Energy Consumption In Patients Research Articles

Energy Metabolism in Residents in the Low- and Moderate Altitude Regions of Central Asia with MAFLD and Type 2 Diabetes Mellitus.

The knowledge about the features of energy metabolism in MAFLD in the population living at different climatic and geographic heights is lacking. The goal of this study is to explore the biochemical parameters of blood and erythrocyte energy consumption in patients with MAFLD with and without DM2 living in the low- and moderate-altitude regions of Central Asia. Our study was carried out on patients living in low-altitude mountains: Bishkek, altitude=750-800 m; n=67 (MAFLD with DM 2: n=24; MAFLD without DM2: n=25; control: n=18), and At-Bashy District, Naryn Region, altitude=2046-2300 m; n=58 (MAFLD with DM2: n=28; MAFLD without DM2: n=18; control: n=12). Non-alcoholic fatty liver disease was diagnosed according to history, laboratory tests, liver ultrasound, and exclusion of other liver diseases. The level of liver fibrosis was determined using the FIB-4 score. Blood adenosine 5'-triphosphate (ATP) was determined using the CellTiter-Glo method. Healthy residents living in moderate altitudes have significantly higher levels of cytosolic ATP in their blood (p+≤+0.05) than residents living in low mountains. MAFLD is characterized by an increase in the level of ATP concentration in their blood. ATP concentration decreased significantly in patients with MAFLD with DM2 living in moderate-altitude in comparison to those living in low-altitude mountains. The results suggest that chronic altitude hypoxia leads to a breakdown in adaptive mechanisms of energy metabolism of ATP in patients with MAFLD with type 2 DM.

Mirtazapine as Appetite Stimulant in Patients With Non–Small Cell Lung Cancer and Anorexia

Currently there is no standard therapy to improve cancer-related anorexia, hampering survival. Mirtazapine has been suggested as a feasible option in this context. To assess the effect of mirtazapine on appetite and energy consumption in patients with advanced non-small cell lung cancer (NSCLC). This randomized, double-blind, placebo-controlled clinical trial including adults was performed in a tertiary cancer care center from August 2018 to May 2022 with a follow-up of 8 weeks. Overall, 134 patients were screened; 114 were assessed for eligibility and 28 were excluded. Patients were randomized in a 1:1 ratio to receive mirtazapine, 15 mg, or placebo for 2 weeks followed by a dose escalation to 30 mg until week 8 or placebo. Both groups received nutritional assessment and dietary advice. Appetite was assessed by the Anorexia Cachexia Scale and energy intake. Dietary parameters were evaluated at baseline, 4 weeks, and 8 weeks, with a 24-hour dietary recall, and energy quantification based on the Mexican system of nutritional equivalents. A total of 86 patients met the inclusion criteria and were randomized to the placebo (n = 43) or the mirtazapine group (n = 43). The mean (SD) age was 63.5 (11.2) years, 41 were women (57.7%) and had adenocarcinoma, Eastern Cooperative Oncology Group performance status scale score of 1, stage IV NSCLC, and were receiving first-line treatment. Baseline characteristics were similar between groups. There was no difference in appetite scores in patients who received mirtazapine or placebo after 4 and 8 weeks. After 4 weeks, mirtazapine significantly increased energy intake (379.3 kcal; 95% CI, 1382.6-576.1; P < .001) including proteins (22.5 g; 95% CI, 11.5-33.4; P = .001), carbohydrates (43.4 g; 95% CI, 13.1-73.8; P = .006), and fats (13.2 g; 95% CI, 6.0-20.4; P = .006). Fats intake was significantly higher in patients in the mirtazapine group (14.5 g vs 0.7 g; P = .02) after 8 weeks. The mirtazapine group significantly decreased the proportion of patients with sarcopenia (82.8% vs 57.1%, P = .03) at 8 weeks. Patients on mirtazapine tolerated the treatment well, but reported a higher perception of nightmares at 2 weeks based on a 10 cm VAS score (0 [25th-75th percentile, 0-1] vs 0 [25th-75th percentile, 0-0] in the control group; P = .009) but this finding was nonsignificant after 4 and 8 weeks. In this randomized clinical trial of patients with advanced NSCLC, there was no difference in appetite scores in all patients who received mirtazapine or placebo, but the mirtazapine group had a significant increase in energy intake through the 4- and 8-week follow-up, mainly in fat intake, which is a better and crucial source of energy. The addition of mirtazapine in the treatment of patients with advanced NSCLC and anorexia may help these patients achieve their energy requirements and improve health-related quality of life, specifically emotional and cognitive functioning. ClinicalTrials.gov Identifier: NCT04748523.

The effect of robot-assisted walking in different modalities on cardiorespiratory responses and energy consumption in patients with subacute stroke

ABSTRACT Objectives The aim of our study was to evaluate the effect of robot-assisted walking in different modalities on cardiorespiratory responses and energy consumption in subacute stroke patients. Methods Our study consisted of 16 individuals between the ages of 18–65 years. Individuals diagnosed with hemiplegia after unilateral ischemic or haemorrhagic stroke constitute the stroke group. Eight subacute stroke individuals were included in the experimental group, and eight healthy individuals were included in the control group. Each participant tested on the Lokomat in three consecutive days in random sequence, with three tests: the first test: 100% guiding strength (GF)and 100% body weight support (BWS); the second test 80% GF, 50% BWS; the third test 60% GF, 30% BWS was achieved. Gas analyzer (Cosmed, Quark CPET, Italy) measurements were made with the help of a mask to evaluate the cardiorespiratory responses of the participants during all tests. Results In the comparison of the three test results of the two groups separately, the stroke group’s oxygen consumption (VO2), carbon dioxide production (VCO2), tidal volume (VT), pulse reserve (HRR), calories burned per hour (EEh), Borg dyspnea values, control group’s VO2, VCO2, VE, HR, HRR, and EEh, Borg values were statistically significantly different (p < 0.005). It was seen that the third test results were significantly greater than the first and second test results (p < 0.005). Discussion By decreasing GF and BWS values during robot-assisted walking, adequate cardio-metabolic and energy response in both subacute stroke patients and healthy individuals could be achieved. These results show us that it is important to consider the cardiorespiratory function of the patient when choosing training protocols.

Correlation between intestinal flora disruption and protein\u2013energy wasting in patients with end-stage renal disease

BackgroundDifferent dialysis treatments may affect the composition and structure of the intestinal flora of dialysis-treated chronic kidney disease (CKD) patients. This study aimed to analyze the correlations between the different flora and the nutritional indexes and further explore the potential metabolic pathways in patients with CKD in end-stage renal disease (ESRD).MethodsAltogether, 102 patients with ESRD were recruited and categorized into the hemodialysis (HD) group (N = 49) and the peritoneal dialysis (PD) group (N = 53). Their biochemical indexes, anthropometric indicators, and inflammatory markers were determined. The total genomic DNA was extracted for 16S ribosomal DNA sequencing. Furthermore, bioinformatics analysis was employed for functional analysis.ResultsAnthropometric indicators, including handgrip strength, mid-upper arm circumference, mid-upper arm muscle circumference, and body mass index, in the HD and PD groups showed a positive correlation with butyric acid-producing bacteria (Rosella and Phascolarctobacterium) and a negative correlation with conditional pathogens (Escherichia spp.). Meanwhile, the inflammatory markers, including high-sensitivity C-reactive protein and interleukin-6, were significantly higher in the PD-protein–energy wasting (PEW) group than in the PD-non-protein–energy wasting (NPEW) group; although they showed an increasing trend in the HD-PEW group, no significant difference was noted. Rosella was considerably scarce in the HD-PEW group than in the HD-NPEW group, whereas Escherichia was substantially more abundant in the PD-PEW group than in the PD-NPEW group. Compared with the HD group, the essential amino acid synthesis pathway, amino acid metabolism-related enzyme pathways, and aminoacyl-transfer RNA biosynthesis pathways were weakened in the PD group. Most carbohydrate metabolic pathways were weakened, although the tricarboxylic acid cycle was slightly enhanced. Concurrently, the fatty acid metabolism was enhanced, whereas fatty acid synthesis was weakened; the metabolic pathways of B vitamins were also weakened. These potential metabolic pathways of the various compounds released by intestinal flora showed a significant correlation with blood biochemical indexes, anthropometric indicators, and inflammatory markers.ConclusionIn patients with ESRD, different dialysis treatments affected the abundance of butyric acid-producing bacteria (Rosella and Phascolarctobacterium) and conditional pathogens (Escherichia spp.). Butyric acid-producing bacteria showed a positive correlation with PEW and showed a negative correlation with Escherichia. Improving the intestinal diversity and increasing the amount of butyric acid-producing bacteria, such as Blautella, Faecococcus, and Phascolarctobacterium, are potential therapeutic approaches to enhance protein–energy consumption in patients with ESRD.

Physical Activity Impacts Walking Distances and Energy Consumption of Patients with Peripheral Artery Disease

Lower extremity peripheral artery disease (PAD) is attributed to buildup of atherosclerotic plaques preventing adequate blood flow, leading to pain during walking, and ultimately physical inactivity. Normal day-to-day levels of physical activity may impact the distance a subject can walk before claudication pain onset, as well as their energy consumption capabilities. This study compared walking performance (initial claudication distance (ICD) and absolute claudication distance (ACD)), and energy consumption (EC) between active and inactive subjects with PAD. The distinction between groups was made using previous research that declared the average PAD patient walks 3586 steps/day. Ten subjects were classified as active (□3586 average steps/day) and sixteen participants as inactive (<3586 steps/day) based on a 7-day accelerometer measurement. The Gardner progressive treadmill test was used to asses ICD, ACD, and EC. EC was measured using a metabolic cart and calculated from the second minute of walking and the last minute prior to stopping due to claudication pain. The average ICD and ACD for the active group were 130.6±106.7 meters and 306.0±184.7 meters, respectively and 143.8±119.0 meters and 248.0±156.0 meters, respectively for the inactive group. The average EC for the second minute and last minute were 9.6±1.9 mlkg-1min-1 and 11.5±2.4 mlkg-1min-1 respectively for active group and 7.0±3.1 mlkg-1min-1 and 8.1±3.8 mlkg-1min-1 respectively for inactive group. The data suggests that the active group had better walking performance and greater energy consumption indicating increased efficiency of oxygen transport and extraction capability in the leg muscles.

Abnormal Gait and Neuromuscular Dysfunction Analysis in Patients with Lumbar Disc Herniation

Abstract The lumbar disc herniation (LDH) has become one of the most common orthopedic diseases. But the effects of LDH on the gait and neuromuscular activities have not been well understood. The purpose of this study was to examine the biomechanical and neuromuscular characteristics in LDH during walking. Sixteen patients with LDH and seven healthy subjects participated in the experiment. All the subjects were required to walk straight along a 5-meters line drawn on the ground at their usual speed. During walking, gait kinematic signals and surface electromyography (sEMG) signals were recorded simultaneously. Seven gait parameters (step length, stride length, step width, cadence, double support phase, single support phase and speed) were extracted for gait assessment. Root mean square (RMS) and median frequency (MDF) of the sEMG signals were extracted for evaluation of neuromuscular function. The bivariate correlation analysis was applied to examine the correlation between gait and muscle activation parameters. The patients with LDH showed decreased cadence, increased muscular activation and increased correlation between single support phase and muscle activation. The LDH can result in slower steps and increased muscle activation, indicating decreased gait flexibility and increased energy consumption in patients with LDH during walking. This study sheds light on the abnormal gait and neuromuscular dysfunction in the LDH patients. The methodology developed in this study may facilitate functional evaluation of LDH.

P.12 - Acute effect of muscle facilitation application on performance and energy expenditure in Duchenne muscular dystrophy

Kinesiological taping is a taping technique usually used for facilitating the muscles of athletes and patients with orthopaedic diseases. The purpose of this study was to investigate the acute effect of kinesiological taping on performance and energy consumption in patients with Duchenne muscular dystrophy (DMD). Twenty children with DMD who were in Level 1 and 2 according to the Brooke lower extremity functional classification (BLEFC) were included in the study. Kinesiological taping with facilitation technique was applied on bilateral quadriceps and tibialis anterior muscles. Performance was assessed by 6 minute walk test (6MWT) and timed performance tests including Gowers, ascending/descending 4 steps, and 10m walk. Energy expenditure was assessed by physiological expenditure index (PEI). The assessments were both applied before taping (BT) and 1 hour after taping (AT). The difference of assessment results between BT and AT was analyzed by Wilcoxon signed ranks test in nonparametric condition. The mean age of children was 99.15 ± 30.25 months. Nine children were classified as Level 1 and 11 as Level 2 according to BLEFC. 6MWT distance (BT: 361.55 ± 95.99m; AT: 368 ± 96.98m), the Gowers (BT: 7.02 ± 4.27 sec, AT: 6.84 ± 4.99 sec), ascending 4 steps (BT: 4.11 ± 2.58 sec, AT: 4.24 ± 3.49 sec), descending 4 steps (BT: 2.87 ± 1.55 sec, AT: 2.68 ± 1.70 sec) and energy consumption (BT: 0.42 ± 0.32beats/m, AT: 0.39 ± 0.41beats/m) were not significantly different between BT and AT (p > 0.05). A statistically significant decrease was determined in 10m walk time between BT and AT (BT: 14.20 ± 12.39 sec AT: 8.42 ± 2.72 sec) (p < 0.05). Our results showed that lower extremity kinesiogical taping did not effect performance and energy consumption in children with DMD in early period. However, it was thought that the long term effect of the kinesiological taping and its effect in the late period should be investigated.