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Resting energy expenditure and body composition in patients with head and neck cancer: An observational study leading to a new predictive equation.
Souza, Micheline Tereza Pires; Singer, Pierre; Ozorio, Gislaine Aparecida; Rosa, Vitor Modesto; Alves, Maria Manuela Ferreira; Mendoza López, Rossana Verónica; Waitzberg, Dan L.
Afiliación
  • Souza MTP; Indirect Calorimetry and Body Composition Clinic of the Cancer Institute of the State of São Paulo, São Paulo, Brazil. Electronic address: Micheline.pires@gmail.com.
  • Singer P; Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Ozorio GA; Multiprofessional Nutrition and Nutrition Therapy Team of the Cancer Institute of the State of São Paulo, São Paulo, Brazil.
  • Rosa VM; Nutrition and Dietetics Service of the Cancer Institute of the State of São Paulo, São Paulo, Brazil.
  • Alves MMF; Nutrition and Dietetics Service of the Cancer Institute of the State of São Paulo, São Paulo, Brazil.
  • Mendoza López RV; Center for Translational Research in Oncology (CTO) of the Cancer Institute of the State of São Paulo, São Paulo, Brazil.
  • Waitzberg DL; Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, Brazil.
Nutrition ; 51-52: 60-65, 2018.
Article en En | MEDLINE | ID: mdl-29605765
OBJECTIVES: Patients with head and neck cancer have changes in body composition and resting energy expenditure (REE) related to significant inflammatory processes. We investigated REE and body composition in a population of patients with head and neck cancer, comparing the measured REE with predicted energy expenditure and deriving an equation of anthropometric values and body composition. METHODS: This retrospective, observational, descriptive study of a single center included patients with head and neck cancer. We evaluated nutritional status by body mass index (BMI) and Patient-Generated Subjective Global Assessment (PG-SGA), body composition by electric bioimpedance, and REE by indirect calorimetry (IC). RESULTS: We included 140 patients, most of whom were men (80.7%), 60 y or older (58.6%), and had advanced disease (77.9%). Most were malnourished by BMI standards (77.9%) and severely malnourished according to the PG-SGA (49.3%), with a fat-free mass below the ideal values (82.9%) associated with sarcopenia (92.1%). Hypermetabolism was 57%. When comparing REE with the Harris-Benedict formula, we found the agreement limits from -546 613 to 240 708, the mean difference was -152 953 (95% confidence interval [CI], -185 844 to -120 062) and Pitman's variance test was r = -0.294 (P = 0.001). When we included the activity factor and the thermogenesis factor in REE and compared with Harris-Benedict, we found the agreement limits from -764.423 to 337.087, a mean difference of -213.668 (95% CI -259.684 to -167.652), and the Pitman's variance text at r = -0.292 (P = 0.001). CONCLUSION: Predictive equations, generally recommended by guidelines, are imprecise when compared with IC measures. Therefore, we suggest a new predictive equation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Composición Corporal / Metabolismo Energético / Neoplasias de Cabeza y Cuello Tipo de estudio: Health_economic_evaluation / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Nutrition Asunto de la revista: CIENCIAS DA NUTRICAO Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Composición Corporal / Metabolismo Energético / Neoplasias de Cabeza y Cuello Tipo de estudio: Health_economic_evaluation / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Nutrition Asunto de la revista: CIENCIAS DA NUTRICAO Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos