Human Nutrition Research Unit, Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.
Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Nutr Clin Pract. 2019 Dec;34(6):922-934. doi: 10.1002/ncp.10374. Epub 2019 Jul 25.
Our purpose was to assess the accuracy of resting energy expenditure (REE) equations in patients with newly diagnosed stage I-IV non-small cell lung, rectal, colon, renal, or pancreatic cancer.
In this cross-sectional study, REE was measured using indirect calorimetry and compared with 23 equations. Agreement between measured and predicted REE was assessed via paired t-tests, Bland-Altman analysis, and percent of estimations ≤ 10% of measured values. Accuracy was measured among subgroups of body mass index (BMI), stage (I-III vs IV), and cancer type (lung, rectal, and colon) categories. Fat mass (FM) and fat-free mass (FFM) were assessed using dual x-ray absorptiometry.
Among 125 patients, most had lung, colon, or rectal cancer (92%, BMI: 27.5 ± 5.6 kg/m , age: 61 ± 11 years, REE: 1629 ± 321 kcal/d). Thirteen (56.5%) equations yielded REE values different than measured (P < 0.05). Limits of agreement were wide for all equations, with Mifflin-St. Jeor equation having the smallest limits of agreement, -21.7% to 11.3% (-394 to 203 kcal/d). Equations with FFM were not more accurate except for one equation (Huang with body composition; bias, limits of agreement: -0.3 ± 11.3% vs without body composition: 2.3 ± 10.1%, P < 0.001). Bias in body composition equations was consistently positively correlated with age and frequently negatively correlated with FM. Bias and limits of agreement were similar among subgroups of patients.
REE cannot be accurately predicted on an individual level, and bias relates to age and FM.
本研究旨在评估新诊断为Ⅰ-Ⅳ期非小细胞肺癌、直肠癌、结肠癌、肾癌或胰腺癌患者的静息能量消耗（REE）方程的准确性。
在这项横断面研究中，使用间接热量测定法测量 REE，并将其与 23 个方程进行比较。通过配对 t 检验、Bland-Altman 分析和预测值与实测值相差小于等于 10%的比例来评估测量值与预测值之间的一致性。根据体重指数（BMI）、分期（Ⅰ-Ⅲ期与Ⅳ期）和癌症类型（肺癌、直肠癌和结肠癌）亚组评估准确性。使用双能 X 线吸收法测量脂肪量（FM）和去脂量（FFM）。
在 125 例患者中，大多数患者患有肺癌、结肠癌或直肠癌（92%，BMI：27.5±5.6kg/m2，年龄：61±11 岁，REE：1629±321kcal/d）。有 13 个（56.5%）方程得出的 REE 值与实测值不同（P<0.05）。所有方程的一致性界限都很宽，其中 Mifflin-St. Jeor 方程的一致性界限最小，为-21.7%至 11.3%（-394 至 203kcal/d）。除了一个方程（Huang 方程，包含身体成分；偏差，一致性界限：-0.3±11.3%，不包含身体成分：2.3±10.1%，P<0.001）外，包含 FFM 的方程并不更准确。身体成分方程的偏差与年龄呈正相关，与 FM 呈负相关。在患者亚组中，偏差和一致性界限相似。
不能准确预测个体的 REE，偏差与年龄和 FM 有关。
