Department of Agricultural, Food, and Nutrition Sciences, Division of Human Nutrition, University of Alberta, Edmonton, Alberta, Canada; University of Colorado School of Medicine, Division of Endocrinology, Metabolism, and Diabetes, Aurora, CO, USA; University of Colorado School of Medicine, Department of Pediatrics, Division of Nutrition, Aurora, CO, USA.
Department of Agricultural, Food, and Nutrition Sciences, Division of Human Nutrition, University of Alberta, Edmonton, Alberta, Canada; Nutrition Services, Alberta Health Services, Edmonton, Alberta, Canada.
Clin Nutr ESPEN. 2020 Dec;40:408-411. doi: 10.1016/j.clnesp.2020.07.020. Epub 2020 Aug 21.
The accuracy of some portable indirect calorimeters in estimating resting energy expenditure (REE) - and hence energy recommendations - among pre-bariatric patients is unknown. Our objective was to assess the accuracy of the MedGem® among individuals with class II or III obesity awaiting bariatric surgery.
Male and female adults who were awaiting bariatric surgery were recruited to this cross-sectional study. MedGem-derived oxygen consumption (O) and REE were compared to O and REE from a metabolic cart. REE was also calculated using several common equations to assess the clinical utility of this portable tool. Body composition was assessed by dual energy X-Ray absorptiometry. Paired t-test and Bland-Altman analysis (expressed as bias [average difference] and limits of agreement [bias ± 2 standard deviations]) evaluated O and REE accuracy.
Twenty-six individuals were included (34 ± 9 years old; n = 20, 76.9% female), with the majority (n = 15, 57.7%) having class II obesity. Neither O (MedGem: 283 ± 63 vs. metabolic cart: 293 ± 64 ml/min, p = 0.114) nor REE (MedGem: 1963 ± 437 vs. metabolic cart: 2047 ± 440 kcal/day, p = 0.057) were different between devices. Body composition did not relate to bias. The MedGem had wide limits of agreement for REE (-504 to 336 kcal/day), which was similar to predictive equations.
Although REE from the MedGem was not different than REE from the metabolic cart, individual-level accuracy was poor and similar to predictive equations in patients with class II or III obesity. Nonetheless, efficacy of repeated assessments during weight loss warrant future investigation.
一些便携式间接测热仪在评估拟接受减重手术的肥胖患者的静息能量消耗（REE）和能量推荐值方面的准确性尚不清楚。我们的目的是评估 MedGem®在等待减重手术的 II 类或 III 类肥胖患者中的准确性。
招募了等待减重手术的男性和女性成年人进行这项横断面研究。MedGem 衍生的耗氧量（O）和 REE 与代谢车的 O 和 REE 进行了比较。还使用几种常见的方程来计算 REE，以评估该便携式工具的临床实用性。通过双能 X 射线吸收法评估身体成分。使用配对 t 检验和 Bland-Altman 分析（表示为偏差[平均差异]和一致性界限[偏差±2 个标准差]）评估 O 和 REE 的准确性。
共纳入 26 名参与者（34±9 岁；n=20，76.9%为女性），其中大多数（n=15，57.7%）患有 II 类肥胖症。O（MedGem：283±63 与代谢车：293±64ml/min，p=0.114）和 REE（MedGem：1963±437 与代谢车：2047±440kcal/天，p=0.057）在两种设备之间均无差异。身体成分与偏差无关。MedGem 对 REE 的一致性界限很宽（-504 至 336kcal/天），与预测方程相似。
尽管 MedGem 的 REE 与代谢车的 REE 不同，但个体水平的准确性较差，与 II 类或 III 类肥胖患者的预测方程相似。然而，在减肥期间进行重复评估的效果仍需要进一步研究。
