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Predicted estimates of resting energy expenditure have limited clinical utility in patients with cirrhosis: an individual patient data analysis. / Limon-Miro, Ana Teresa; Jackson, Clive Douglas; Eslamparast, Tannaz ; Yamanaka-Okumura, Hisami ; Plank, Lindsay Dudley ; Henry, Christiani Jeyakumar; Madden, Angela; 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 .

In: Journal of Hepatology, 26.01.2022.

Research output: Contribution to journalArticlepeer-review

Harvard

Limon-Miro, AT, Jackson, CD, Eslamparast, T, Yamanaka-Okumura, H, Plank, LD, Henry, CJ, Madden, A, Ferreira, LG, Kalaitzakis, E, Prieto de Frías, C, Knudsen, AW, Gramlich, L, Raman, M, Alberda, C, Belland, D, Den Heyer, V, Tandon, P & Morgan, MY 2022, 'Predicted estimates of resting energy expenditure have limited clinical utility in patients with cirrhosis: an individual patient data analysis', Journal of Hepatology. https://doi.org/10.1016/j.jhep.2022.01.005

APA

Limon-Miro, A. T., Jackson, C. D., Eslamparast, T., Yamanaka-Okumura, H., Plank, L. D., Henry, C. J., Madden, A., Ferreira, L. G., Kalaitzakis, E., Prieto de Frías, C., Knudsen, A. W., Gramlich, L., Raman, M., Alberda, C., Belland, D., Den Heyer, V., Tandon, P., & Morgan, M. Y. (2022). Predicted estimates of resting energy expenditure have limited clinical utility in patients with cirrhosis: an individual patient data analysis. Journal of Hepatology. https://doi.org/10.1016/j.jhep.2022.01.005

Vancouver

Author

Limon-Miro, Ana Teresa ; Jackson, Clive Douglas ; Eslamparast, Tannaz ; Yamanaka-Okumura, Hisami ; Plank, Lindsay Dudley ; Henry, Christiani Jeyakumar ; Madden, Angela ; 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 . / Predicted estimates of resting energy expenditure have limited clinical utility in patients with cirrhosis: an individual patient data analysis. In: Journal of Hepatology. 2022.

Bibtex

@article{fd11da83c4254cf687cb3efdb29dabff,
title = "Predicted estimates of resting energy expenditure have limited clinical utility in patients with cirrhosis: an individual patient data analysis",
abstract = "Background & Aim: 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.  Methods: Individual mREE data were available for 900 patients with cirrhosis (mean [±1SD] age 55.7±11.6 yr; 70% men; 52% south-east Asian) and 282 healthy controls (mean age 36.0±12.8 yr; 52% men; 18% south-east Asian). Metabolic status was classified using thresholds based on the mean±1SD 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 three new prediction models which included sex, ethnicity, body composition measures, and MELD scores.  Results: 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/24hr; p<0.001); there were no significant sex differences. The mean mREE was significantly higher in Caucasian than Asian patients (23.1±4.4 cf. 21.7±2.9 kcal/kg/24hr; p<0.001). Overall, 37.1% of Caucasians and 25.3% of Asians were classified as hypermetabolic. The differences between mREE and pREE were both statistically and clinically relevant; in the total patient population, pREE estimates ranged from 501 kcal/24hr less to 548 kcal/24hr more than the mREE. Newly-derived prediction equations provided better estimates of mREE but still had limited clinical utility.  Conclusions: Prediction equations do not provide useful estimates of REE in patients with cirrhosis. REE should be directly measured. ",
author = "Limon-Miro, {Ana Teresa} and Jackson, {Clive Douglas} and Tannaz Eslamparast and Hisami Yamanaka-Okumura and Plank, {Lindsay Dudley} and Henry, {Christiani Jeyakumar} and Angela Madden and Ferreira, {Livia Garcia} and Evangelos Kalaitzakis and {Prieto de Fr{\'i}as}, C{\'e}sar and Knudsen, {Anne Wilkens} and Leah Gramlich and Maitreyi Raman and Cathy Alberda and Dawn Belland and {Den Heyer}, Vanessa and Puneeta Tandon and Morgan, {Marsha Yvonne}",
note = "{\textcopyright} 2022 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver. This is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.1016/j.jhep.2022.01.005",
year = "2022",
month = jan,
day = "26",
doi = "10.1016/j.jhep.2022.01.005",
language = "English",
journal = "Journal of Hepatology",
issn = "0168-8278",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Predicted estimates of resting energy expenditure have limited clinical utility in patients with cirrhosis: an individual patient data analysis

AU - Limon-Miro, Ana Teresa

AU - Jackson, Clive Douglas

AU - Eslamparast, Tannaz

AU - Yamanaka-Okumura, Hisami

AU - Plank, Lindsay Dudley

AU - Henry, Christiani Jeyakumar

AU - Madden, Angela

AU - Ferreira, Livia Garcia

AU - Kalaitzakis, Evangelos

AU - Prieto de Frías, César

AU - Knudsen, Anne Wilkens

AU - Gramlich, Leah

AU - Raman, Maitreyi

AU - Alberda, Cathy

AU - Belland, Dawn

AU - Den Heyer, Vanessa

AU - Tandon, Puneeta

AU - Morgan, Marsha Yvonne

N1 - © 2022 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver. This is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.1016/j.jhep.2022.01.005

PY - 2022/1/26

Y1 - 2022/1/26

N2 - Background & Aim: 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.  Methods: Individual mREE data were available for 900 patients with cirrhosis (mean [±1SD] age 55.7±11.6 yr; 70% men; 52% south-east Asian) and 282 healthy controls (mean age 36.0±12.8 yr; 52% men; 18% south-east Asian). Metabolic status was classified using thresholds based on the mean±1SD 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 three new prediction models which included sex, ethnicity, body composition measures, and MELD scores.  Results: 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/24hr; p<0.001); there were no significant sex differences. The mean mREE was significantly higher in Caucasian than Asian patients (23.1±4.4 cf. 21.7±2.9 kcal/kg/24hr; p<0.001). Overall, 37.1% of Caucasians and 25.3% of Asians were classified as hypermetabolic. The differences between mREE and pREE were both statistically and clinically relevant; in the total patient population, pREE estimates ranged from 501 kcal/24hr less to 548 kcal/24hr more than the mREE. Newly-derived prediction equations provided better estimates of mREE but still had limited clinical utility.  Conclusions: Prediction equations do not provide useful estimates of REE in patients with cirrhosis. REE should be directly measured.

AB - Background & Aim: 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.  Methods: Individual mREE data were available for 900 patients with cirrhosis (mean [±1SD] age 55.7±11.6 yr; 70% men; 52% south-east Asian) and 282 healthy controls (mean age 36.0±12.8 yr; 52% men; 18% south-east Asian). Metabolic status was classified using thresholds based on the mean±1SD 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 three new prediction models which included sex, ethnicity, body composition measures, and MELD scores.  Results: 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/24hr; p<0.001); there were no significant sex differences. The mean mREE was significantly higher in Caucasian than Asian patients (23.1±4.4 cf. 21.7±2.9 kcal/kg/24hr; p<0.001). Overall, 37.1% of Caucasians and 25.3% of Asians were classified as hypermetabolic. The differences between mREE and pREE were both statistically and clinically relevant; in the total patient population, pREE estimates ranged from 501 kcal/24hr less to 548 kcal/24hr more than the mREE. Newly-derived prediction equations provided better estimates of mREE but still had limited clinical utility.  Conclusions: Prediction equations do not provide useful estimates of REE in patients with cirrhosis. REE should be directly measured.

U2 - 10.1016/j.jhep.2022.01.005

DO - 10.1016/j.jhep.2022.01.005

M3 - Article

JO - Journal of Hepatology

JF - Journal of Hepatology

SN - 0168-8278

ER -