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验证有神经支配和去神经支配的慢性脊髓损伤患者基础代谢率方程。

Validation of basal metabolic rate equations in persons with innervated and denervated chronic spinal cord injury.

机构信息

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.

出版信息

Physiol Rep. 2024 Jun;12(11):e16099. doi: 10.14814/phy2.16099.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/974f/11176742/9c090693aa1b/PHY2-12-e16099-g006.jpg

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