比较间接测热法与不同能量方程对肾移植患者静息能量消耗的测定。

A Comparison of the Indirect Calorimetry and Different Energy Equations for the Determination of Resting Energy Expenditure of Patients With Renal Transplantation.

机构信息

Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Besevler, Ankara, Turkey.

Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Besevler, Ankara, Turkey; Faculty of Health Sciences, Department of Nutrition and Dietetics, Izmir Katip Celebi University, Izmir, Turkey.

出版信息

J Ren Nutr. 2021 May;31(3):296-305. doi: 10.1053/j.jrn.2020.05.004. Epub 2020 Jul 15.

DOI:10.1053/j.jrn.2020.05.004

PMID:32682604

Abstract

OBJECTIVE

We aimed to evaluate the agreement between the resting energy expenditure (REE) obtained by indirect calorimetry and eight prediction equations in adult patients with renal transplantation and a newly developed REE prediction equation for use in patients with renal transplantation in the clinic.

METHODS

A total of 51 patients (30 males and 21 females) were involved in the study. The REE was measured by indirect calorimetry and compared with the previous prediction equations. The agreement was assessed by the interclass correlation coefficient and by Bland-Altman plot analysis.

RESULTS

No significant difference was found in terms of age and body mass index between the genders. Differences between the predicted and measured REEs were maximum in the Bernstein equation (-478 kcal) and minimum in the Cunningham equation (-69 kcal). It was found that underprediction values varied from 27.5% (chronic kidney disease equation) to 98.0% (Bernstein equation). The highest overprediction value was found in the Schofield equation (17.7%). The Cunningham equation and the new equation had the lowest root mean square error (265 kcal/day). In this study, fat-free mass (FFM) was found to be the most significant variable in multiple regression analysis (r: 0.55). The new specific equation based on FFM was generated as 424.2 + 24.7∗FFM (kg). Besides that, it was found that the new equation and Cunningham equation were distributed randomly according to Bland-Altman analysis. A supplementary new equation based on available anthropometric measurements was developed as -1996.8 + 19.1∗height (cm) + 7.2∗body weight (kg).

CONCLUSION

This study showed that most of the predictive equations significantly underestimated REE. In patients with renal transplantation, if the REE is not measurable by indirect calorimetry, the use of the proposed equations will be more accurate.

摘要

目的

评估间接测热法获得的静息能量消耗（REE）与成人肾移植患者的 8 种预测方程以及新开发的肾移植患者 REE 预测方程之间的一致性。

方法

本研究纳入 51 例患者（30 名男性和 21 名女性）。REE 通过间接测热法测量，并与之前的预测方程进行比较。通过组内相关系数和 Bland-Altman 图分析评估一致性。

结果

男女患者的年龄和体重指数无显著差异。预测 REE 与实测 REE 之间的差异在 Bernstein 方程中最大（-478 kcal），在 Cunningham 方程中最小（-69 kcal）。发现低估值从 27.5%（慢性肾脏病方程）到 98.0%（Bernstein 方程）不等。Schofield 方程的高估值最高（17.7%）。Cunningham 方程和新方程的均方根误差（265 kcal/d）最低。本研究中，去脂体重（FFM）是多元回归分析中最显著的变量（r：0.55）。基于 FFM 的新特定方程为 424.2 + 24.7∗FFM（kg）。此外，根据 Bland-Altman 分析，发现新方程和 Cunningham 方程呈随机分布。根据可用的人体测量学测量结果，开发了一个新的补充方程：-1996.8 + 19.1∗身高（cm）+ 7.2∗体重（kg）。