Abstract
ABSTRACTBackground: Reliable measurement of basal energy expenditure (BEE) in liver transplant (LT) recipients is necessary for adapting energy requirements, improving nutritional status and preventing weight gain. Indirect calorimetry (IC) is the gold standard for measuring BEE. However, BEE may be estimated through alternative methods, including electrical bioimpedance (BI), Harris-Benedict Equation (HBE), and Mifflin-St. Jeor Equation (MSJ) that carry easier applicability and lower cost. Aim: To determine which of the three alternative methods for BEE estimation (HBE, BI and MSJ) would provide most reliable BEE estimation in LT recipients. Methods: Prospective cross-sectional study including dyslipidemic LT recipients in follow-up at a 735-bed tertiary referral university hospital. Comparisons of BEE measured through IC to BEE estimated through each of the three alternative methods (HBE, BI and MSJ) were performed using Bland-Altman method and Wilcoxon Rank Sum test. Results: Forty-five patients were included, aged 58±10 years. BEE measured using IC was 1664±319 kcal for males, and 1409±221 kcal for females. Average difference between BEE measured by IC (1534±300 kcal) and BI (1584±377 kcal) was +50 kcal (p=0.0384). Average difference between the BEE measured using IC (1534±300 kcal) and MSJ (1479.6±375 kcal) was -55 kcal (p=0.16). Average difference between BEE values measured by IC (1534±300 kcal) and HBE (1521±283 kcal) was -13 kcal (p=0.326). Difference between BEE estimated through IC and HBE was less than 100 kcal for 39 of all 43patients. Conclusions: Among the three alternative methods, HBE was the most reliable for estimating BEE in LT recipients.
Highlights
Hypolipidemia may be a common finding in cirrhotic patients[3], there is a rising prevalence of obesity and metabolic syndrome after liver transplantation[1,11]
Among alternative methods for estimating the basal energy expenditure (BEE) - known as Basal Metabolic Rate (BMR) - stand Bioelectrical Impedance (BI), the Harris-Benedict equation (HBE) and Mifflin-St
The aim of this study was to measure BEE in liver transplant (LT) recipients through Indirect calorimetry (IC) and compare IC-calculated BEE values to those estimated through three alternative methods BI, Harris-Benedict Equation (HBE) and Mifflin-St
Summary
Hypolipidemia may be a common finding in cirrhotic patients[3], there is a rising prevalence of obesity and metabolic syndrome after liver transplantation[1,11]. Accurate estimation of the basal energy expenditure (BEE), in liver transplant (LT) recipients is necessary to guide improvements on nutritional status and prevent weight gain[2]. Indirect calorimetry (IC) is considered as the gold standard method for measuring BEE. It has technical limitations that include the need for well trained personnel and an elevated cost[2]. There are other methods for estimating the BEE that are easier. Among alternative methods for estimating the BEE - known as Basal Metabolic Rate (BMR) - stand Bioelectrical Impedance (BI), the Harris-Benedict equation (HBE) and Mifflin-St. Jeor equation (MSJ)
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