Kyle U G, Pichard C, Rochat T, Slosman D O, Fitting J W, Thiebaud D
Division of Clinical Nutrition, University Hospital, Geneva, Switzerland.
Eur Respir J. 1998 Oct;12(4):960-6. doi: 10.1183/09031936.98.12040960.
Malnutrition in patients with severe respiratory insufficiency can lead to severe complications, justifying the use of objective nutritional assessment techniques, such as bioelectrical impedance analysis (BIA), which is an easy, noninvasive method of measuring body composition. The purpose of this study was to develop, and validate against dual-energy X-ray absorptiometry (DXA), a BIA formula to predict fat-free mass (FFM) specific for patients with chronic severe respiratory insufficiency. Seventy-five ambulatory patients (15 females and 60 males) with severe chronic respiratory insufficiency (obstructive and restrictive) aged 63.6+/-19.2 yrs (mean+/-SD), in a stable pulmonary and cardiac condition for > or = 2 months, were measured simultaneously with BIA and DXA. Patients younger than 45 yrs of age and with a body mass index > or = 32 kg x m(-2) were excluded. The best-fitting multiple regression equation to predict FFM = -6.06 +/- (height x 0.283) +/- (weight x 0.207) - (resistance x 0.024) +/- (sex (males=1, females=0) x 4.036), gave a correlation coefficient of r=0.952, slope+/-SEM 0.902+/-0.034, standard error of the estimate 1.670, and p<0.0001. The mean difference for FFM was 0.2+/-2.3 kg (mean+/-SD) and percentage fat mass was -0.7+/-3.8%. These results suggest that the bioelectrical impedance analysis formula specific to patients with severe respiratory insufficiency give a better correlation and smaller mean differences than 12 different bioelectrical impedance analysis formulae described in the medical literature. A prediction equation, validated against dual-energy X-ray absorptiometry and based on subjects with similar clinical characteristics, is more applicable to the patients with respiratory insufficiency than a formula developed for healthy subjects.
严重呼吸功能不全患者的营养不良可导致严重并发症，这使得使用客观营养评估技术成为必要，例如生物电阻抗分析（BIA），它是一种测量身体成分的简便、非侵入性方法。本研究的目的是开发一种针对慢性严重呼吸功能不全患者预测去脂体重（FFM）的BIA公式，并与双能X线吸收法（DXA）进行验证。75名非卧床患者（15名女性和60名男性）患有严重慢性呼吸功能不全（阻塞性和限制性），年龄63.6±19.2岁（平均±标准差），肺部和心脏状况稳定≥2个月，同时采用BIA和DXA进行测量。排除年龄小于45岁且体重指数≥32 kg·m⁻²的患者。预测FFM的最佳拟合多元回归方程为：FFM = -6.06 ±（身高×0.283）±（体重×0.207） - （电阻×0.024）±（性别（男性 = 1，女性 = 0）×4.036），相关系数r = 0.952，斜率±标准误0.902±0.034，估计标准误1.670，p < 0.0001。FFM的平均差异为0.2±2.3 kg（平均±标准差），脂肪量百分比为 -0.7±3.8%。这些结果表明，特定于严重呼吸功能不全患者的生物电阻抗分析公式比医学文献中描述的12种不同生物电阻抗分析公式具有更好的相关性和更小的平均差异。一个经双能X线吸收法验证且基于具有相似临床特征受试者的预测方程，比为健康受试者开发的公式更适用于呼吸功能不全患者。
