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成人克罗恩病患者静息能量消耗的新预测方程。

New Predictive Equations for Estimating Resting Energy Expenditure in Adults With Crohn's Disease.

机构信息

Internal Medicine and Clinical Nutrition Unit, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy.

Gastroenterology Unit, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy.

出版信息

JPEN J Parenter Enteral Nutr. 2020 Aug;44(6):1021-1028. doi: 10.1002/jpen.1790. Epub 2020 Feb 3.

Abstract

BACKGROUND

Increased resting energy expenditure (REE) has been hypothesized to be a potential cause of weight loss in individuals with Crohn's disease (CD). This study aimed to develop and validate new predictive equations for estimating REE in adults with CD.

METHODS

Adults, ages 18-65 years, with CD were recruited. Anthropometry, indirect calorimetry, and bioimpedance analysis were performed in all patients. Disease activity was assessed by Crohn's Disease Activity Index. The new predictive equations were generated using different regression models. Prediction accuracy of the new equations was assessed and compared with the most commonly used equations.

RESULTS

A total of 270 CD patients (159 males, 111 females) were included and randomly assigned to the calibration (n = 180) and validation groups (n = 90). REE was directly correlated with weight and bioimpedance index, whereas the relation with both age and disease activity was inverse. The new equations were suitable for estimating REE at population level (bias: -0.2 and -0.3, respectively). Individual accuracy was good in both models (≥80%, respectively), especially in females; and similar results were shown by some of the selected equations. But, when accuracy was set within ±5%, the new equations gave the highest prediction.

CONCLUSION

The new, disease-specific, equations for predicting REE in individuals with CD give a good prediction accuracy as far as those proposed in the literature for the general population. However, the new ones performed better at the individual level. Further studies are needed to verify the reliability and usefulness of these new equations.

摘要

背景

人们推测,克罗恩病(CD)患者静息能量消耗(REE)增加是导致体重减轻的一个潜在原因。本研究旨在为 CD 成人患者开发和验证新的 REE 预测方程。

方法

招募年龄在 18-65 岁之间的 CD 成人患者。所有患者均进行人体测量学、间接测热法和生物电阻抗分析。通过克罗恩病活动指数评估疾病活动。使用不同的回归模型生成新的预测方程。评估新方程的预测准确性,并与最常用的方程进行比较。

结果

共纳入 270 例 CD 患者(159 例男性,111 例女性),并随机分为校准组(n=180)和验证组(n=90)。REE 与体重和生物电阻抗指数直接相关,而与年龄和疾病活动的关系则相反。新方程适用于估计人群水平的 REE(偏差分别为-0.2 和-0.3)。两种模型的个体准确性均较好(分别为≥80%),尤其是女性;部分选定方程也显示出相似的结果。但是,当准确性设定在±5%以内时,新方程的预测效果最佳。

结论

针对 CD 患者预测 REE 的新的、特定于疾病的方程在预测准确性方面与文献中提出的针对普通人群的方程相当。但是,在个体水平上,新方程的表现更好。需要进一步的研究来验证这些新方程的可靠性和实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f54b/7496798/96f13984c584/JPEN-44-1021-g001.jpg

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