Johnson R K, Hildreth H G, Contompasis S H, Goran M I
Department of Nutritional Sciences, University of Vermont, Burlington 05405, USA.
J Am Diet Assoc. 1997 Sep;97(9):966-70. doi: 10.1016/s0002-8223(97)00233-2.
To characterize total energy expenditure (TEE) in free-living adults with cerebral palsy (CP) using the doubly labeled water technique, and to determine those physiologic variables and characteristics of CP that were markers of TEE in adults with CP.
TEE was measured using the doubly labeled water technique in 30 free-living adults with CP (12 women, 18 men). To determine the best markers of TEE, the following factors were examined: CP status, resting metabolic rate (RMR), anthropometric characteristics and body composition by means of dual-energy x-ray absorptiometry (DXA) and skinfold thickness measurements, energy cost of leisure-time activities, and oral-motor impairment.
Means +/- standard deviations, t tests, Pearson product-moment correlation coefficients, Spearman rank correlation coefficients, chi 2, stepwise multiple-correlation regression analysis, and analysis of covariance were used to examine the relationships among variables of interest.
TEE was highly variable in the sample (mean = 2,455 +/- 622 kcal/day for men and 1,986 +/- 363 kcal/day for women). Stepwise regression analysis showed that TEE was best predicted in the sample by RMR, percentage body fat determined by DXA, ambulation status, and sex (multiple R = .68, P = .003). When practical, easily measured variables were used, TEE was best predicted by height, ambulation status, percentage body fat by skinfold thickness measurements, and sex (multiple R = .61, P. = 018). The contribution of energy expended in physical activity to TEE was significantly higher in the ambulatory subjects than the nonambulatory subjects (25% vs 16%, respectively; P = .009).
The high degree of variability in TEE, largely attributable to high interindividual variation in energy expended in physical activity, makes it difficult to provide general guidelines for energy requirements for adults with CP. Because ambulation status was an important predictor of TEE, it must be accounted for in estimating energy requirements in this population.
采用双标记水技术对自由生活的成年脑瘫患者的总能量消耗（TEE）进行特征描述，并确定脑瘫患者中作为TEE标志物的生理变量和特征。
采用双标记水技术对30名自由生活的成年脑瘫患者（12名女性，18名男性）进行TEE测量。为确定TEE的最佳标志物，研究了以下因素：脑瘫状况、静息代谢率（RMR）、人体测量学特征以及通过双能X线吸收法（DXA）和皮褶厚度测量得出的身体成分、休闲活动的能量消耗以及口腔运动障碍。
采用均值±标准差、t检验、Pearson积矩相关系数、Spearman等级相关系数、卡方检验、逐步多元相关回归分析和协方差分析来研究相关变量之间的关系。
样本中的TEE变化很大（男性平均为2455±622千卡/天，女性平均为1986±363千卡/天）。逐步回归分析表明，样本中TEE的最佳预测指标为RMR、通过DXA测定的体脂百分比、行走状态和性别（复相关系数R = 0.68；P = 0.003）。当使用实际的、易于测量的变量时，TEE的最佳预测指标为身高、行走状态、通过皮褶厚度测量得出的体脂百分比和性别（复相关系数R = 0.61；P = 0.018）。能走动的受试者体力活动消耗的能量对TEE的贡献显著高于不能走动的受试者（分别为25%和16%；P = 0.009）。
TEE的高度变异性很大程度上归因于体力活动能量消耗的个体间差异很大，这使得难以提供成年脑瘫患者能量需求的一般指南。由于行走状态是TEE的重要预测指标，因此在估计该人群的能量需求时必须予以考虑。
