Comparison of Estimates of Resting Energy Expenditure Equations in Haemodialysis Patients

2017 ◽  
Vol 40 (3) ◽  
pp. 96-101 ◽  
Author(s):  
Rachel Hung ◽  
Sivakumar Sridharan ◽  
Ken Farrington ◽  
Andrew Davenport

Purpose Waste products of metabolism accumulate in patients with chronic kidney disease, and require clearance by haemodialysis (HD). We wished to determine whether there was an association between resting energy expenditure (REE) and total energy expenditure (TEE) in HD patients and body composition. Subjects/Methods We determined REE by recently validated equations (CKD equation) and compared REE with that estimated by standard equations for REE, and TEE calculated from patient reported physical activity, in HD patients with corresponding body composition measured by dual energy X-ray absorptiometry (DEXA) scanning. Results We studied 107 patients, 69 male (64.5%), mean age 62.7 ± 15.1 years. The CKD equation REE was 72.5 ± 13.3 watts (W) and TEE 83.2 ± 9.7 W There was a strong association between REE with body surface area (BSA) (r2 = 0.80), total soft lean and fat lean tissue mass (r2 = 0.69), body mass index (BMI) (r2 = 0.34), all p<0.001. REE estimated using the modified Harris Benedict, Mifflin St. Jeor, Katch McArdle, Bernstein and Robertson equations underestimated REE compared to the CKD equation. TEE was more strongly associated with BSA (r2 = 0.51), appendicular muscle mass (r2 = 0.42), than BMI (r2 = 0.15) all p<0.001. TEE was greater for those employed (104.9 ± 10.7 vs. 83.1 ± 12.3 W, p<0.001), and with no co-morbidity (88.7 ± 14.8 vs. 82.7 ± 12.3 W, P<0.05). Conclusions Standard equations underestimate REE in HD patients compared to the CKD equation. TEE was greater in those with more skeletal muscle mass, in those who were employed and in those with the least comorbidity. More metabolically active patients may well require greater dialytic clearances.

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 340
Author(s):  
Edyta Łuszczki ◽  
Anna Bartosiewicz ◽  
Katarzyna Dereń ◽  
Maciej Kuchciak ◽  
Łukasz Oleksy ◽  
...  

Establishing the amount of energy needed to cover the energy demand of children doing sport training and thus ensuring they achieve an even energy balance requires the resting energy expenditure (REE) to be estimated. One of the methods that measures REE is the indirect calorimetry method, which may be influenced by many factors, including body composition, gender, age, height or blood pressure. The aim of the study was to assess the correlation between the resting energy expenditure of children regularly playing football and selected factors that influence the REE in this group. The study was conducted among 219 children aged 9 to 17 using a calorimeter, a device used to assess body composition by the electrical bioimpedance method by means of segment analyzer and a blood pressure monitor. The results of REE obtained by indirect calorimetry were compared with the results calculated using the ready-to-use formula, the Harris Benedict formula. The results showed a significant correlation of girls’ resting energy expenditure with muscle mass and body height, while boys’ resting energy expenditure was correlated with muscle mass and body water content. The value of the REE was significantly higher (p ≤ 0.001) than the value of the basal metabolic rate calculated by means of Harris Benedict formula. The obtained results can be a worthwhile suggestion for specialists dealing with energy demand planning in children, especially among those who are physically active to achieve optimal sporting successes ensuring proper functioning of their body.


2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S191-S192
Author(s):  
D Vranesic Bender ◽  
L Cengic ◽  
D Ljubas Kelecic ◽  
I Karas ◽  
A Grbin Hodžić ◽  
...  

Abstract Background As a feature of changing phenotype of IBD in the last decade, we observe increased rates of obesity and increased BMI values as well as changes in body composition. Special interest is the impact of biological therapy on body composition and prevalence of obesity in IBD patients, since the data on this topic are limited. The aim of this study was to determine body composition and resting energy expenditure of patients treated with biological therapy. Methods The study included 74 patients (39 male and 35 female) at the Clinical Hospital Center Zagreb (52 patients with Crohn’s disease and 22 with ulcerative colitis) treated with infliximab/adalimumab/ustekinumab/vedolizumab. Resting energy expenditure was measured by the indirect calorimetry (Cosmed Quark CPET) and compared with the predicted resting energy expenditure calculated using Harris-Benedict equation. Detailed medical and nutritional anamnesis was taken and we measured the following body composition parameters using TANITA body composition analyser, BC-420MA: body mass index (BMI), fat mass (FM), visceral fat rating (VFR), muscle mass (MM) and skeletal muscle mass index (SMI) was calculated. Results Increased BMI was observed in 32% of the patients, while 41% of the whole sample had an increased FM. The mean value of skeletal muscle index (SMI) was 9,061,15 kg m−2 and it revealed the presence of moderate sarcopenia in 32 patients (43%), of which 30 were men. Indirect calorimetry (IC) obtained the value of resting energy expenditure (REE), with the measured REE (1569,81240,95 kcal) on average significantly lower than predicted (1640,36255,28 kcal), t(73)=−3.023, p &lt; 0.05. The results of this study revealed a significant prevalence of moderate sarcopenia in men, increased body mass and fat mass, and slightly lowered resting energy expenditure. There was no significant difference between body composition parameters and REE between different types of biological therapy. Conclusion The incidence of classical forms of malnutrition in this group of patients is significantly lower in comparison with standard therapy and previous experience. Most of the patients were well nourished and we observed trends toward overweight and sarcopenic obesity in some patients. A slight decrease in REE in the whole sample could be a reflection of impact of biological therapy on fat tissue and profound modulation of lipid metabolism as well as decreased muscle mass and physical activity level of the patients.


2018 ◽  
Vol 6 (23) ◽  
pp. e13940 ◽  
Author(s):  
Nousayhah Amdanee ◽  
Wenjuan Di ◽  
Juan Liu ◽  
Jing Yu ◽  
Yunlu Sheng ◽  
...  

Author(s):  
Claudia Irene Maushart ◽  
Jaël Rut Senn ◽  
Rahel Catherina Loeliger ◽  
Judith Siegenthaler ◽  
Fabienne Bur ◽  
...  

Abstract Context Thyroid hormone is crucial for the adaptation to cold. Objective To evaluate the effect of hyperthyroidism on resting energy expenditure (REE), cold-induced thermogenesis (CIT) and changes in body composition and weight. Design Prospective cohort study. Setting Endocrine outpatient clinic at tertiary referral center. Patients Eighteen patients with overt hyperthyroidism. Main Outcome Measures We measured REE during hyperthyroidism, after restoring euthyroid TH levels and after 3 months of normal thyroid function. In fourteen patients energy expenditure (EE) was measured before and after a mild cold exposure of two hours and CIT was the difference between EEcold and EEwarm. Skin temperatures at eight positions were recorded during the study visits. Body composition was assessed by dual X-ray absorption. Results Free T4 (fT4) and free T3 (fT3) decreased significantly over time (fT4, p=0.0003; fT3, p=0.0001). REE corrected for lean body mass (LBM) decreased from 42 ± 6.7 kcal/24h/kg LBM in the hyperthyroid to 33±4.4 kcal/24h/kg LBM (-21%, p&lt;0.0001 vs hyperthyroid) in the euthyroid state and three months later to 33 ± 5.2 kcal/24h/kg LBM (-21%, p=0.0022 vs. hyperthyroid, overall p&lt;0.0001). Free T4 (p=0.0001) and free T3 (p&lt;0.0001) were predictors of REE. CIT did not change from the hyperthyroid to the euthyroid state (p=0.96). Hyperthyroidism led to increased skin temperature at warm ambient conditions but did not alter core body temperature, nor skin temperature after cold exposure. Weight regain and body composition were not influenced by REE and CIT during the hyperthyroid state. Conclusions CIT is not increased in patients with overt hyperthyroidism.


2011 ◽  
Vol 57 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Ayana HASEGAWA ◽  
Chiyoko USUI ◽  
Hiroshi KAWANO ◽  
Shizuo SAKAMOTO ◽  
Mitsuru HIGUCHI

Nutrition ◽  
2018 ◽  
Vol 51-52 ◽  
pp. 60-65 ◽  
Author(s):  
Micheline Tereza Pires Souza ◽  
Pierre Singer ◽  
Gislaine Aparecida Ozorio ◽  
Vitor Modesto Rosa ◽  
Maria Manuela Ferreira Alves ◽  
...  

2020 ◽  
Vol 105 (4) ◽  
pp. e1741-e1748 ◽  
Author(s):  
Emanuele Muraca ◽  
Stefano Ciardullo ◽  
Alice Oltolini ◽  
Francesca Zerbini ◽  
Eleonora Bianconi ◽  
...  

Abstract Context Growing evidence suggests that appropriate levothyroxine (LT4) replacement therapy may not correct the full set of metabolic defects afflicting individuals with hypothyroidism. Objective To assess whether obese subjects with primary hypothyroidism are characterized by alterations of the resting energy expenditure (REE). Design Retrospective analysis of a set of data about obese women attending the outpatients service of a single obesity center from January 2013 to July 2019. Patients A total of 649 nondiabetic women with body mass index (BMI) &gt; 30 kg/m2 and thyrotropin (TSH) level 0.4–4.0 mU/L were segregated into 2 groups: patients with primary hypothyroidism taking LT4 therapy (n = 85) and patients with normal thyroid function (n = 564). Main outcomes REE and body composition assessed using indirect calorimetry and bioimpedance. Results REE was reduced in women with hypothyroidism in LT4 therapy when compared with controls (28.59 ± 3.26 vs 29.91 ± 3.59 kcal/kg fat-free mass (FFM)/day), including when adjusted for age, BMI, body composition, and level of physical activity (P = 0.008). This metabolic difference was attenuated only when adjustment for homeostatic model assessment of insulin resistance (HOMA-IR) was performed. Conclusions This study demonstrated that obese hypothyroid women in LT4 therapy, with normal serum TSH level compared with euthyroid controls, are characterized by reduced REE, in line with the hypothesis that standard LT4 replacement therapy may not fully correct metabolic alterations related to hypothyroidism. We are not able to exclude that this feature may be influenced by the modulation of insulin sensitivity at the liver site, induced by LT4 oral administration.


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