使用三轴加速度计和体力活动问卷评估 2 型糖尿病老年患者总能量消耗和体力活动水平的有效性：CLEVER-DM 研究。
Validity of the Use of a Triaxial Accelerometer and a Physical Activity Questionnaire for Estimating Total Energy Expenditure and Physical Activity Level among Elderly Patients with Type 2 Diabetes Mellitus: CLEVER-DM Study.
机构信息
Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan,
出版信息
Ann Nutr Metab. 2020;76(1):62-72. doi: 10.1159/000506223. Epub 2020 Mar 13.
INTRODUCTION
Evaluation of total energy expenditure (TEE) and physical activity level (PAL) is important for treatment of patients with type 2 diabetes mellitus (T2DM). However, the validity of accelerometers (ACC) and physical activity questionnaires (PAQ) for estimating TEE and PAL remains unknown in elderly populations with T2DM. We evaluated the accuracy of TEE and PAL results estimated by an ACC (TEEACC and PALACC) and a PAQ (TEEPAQ and PALPAQ) in elderly patients with T2DM.
METHODS
Fifty-one elderly patients with T2DM (aged 61-79 years) participated in this study. TEEACC was calculated with PALACC using a triaxial ACC (Active style Pro HJA-750c) over 2 weeks and predicted basal metabolic rate (BMR) by Ganpule's equation. TEEPAQ was estimated using predicted BMR and the PALPAQ from the -Japan Public Health Center Study-Long questionnaire. We compared the results to TEEDLW measured with the doubly labeled water (DLW) method and PALDLW calculated with BMR using indirect calorimetry.
RESULTS
TEEDLW was 2,165 ± 365 kcal/day, and TEEACC was 2,014 ± 339 kcal/day; TEEACC was strongly correlated with TEEDLW (r = 0.87, p < 0.01) but significantly underestimated (-150 ± 183 kcal/day, p < 0.05). There was no significant difference in TEEPAQ and TEEDLW (-49 ± 284 kcal/day), while the range of difference seemed to be larger than TEEACC. PALDLW, PALACC, and PALPAQ were calculated to be 1.71 ± 0.17, 1.69 ± 0.16, and 1.78 ± 0.24, respectively. -PALACC was strongly correlated with PALDLW (r = 0.71, p < 0.01), and there was no significant difference between the 2 values. PALPAQ was moderately correlated with PALDLW (r = 0.43, p < 0.01) but significantly overestimated. Predicted BMR was significantly lower than the BMR -measured by indirect calorimetry (1,193 ± 186 vs. 1,262 ± 155 kcal/day, p < 0.01).
CONCLUSIONS
The present ACC and questionnaire showed acceptable correlation of TEE and PAL compared with DLW method in elderly patients with T2DM. Systematic errors in estimating TEE may be improved by the better equation for predicting BMR.
简介
评估总能量消耗（TEE）和体力活动水平（PAL）对于 2 型糖尿病（T2DM）患者的治疗非常重要。然而，在患有 T2DM 的老年人群中，加速度计（ACC）和体力活动问卷（PAQ）用于估计 TEE 和 PAL 的准确性仍不清楚。我们评估了 T2DM 老年患者使用三轴 ACC（Active style Pro HJA-750c）在 2 周内计算的 TEEACC（PALACC）和 PALACC（TEEPAQ）和 PAQ（PALPAQ）的准确性。TEEACC 通过 Ganpule 方程预测基础代谢率（BMR），TEEPAQ 则使用预测的 BMR 和来自日本公共卫生中心研究长问卷的 PALPAQ 进行估算。我们将这些结果与使用双标记水（DLW）方法测量的 TEEDLW 和使用间接测热法计算的 PALDLW 进行了比较。
结果
TEEDLW 为 2165±365kcal/天，TEEACC 为 2014±339kcal/天；TEEACC 与 TEEDLW 高度相关（r=0.87，p<0.01），但明显低估（-150±183kcal/天，p<0.05）。TEEPAQ 与 TEEDLW 无显著差异（-49±284kcal/天），但差异范围似乎大于 TEEACC。PALDLW、PALACC 和 PALPAQ 分别计算为 1.71±0.17、1.69±0.16 和 1.78±0.24。-PALACC 与 PALDLW 高度相关（r=0.71，p<0.01），且两者无显著差异。PALPAQ 与 PALDLW 中度相关（r=0.43，p<0.01），但明显高估。预测的 BMR 明显低于间接测热法测量的 BMR（1193±186 与 1262±155kcal/天，p<0.01）。
结论
在患有 T2DM 的老年患者中，与 DLW 方法相比，本研究中的 ACC 和问卷在 TEE 和 PAL 的相关性方面表现出可接受的结果。通过更好的预测 BMR 方程，可能会改善 TEE 估计中的系统误差。
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