Spinal Cord Injury and Disorders Center, Richmond VA Medical Center, Richmond, Virginia, USA.
Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
Physiol Rep. 2024 Jun;12(11):e16099. doi: 10.14814/phy2.16099.
Basal metabolic rate (BMR) measurement is time consuming and requires specialized equipment. Prediction equations allow clinicians and researchers to estimate BMR; however, their accuracy may vary across individuals with chronic spinal cord injury (SCI). The objective of this study was to investigate the validity of SCI-specific equations as well as able-bodied (AB) prediction equations in individuals with upper motor neuron (UMN), lower motor neuron (LMN), and females with SCI. Twenty-six men and women with chronic SCI (n = 12 innervated males, n = 6 innervated females, n = 8 denervated males) participated in this cross-sectional study. BMR values were measured by indirect calorimetry. Body composition (dual-energy X-ray absorptiometry and anthropometrics) assessment was conducted. AB-prediction equations [Cunningham, Nelson, Owen, Harris and Benedict, Mifflin, Schofield, Henry] and SCI-specific equations [Chun and Nightingale & Gorgey] were used to estimate and validate BMR. The accuracy of AB-specific FFM equations in predicting BMR was evaluated using Bland-Altman plots, paired t-tests, and error metrics. Measured BMR for innervated males, females, and denervated males was 1436 ± 213 kcal/day, 1290 ± 114, and 1597 ± 333 kcal/day, respectively. SCI-specific equations by Chun et al., Nightingale & Gorgey, and AB-specific FFM equations accurately predicted BMR for innervated males. For the denervated males, Model 4 equation by Nightingale & Gorgey was not different (p = 0.18), and Bland-Altman analyses showed negative mean bias but similar limits of agreement between measured and predicted BMR for the SCI-specific equations and AB-specific FFM equations. We demonstrated that SCI-specific equations accurately predicted BMR for innervated males but underpredicted it for denervated males. The Model 4 equation by Nightingale & Gorgey accurately estimated BMR in females with SCI. Findings from the current study will help to determine caloric needs in different sub-groups of SCI.
基础代谢率 (BMR) 的测量既耗时又需要专门的设备。预测方程可让临床医生和研究人员估算 BMR;然而,它们在患有慢性脊髓损伤 (SCI) 的个体中的准确性可能会有所不同。本研究的目的是调查 SCI 特异性方程以及健全 (AB) 预测方程在患有上运动神经元 (UMN)、下运动神经元 (LMN) 和 SCI 女性的个体中的有效性。26 名患有慢性 SCI 的男性和女性 (n=12 名有神经支配的男性,n=6 名有神经支配的女性,n=8 名去神经支配的男性) 参与了这项横断面研究。BMR 值通过间接测热法测量。进行了身体成分 (双能 X 射线吸收法和人体测量学) 评估。使用 AB 预测方程 [Cunningham、Nelson、Owen、Harris 和 Benedict、Mifflin、Schofield、Henry] 和 SCI 特异性方程 [Chun 和 Nightingale & Gorgey] 来估算和验证 BMR。使用 Bland-Altman 图、配对 t 检验和误差指标评估 AB 特异性 FFM 方程预测 BMR 的准确性。有神经支配的男性、女性和去神经支配的男性的实测 BMR 分别为 1436±213kcal/天、1290±114kcal/天和 1597±333kcal/天。Chun 等人的 SCI 特异性方程、Nightingale & Gorgey 的方程和 AB 特异性 FFM 方程准确预测了有神经支配的男性的 BMR。对于去神经支配的男性,Nightingale & Gorgey 的方程 4 型没有差异 (p=0.18),Bland-Altman 分析显示 SCI 特异性方程和 AB 特异性 FFM 方程之间实测和预测 BMR 的平均偏差为负,但协议界限相似。我们证明,SCI 特异性方程准确预测了有神经支配的男性的 BMR,但低估了去神经支配的男性的 BMR。Nightingale & Gorgey 的方程 4 型准确估计了 SCI 女性的 BMR。本研究的结果将有助于确定不同 SCI 亚组的热量需求。