Predicted estimates of resting energy expenditure have limited clinical utility in patients with cirrhosis

Malnutrition is associated with adverse clinical outcomes in patients with cirrhosis. Accurate assessment of energy requirements is needed to optimize dietary intake. Resting energy expenditure (REE), the major component of total energy expenditure, can be measured using indirect calorimetry (mREE)...

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Published in:Journal of hepatology 2022-07, Vol.77 (1), p.98-107
Main Authors: Limon-Miro, Ana Teresa, Jackson, Clive Douglas, Eslamparast, Tannaz, Yamanaka-Okumura, Hisami, Plank, Lindsay Dudley, Henry, Christiani Jeyakumar, Madden, Angela Mary, Ferreira, Livia Garcia, Kalaitzakis, Evangelos, Prieto de Frías, César, Knudsen, Anne Wilkens, Gramlich, Leah, Raman, Maitreyi, Alberda, Cathy, Belland, Dawn, Den Heyer, Vanessa, Tandon, Puneeta, Morgan, Marsha Yvonne
Format: Article
Language:English
Subjects:
Age
Body composition
Body weight
Calorimetry
Cirrhosis
Dietary intake
Energy
Energy expenditure
Energy requirements
Estimates
Ethnicity
indirect calorimetry
Liver cirrhosis
liver disease
Liver diseases
Malnutrition
Minority & ethnic groups
Patients
prediction equations
Prediction models
resting energy expenditure
sex
Sex differences
White people
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Summary:Malnutrition is associated with adverse clinical outcomes in patients with cirrhosis. Accurate assessment of energy requirements is needed to optimize dietary intake. Resting energy expenditure (REE), the major component of total energy expenditure, can be measured using indirect calorimetry (mREE) or estimated using prediction equations (pREE). This study assessed the usefulness of predicted estimates of REE in this patient population. Individual mREE data were available for 900 patients with cirrhosis (mean [±1 SD] age 55.7±11.6 years-old; 70% men; 52% south-east Asian) and 282 healthy controls (mean age 36.0±12.8 years-old; 52% men; 18% south-east Asian). Metabolic status was classified using thresholds based on the mean ± 1 SD of the mREE in the healthy controls. Comparisons were made between mREE and pREE estimates obtained using the Harris-Benedict, Mifflin, Schofield and Henry equations. Stepwise regression was used to build 3 new prediction models which included sex, ethnicity, body composition measures, and model for end-stage liver disease scores. The mean mREE was significantly higher in patients than controls when referenced to dry body weight (22.4±3.8 cf. 20.8±2.6 kcal/kg/24 hr; p
ISSN:0168-8278
1600-0641
DOI:10.1016/j.jhep.2022.01.005