study was funded by grants from the Institute for Safety, Compensation and Recovery Research (ISCRR Project # NGE-E-13-078) and Austin Medical Research Foundation. M Panisset was supported by an Australian Postgraduate Award.
前瞻性、观察性
评估总能量消耗（TEE）的参考方法（双标记水，DLW）与发表的用于估计急性脊髓损伤（SCI）能量需求的方程之间的一致性。
澳大利亚维多利亚州
20 名创伤性 SCI 后 8 周内的参与者（18 名男性）完成了 DLW、人体测量和饮食摄入评估。使用 Harris-Benedict、Schofield、Henry、Nelson、Buchholz 和 Chun 方程预测能量需求，乘以 1.3 的综合活动和应激系数，并使用比例法（kJ/kg 体重）。通过从 TBW 衍生的 DLW 和生物电阻抗光谱法（BIS）计算去脂体重（FFM）和脂肪量（FM）。
受伤后中位数时间为 41 天。TEE 的中位数为 9.1 MJ。在 Chun（r=0.39）、Harris-Benedict 方程（r=0.30）、比例法（r=0.23）和 Buchholz（r=0.31）和 Nelson 方程（r=0.35）中，TEE 与预测的能量需求之间发现了良好的一致性，这些方程均包含 FFM 和/或 FM 的测量值。其他方程与 DLW 显示出弱一致性。当去除两名高代谢患者后，Buchholz 方程的 TEE 与预测能量需求之间的一致性增加到中等程度（r=0.72），Nelson 和 Chun 方程的一致性增加到中等程度（r=0.53 和 r=0.53）。Buchholz 方程的一致性最小（-2.4-2.3 MJ/d）。
在急性 SCI 患者中，特异性 Buchholz 方程的预测值最佳，该方程包含 FFM，可从 BIS 或 DLW 中得出。
该研究由 Institute for Safety, Compensation and Recovery Research（ISCRR 项目#NGE-E-13-078）和 Austin Medical Research Foundation 资助。M Panisset 得到了澳大利亚研究生奖学金的支持。
