Pisanu Silvia, Deledda Andrea, Loviselli Andrea, Huybrechts Inge, Velluzzi Fernanda
Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.
Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
J Nutr Metab. 2020 Aug 4;2020:2327017. doi: 10.1155/2020/2327017. eCollection 2020.
Even though the validity of accelerometers for the measurement of energy expenditure (EE) has been demonstrated for normal-weight individuals, the applicability of this instrument in obese individuals remains controversial. This review aims to summarize the level of agreement between accelerometers and the gold standards (indirect calorimetry and doubly labelled water) for the measurement of energy expenditure (EE) in obese or overweight individuals.
The literature search was limited to comparison studies assessing agreement in EE determination between accelerometers and indirect calorimetry (IC) or doubly labelled water (DLW). We searched in PubMed and in Scopus until March 1, 2019. The analysis was restricted to obese or overweight adult individuals. The following descriptive information was extracted for each study: sample size, characteristics of participants (sex, age, BMI, fat mass percentage, any pathological conditions, modality of recruitment in the study, and exclusion criteria), accelerometer description (model, type and body position), and type of gold standard and validity protocol (duration, conditions, and requirements during and before the experiment). Three review authors independently screened the obtained results, and the quality of the selected articles was assessed by the QUADAS-2 tool.
We obtained seventeen eligible articles, thirteen of which showed concerns for the applicability section, due to the patient selection. Regarding the accelerometers, nine devices were validated in the included studies with the BodyMedia SenseWear® (SWA) being the most frequently validated. Although correlations between accelerometers and the gold standard were high in some studies, agreement between the two methods was low, as shown by the Bland-Altman plots.
Most accelerometer estimations of EE were inaccurate for obese/overweight subjects, and authors advise to improve the accuracy of algorithms for SWA software, or the predicted equations for estimating EE from other accelerometers.
尽管加速度计测量能量消耗（EE）的有效性已在正常体重个体中得到证实，但该仪器在肥胖个体中的适用性仍存在争议。本综述旨在总结加速度计与测量肥胖或超重个体能量消耗（EE）的金标准（间接测热法和双标记水法）之间的一致性水平。
文献检索仅限于评估加速度计与间接测热法（IC）或双标记水法（DLW）在EE测定方面一致性的比较研究。我们在PubMed和Scopus中进行检索，直至2019年3月1日。分析仅限于肥胖或超重的成年个体。为每项研究提取以下描述性信息：样本量、参与者特征（性别、年龄、体重指数、体脂百分比、任何病理状况、研究中的招募方式和排除标准）、加速度计描述（型号、类型和身体位置）以及金标准类型和有效性方案（实验期间和之前的持续时间、条件和要求）。三位综述作者独立筛选所得结果，并使用QUADAS - 2工具评估所选文章的质量。
我们获得了17篇符合条件的文章，其中13篇因患者选择问题在适用性部分存在问题。关于加速度计，在所纳入的研究中对9种设备进行了验证，其中BodyMedia SenseWear®（SWA）是验证最为频繁的。尽管在一些研究中加速度计与金标准之间的相关性较高，但如Bland - Altman图所示，两种方法之间的一致性较低。
对于肥胖/超重受试者，大多数加速度计对EE的估计不准确，作者建议改进SWA软件算法的准确性，或改进其他加速度计估计EE的预测方程。
