目的 分析间接测热法（indirect calorimetry, IC）与Harris-Benedict、Mifflin公式计算和人体成分预测法测定素食人群静息能量消耗的一致性和相关性,以指导目标能量营养方案的制定。方法 选取2023年 11月至12月招募的138例北京地区素食人群为研究对象,应用IC测定REE,对Harris-Benedict、Mifflin公式计算和人体成分预测三种方法估算的静息能量消耗（predicted resting energy expenditure,PREE）与实测静息能量消耗（measured resting energy expenditure,MREE）进行一致性、相关性分析。配对样本应用t检验或Mann-Whitney U检验分析,Bland-Altman法分析MREE与PREE的一致性,采用Spearman对MREE与PREE进行相关性分析。结果 纳入分析的138例素食人群中,女性100例,男性38例;男性MREE（1711.32±250.51）kcal明显高于女性（1333.56±163.08）kcal（P=0.000）;Spearman双变量相关分析,三种方法预测值与实测值均呈明显正相关（P<0.05）,其中人体成分预测法（r=0.76）相关性最强;Bland-Altman一致性分析发现,三种预测方法的95%一致性界限分别为(–360.76,254.68) kcal/d、(–437.72,188.18) kcal/d、(–416.00,177.84) kcal/d,均超出了临床可接受范围–140.60~140.60 kcal/d。结论 北京地区素食人群MREE与PREE存在显著正相关性,预测值低于实测值,不具备一致性。
Abstract
Objective To analyze the consistency and correlation between the resting energy expenditures derived from indirect calorimetry (IC) , Harris-Benedict and Mifflin equations and body composition prediction in (REE) vegetarians, to guide the development of targeted energy nutrition programs. Methods A total of 138 cases were recruited from November to December, 2023. REE was measured by indirect calorimetry (MREE) Harris-benedict and Mifflin equations and body composition were used to calculate the predicted resting energy expenditure (PREE). The consistency between MREE and PREE was analyzed by Bland-Altman method and the correlation between MREE and PREE was analyzed by Spearman method. Results Of the 138 vegetarians, 100 were females and 38 were males. The MREE of the males (1711.32±250.51) kcal was significantly higher than that of the females (1333.56±163.08) kcal (P=0.000). Spearman bivariate correlation analysis showed that the predicted values by the three methods were positively correlated with the measured values (P<0.05), and the values estimated from human body composition (R=0.76) had the strongest correlation. The results of Bland-Altman analysis showed that the 95% consistent limits of the three methods were (–360.76,254.68) kcal/d, (–437.72,188.18) kcal/d, (–416.00,177.84) kcal/d, which were beyond the acceptable range of –140.60-140.60 kcal/d. Conclusion There was a significant positive correlation between the MREE and the PREE in vegetarians, and the PREE was lower than the MREE.
关键词
静息能量消耗 /
间接测热法 /
素食
Key words
resting energy expenditure /
indirect calorimetry /
vegetarian
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Veleba J, Matoulek M, Hill M, et al. “A vegetarian vs. conventional hypocaloric diet: the effect on physical fitness in response to aerobic exercise in patients with type 2 diabetes.” a parallel randomized study[J]. Nutrients,2016,8:671.
[2] Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit[J]. Clin Nutr,2019,38:48–79.
[3] Fraipont V, Preiser JC.Energy estimation and measurement in critically ill patients[J]. J Parenter Enteral Nutr,2013,37:705–713.
[4] Harris JA, Benedict FG.A biometric study of human basal metabolism[J]. Proc Natl Acad Sci USA, 1918,4:370–373.
[5] Mifflin MD, St Jeor ST, Hill LA, et al. A new predictive equation for resting energy expenditure in healthy individuals[J]. Am J Clin Nutr,1990,51:241–247.
[6] McClave SA, Spain DA, Skolnick JL, et al. Achievement of steady state optimizes results when performing indirect calorimetry[J]. J Parenter Enteral Nutr,2003,27:16–20.
[7] Madden AM, Mulrooney HM, Shah S, et al. Estimation of energy expenditure using prediction equations in overweight and obese adults: a systematic review[J]. J Hum Nutr Diet, 2016,29: 458476.
[8] 于康. 临床营养支持治疗[M].3版.北京:北京中国协和医科大学出版社,2021.
[9] 鹿琦,朱晓梅. 南京市40~60岁人群能量消耗相关因素研究[J]. 南京医科大学学报(自然科学版),2017,37:437–441.
[10] Krishnan CK, Mehrabian M, Lusis AJ.Sex differences in metabolism and cardiometabolic disorders[J]. Curr Opin Lipidol,2018,29:404–410.
[11] 单清,包云,张舒. 不同性别老年人群静息能量消耗影响因素分析[J]. 实用老年医学,2020,34:155–158.
[12] Klausen B, Toubro S, Astrup A.Age and sex effects on energy expenditure[J]. Am J Clin Nutr, 1997 65:895–907.
[13] 李杨,王新颖. 间接能量代谢测定仪的临床应用[J]. 肠外与肠内营养,2012,19:118–121.
[14] 陈丽君,周琪,袁侨英. 基于人体成分分析的中国成人静息能量消耗及预测公式的研究[J]. 重庆医学,2022,51:1320–1325.
[15] 卞月梅,尤祥妹. 代谢车测定老年慢病患者静息能量消耗与HB公式比较[J]. 解放军预防医学杂志,2018,36:21–23.
[16] 谢海雁,于康,安奇志,等. 代谢车间接测热法、公式推测法及人体成分测定法用于测定静息能量消耗的比较[J]. 中华临床营养杂志,2018,26:90–93.
[17] 孙学丽,齐玉梅,周素宏. 用公式计算与实测静息能量消耗的2型糖尿病患者对比观察[J]. 中华临床营养杂志,2016,24:226–229.
[18] Olivier N, Wenhold FA, Becker P.Resting energy expenditure of black overweight women in South Africa is lower than of white women[J]. Ann Nutr Metab,2016,69:24–30.
