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New specific equation to estimate resting energy expenditure in severely obese patients.

Abstract

Calculating the estimated resting energy expenditure (REE) in severely obese patients is useful, but there is controversy concerning the effectiveness of available prediction equations (PE) using body weight (BW). We evaluated the efficacy of REE equations against indirect calorimetry (IC) in severely obese subjects and aimed to develop a new equation based on body composition compartments. One hundred and twenty severely obese patients had their REE measured (MREE) by IC and compared to the most commonly used PE (Harris-Benedict (HB), Ireton-Jones, Owen, and Mifflin St. Jeor). In a random sample (n = 60), a new REE equation based on fat-free mass (FFM) was developed and validated. All PE studied failed to estimate REE in severe obesity (low concordance correlation coefficient (CCC) and limits of agreement of nearly 50% of the sample ±10% of MREE). The HB equation using actual BW exhibited good results for all samples when compared to IC (2,117 ± 518 kcal/day by HB vs. 2,139 ± 423 kcal/day by MREE, P > 0.01); these results were blunted when patients were separated by gender (2,771 vs. 2,586 kcal/day, P < 0.001 in males and 1,825 vs. 1,939 kcal/day, P < 0.001 in females). A new resting energy expenditure equation prediction was developed using FFM, Horie-Waitzberg, & Gonzalez, expressed as 560.43 + (5.39 × BW) + (14.14 × FFM). The new resting energy expenditure equation prediction, which uses FFM and BW, demonstrates higher accuracy, precision, CCC, and limits of agreement than the standard PE in patients when compared to MREE (2,129 ± 45 kcal/day vs. 2,139 ± 423 kcal/day, respectively, P = 0.1).The new equation developed to estimate REE, which takes into account both FFM and BW, provides better results than currently available equations.

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  • Authors+Show Affiliations

    ,

    Department of Gastroenterology, Digestive Surgery Division, University of São Paulo, School of Medicine, São Paulo, Brazil. mikahorie@gmail.com

    , , ,

    Source

    Obesity (Silver Spring, Md.) 19:5 2011 May pg 1090-4

    MeSH

    Adolescent
    Adult
    Basal Metabolism
    Calorimetry, Indirect
    Female
    Humans
    Male
    Mathematical Concepts
    Middle Aged
    Obesity, Morbid
    Predictive Value of Tests
    Reproducibility of Results
    Young Adult

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't
    Validation Studies

    Language

    eng

    PubMed ID

    21233808

    Citation

    Horie, Lilian M., et al. "New Specific Equation to Estimate Resting Energy Expenditure in Severely Obese Patients." Obesity (Silver Spring, Md.), vol. 19, no. 5, 2011, pp. 1090-4.
    Horie LM, Gonzalez MC, Torrinhas RS, et al. New specific equation to estimate resting energy expenditure in severely obese patients. Obesity (Silver Spring). 2011;19(5):1090-4.
    Horie, L. M., Gonzalez, M. C., Torrinhas, R. S., Cecconello, I., & Waitzberg, D. L. (2011). New specific equation to estimate resting energy expenditure in severely obese patients. Obesity (Silver Spring, Md.), 19(5), pp. 1090-4. doi:10.1038/oby.2010.326.
    Horie LM, et al. New Specific Equation to Estimate Resting Energy Expenditure in Severely Obese Patients. Obesity (Silver Spring). 2011;19(5):1090-4. PubMed PMID: 21233808.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - New specific equation to estimate resting energy expenditure in severely obese patients. AU - Horie,Lilian M, AU - Gonzalez,M Cristina, AU - Torrinhas,Raquel S, AU - Cecconello,Ivan, AU - Waitzberg,Dan L, Y1 - 2011/01/13/ PY - 2011/1/15/entrez PY - 2011/1/15/pubmed PY - 2012/5/5/medline SP - 1090 EP - 4 JF - Obesity (Silver Spring, Md.) JO - Obesity (Silver Spring) VL - 19 IS - 5 N2 - Calculating the estimated resting energy expenditure (REE) in severely obese patients is useful, but there is controversy concerning the effectiveness of available prediction equations (PE) using body weight (BW). We evaluated the efficacy of REE equations against indirect calorimetry (IC) in severely obese subjects and aimed to develop a new equation based on body composition compartments. One hundred and twenty severely obese patients had their REE measured (MREE) by IC and compared to the most commonly used PE (Harris-Benedict (HB), Ireton-Jones, Owen, and Mifflin St. Jeor). In a random sample (n = 60), a new REE equation based on fat-free mass (FFM) was developed and validated. All PE studied failed to estimate REE in severe obesity (low concordance correlation coefficient (CCC) and limits of agreement of nearly 50% of the sample ±10% of MREE). The HB equation using actual BW exhibited good results for all samples when compared to IC (2,117 ± 518 kcal/day by HB vs. 2,139 ± 423 kcal/day by MREE, P > 0.01); these results were blunted when patients were separated by gender (2,771 vs. 2,586 kcal/day, P < 0.001 in males and 1,825 vs. 1,939 kcal/day, P < 0.001 in females). A new resting energy expenditure equation prediction was developed using FFM, Horie-Waitzberg, & Gonzalez, expressed as 560.43 + (5.39 × BW) + (14.14 × FFM). The new resting energy expenditure equation prediction, which uses FFM and BW, demonstrates higher accuracy, precision, CCC, and limits of agreement than the standard PE in patients when compared to MREE (2,129 ± 45 kcal/day vs. 2,139 ± 423 kcal/day, respectively, P = 0.1).The new equation developed to estimate REE, which takes into account both FFM and BW, provides better results than currently available equations. SN - 1930-739X UR - https://www.unboundmedicine.com/medline/citation/21233808/New_specific_equation_to_estimate_resting_energy_expenditure_in_severely_obese_patients_ L2 - https://doi.org/10.1038/oby.2010.326 DB - PRIME DP - Unbound Medicine ER -