Azcue M P, Zello G A, Levy L D, Pencharz P B
Research Institute, Hospital for Sick Children, Ontario, Canada.
J Pediatr. 1996 Dec;129(6):870-6. doi: 10.1016/s0022-3476(96)70031-8.
To determine the relationship between resting energy expenditure and body cell mass in a group of children with spastic quadriplegic cerebral palsy (SQCP) in comparison with a group of healthy volunteers.
Children with SQCP (n = 13) and healthy control subjects (n = 21) participated in the study. Resting energy expenditure (REE) by indirect calorimetry, as well as body composition measurements were obtained. Those included skinfold measurements, isotope dilution methods for total body water and extracellular water (2H2O or H2(18)O and NaBr, respectively), and bioelectrical impedance analysis. Intracellular water was calculated as total body water minus extracellular water.
Overall REE in children with SQCP was significantly less than in control subjects or from predicted World Health Organization equations. There was a poor correlation between REE and weight or height for children with SQCP and those for control subjects. Children with SQCP showed a higher variance and small improvement in the correlation between REE and lean body mass or intracellular water in comparison with control subjects. Nine of the thirteen children with SQCP had significantly reduced REE per unit of lean tissue or intracellular water. Furthermore, bioelectrical impedance analysis was validated against dilution methods as a suitable technique for measuring total body water (r2 = 0.90, r = 0.95) and extracellular water (r2 = 0.84, r = 0.92) in children with SQCP.
REE in children with SQCP is poorly correlated with body cell mass. We postulate that the central nervous system plays a crucial role in energy regulation. In children with SQCP, individual energy expenditure should be measured so that optimal nutritional status can be achieved. Bioelectrical impedance analysis can be used in this population to measure body water spaces.
确定一组痉挛性四肢瘫脑瘫（SQCP）儿童与一组健康志愿者相比，静息能量消耗与身体细胞质量之间的关系。
SQCP儿童（n = 13）和健康对照者（n = 21）参与了本研究。通过间接测热法获得静息能量消耗（REE），并进行身体成分测量。这些测量包括皮褶厚度测量、分别用于测量总体水和细胞外水的同位素稀释法（分别为2H2O或H2(18)O和溴化钠）以及生物电阻抗分析。细胞内水通过总体水减去细胞外水来计算。
SQCP儿童的总体REE显著低于对照组或世界卫生组织预测方程计算的值。SQCP儿童和对照组儿童的REE与体重或身高之间的相关性较差。与对照组相比，SQCP儿童在REE与瘦体重或细胞内水之间的相关性方面表现出更高的变异性和较小的改善。13名SQCP儿童中有9名每单位瘦组织或细胞内水的REE显著降低。此外，在SQCP儿童中，生物电阻抗分析作为一种测量总体水（r2 = 0.90，r = 0.95）和细胞外水（r2 = 0.84，r = 0.92）的合适技术，已通过与稀释法对比得到验证。
SQCP儿童的REE与身体细胞质量相关性较差。我们推测中枢神经系统在能量调节中起关键作用。对于SQCP儿童，应测量个体能量消耗，以便实现最佳营养状态。生物电阻抗分析可用于该人群测量身体水空间。
