Which equation should be used to measure energy expenditure in HIV-infected patients?

Authors

  • Helena Siqueira VASSIMON Universidade de Franca
  • Jacqueline Pontes MONTEIRO Universidade de São Paulo
  • Alcyone Artioli MACHADO Universidade de São Paulo
  • Francisco José Albuquerque de PAULA Universidade de São Paulo
  • Andressa KUTSCHENKO Universidade de São Paulo
  • Alceu Afonso JORDÃO Universidade de São Paulo

Keywords:

Calorimetry, indirect, Energy metabolism, HIV

Abstract

Objective
In view of the practical need to use equations for the evaluation of energy expenditure in HIV-infected patients, the objective of the present study was to determine the concordance between the energy expenditure values obtained by indirect calorimetry as the gold standard and those obtained by predictive equations elaborated from data for the healthy population: Harris-Benedict, Schofield and Cunningham, and by equations elaborated from data for HIV-infected patients: Melchior (1991-1993).

Methods
The study was conducted at the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto on 32 HIV-infected men under treatment with highly active antiretroviral therapy. Resting energy expenditure was measured by indirect calorimetry and estimated on the basis of measurement of O2 consumption and CO2
production.

Results
Statistical analysis revealed weak concordance for the Harris-Benedict (0.38) and Cunningham (0.34) equations and satisfactory concordance for the Schofield equation (0.47). Only the two Melchior equations (1991 and 1993) showed strong concordance with the values obtained by indirect calorimetry (0.63 and 0.66, respectively) and could be used in practice.

Conclusion
The best equations seem to be population-specific, such as the Melchior equations elaborated for HIV-infected patients.

References

Vassimon HS, Jordao AA, Paula FJA, Machado AA, Monteiro JP. Comparison of bioelectrical impedance with skinfold thickness and X-ray

absorptiometry to measure body composition in HIV-infected with lipodistrophy. Nutr Hosp. 2011; 26(3):458-64. doi: 10.3305/nh.2011.26.3.4794.

Lichtenstein K, Balasubramanyam A, Sekhar R, Freedland E. HIV-associated adipose redistribution syndrome (HARS): Etiology and pathophysiological mechanisms. AIDS Res Ther. 2007; 4:14. doi: 10.1186/1742-6405-4-14.

Haugen HA, Chan LN, Li F. Indirect calorimetry: A practical guide for clinicians. Nutr Clin Pract. 2007; 22(4):377-88.

Wahrlich V, Anjos LA. Historical and methodological aspects of the measurement and prediction of basal metabolic rate: A review. Cad Saúde Pública. 2001; 17(4):801-17.

Lopes AL, Silva, DP, Zacca R, Castro FAS, Oliveira AR. Validação de equações de predição da taxa metabólica basal por meio de calorimetria indireta em indivíduos obesos. Rev Bras Ativ Física Saúde. 2010; 15(4):243-38.

Fett CA, Fett WC, Marchini JS. Resting energy expenditure measured vs. estimated and this relationship with body composition in women. Arq Bras Endocrinol Metabol. 2006; 50(6):1050-8.

Rao Z, Wu X, Liang B, Wang M, Hu W. Comparison of five equations for estimating resting energy expenditure in Chinese young, normal weight healthy adults. Eur J Med Res. 2012; 17-26. doi: 10.1186/2047-783X-17-26.

Batterham MJ, Morgan-Jones J, Greenop P, Garsia R, Gold J, Caterson I. Calculating energy requirements for men with HIV/AIDS in the era of

highly active antiretroviral therapy. Eur J Clin Nutr. 2003; 57(2):209-17.

Weir JB. New methods for calculating metabolic rate with special reference to protein metabolism. 1949. Nutrition. 1990; 6(3):213-21.

Cunningham JJ. Body composition as a determinant of energy expenditure: A synthetic review and a proposed general prediction equation. Am J Clin Nutr. 1991; 54(6):963-9.

Harris JA, Benedict FG. A biometric study of human basal metabolism. Proc Natl Acad Sci. 1918; 4(12):370-3.

Melchior JC, Raguin G, Boulier A, Bouvet E, Rigaud D, Matheron S, et al. Resting energy expenditure in human immunodeficiency virus-infected patients: Comparison between patients with and without secondary infections. Am J Clin Nutr. 1993; 57(5):614-9.

Melchior JC, Salmon D, Rigaud D, Leport C, Bouvet E, Detruchis P, et al. Resting energy expenditure is increased in stable, malnourished HIV-infected patients. Am J Clin Nutr. 1991; 53(2):437-41.

Schofield WN. Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr. 1985; 39(Suppl 1):5-41.

St Laurent RT. Evaluating agreement with a gold standard in method comparison studies. Biometrics. 1998; 54(2):537-45.

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977; 33(1):159-74.

Bland JM, Altman DG. Statisctical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986; 327(8476): 307-10.

Batterham MJ. Investigating heterogeneity in studies of resting energy expenditure in persons with HIV/AIDS: A meta-analysis. Am J Clin Nutr. 2005; 81(3):702-13.

Vassimon HS, Paula FJ, Machado AA, Monteiro JP, Jordao AA Jr. Hypermetabolism and altered substrate oxidation in HIV-infected patients with lipodystrophy. Nutrition. 2012; 28(9):912-6. doi: 10.1016/j.nut.2011.12.010.

Hommes MJ, Romijn JA, Endert E, Sauerwein HP. Resting energy expenditure and substrate oxidation in human immunodeficiency virus (HIV)-infected asymptomatic men: HIV affects host metabolism in the early asymptomatic stage. Am J Clin Nutr. 1991; 54(2):311-5.

Shevitz AH, Knox TA, Spiegelman D, Roubenoff R, Gorbach SL, Skolnik PR. Elevated resting energy expenditure among HIV-seropositive persons receiving highly active antiretroviral therapy. Aids. 1999; 13(11):1351-7.

Kosmiski LA, Bessesen DH, Stotz SA, Koeppe JR, Horton TJ. Short-term energy restriction reduces resting energy expenditure in patients with HIV lipodystrophy and hypermetabolism. Metabolism. 2007; 56(2):289-95.

Kosmiski LA, Ringham BM, Grunwald GK, Bessesen DH. Dual-energy X-ray absorptiometry modeling to explain the increased resting energy expenditure associated with the HIV lipoatrophy syndrome. Am J Clin Nutr. 2009; 90(6):1525-31.

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Published

2023-04-20

How to Cite

Siqueira VASSIMON, H. ., Pontes MONTEIRO, J., Artioli MACHADO, A. ., Albuquerque de PAULA, F. J. ., KUTSCHENKO, A. ., & JORDÃO, A. A. . (2023). Which equation should be used to measure energy expenditure in HIV-infected patients?. Brazilian Journal of Nutrition, 26(2). Retrieved from https://periodicos.puc-campinas.edu.br/nutricao/article/view/8414

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ORIGINAL ARTICLE