[The study of resting energy expenditure equation for short bowel syndrome patients].Zhonghua Wai Ke Za Zhi 2011; 49(5):400-3ZW
To determine the accuracy of resting energy expenditure (REE) calculated by using the Harris-Benedict (HB) equation, Food and Agriculture Organization/World Health Organization/United Nations University (FAO/WHO/UNU) equations (FAO equations), Shizgal-Rosa (SR) equation and the LIU equation in patients with short bowel syndrome (SBS). In addition, to explore the relationship between measured REE and body weight, fat free mass, body cell mass, fat mass and fat mass percent.
Fourty-one SBS patients including 30 male and 11 female, aged from 18 to 60 years admitted between January 2001 and October 2010 were enrolled in this study. All patients required long-term parenteral or enteral plus parenteral nutrition support. Their mean age and mean stature were (37 ± 16) years and (164.3 ± 9.0) cm, and the average body weight and residual small intestine was (47.4 ± 9.3) kg and (52 ± 45) cm. Measured REEs and calculated REEs of SBS patients were estimated respectively by indirect calorimetry and REE equations, and then defined the difference of them. And body mass were metered by body composition analyzer.
A significant correlation was found between measured REEs (1218 ± 293) Kcal and calculated REEs from the HB equation (r = 0.588, P < 0.01), the SR equations (r = 0.591, P < 0.01), the FAO equations (r = 0.411, P < 0.01) and the LIU equation (r = 0.585, P < 0.01). In the total sample, the paired t test between measured REEs and REEs derived from the HB equation, SR equation and FAO equation showed no significant difference (P > 0.05). However, measured REEs were significantly higher than REEs calculated using the LIU equations by 14.17% (P < 0.01). There was also a significant correlation between measured REEs and body weight, fat free mass and body cell mass (r = 0.548, 0.641 and 0.581).
Indirect calorimetry is preferred when an accurate REE estimate of SBS patients is necessary. However, if this machine is not available, SR equation is recommended to use and LIU equation must be avoided. Fat free mass may be more useful than body weight in REE calculation.