Conceitos da calorimetria indireta sobre distúrbios metabólicos: uma revisão narrativa
DOI:
https://doi.org/10.11606/issn.1679-9836.v99i6p581-590Palavras-chave:
Calorimetria indireta, Oxidação de substratos, Quociente respiratório, Gasto energético, Distúrbios metabólicosResumo
Introdução: A calorimetria indireta continua sendo um padrão ouro na avaliação do gasto energético de repouso no campo clínico. Por meio de suas medições, é possível oferecer as necessidades energéticas de um paciente para maximizar os benefícios da terapia nutricional. No entanto, os conceitos e as bases metodológicas dos dados coletados podem ser dificultosos para serem interpretados pelos usuários na prática clínica. Objetivo: abordar os conceitos de gasto energético diário total e seus componentes, e, apresentar os aspectos metodológicos da calorimetria indireta que podem servir como guia no campo clínico. Método: Revisão bibliográfica narrativa, realizada pelas bases de dados eletrônicas Pubmed (US National Library of Medicine), SCOPUS e Scientific Electronic Library Online (SciELO). A pesquisa foi realizada no período entre 1905-2019, utilizando os seguintes identificadores em Descritores em Ciências da Saúde: Metabolismo Basal, Metabolismo Energético e Calorimetria Indireta. Foram selecionadas 55 pesquisas publicadas que apresentaram conteúdos relacionados aos objetivos deste estudo. Resultado: O gasto energético total diário (GETD) é composto por três componentes principais, tais como: atividade física (AF), efeito térmico dos alimentos (TEF) e taxa metabólica basal (TMB) e / ou gasto energético de repouso (GER). O GER é geralmente avaliado por calorimetria indireta, que também fornece informações sobre o coeficiente respiratório (CR) e oxidação de substratos, que pode variar de acordo com o metabolismo do paciente, como algum distúrbio metabólico, obesidade ou desnutrição. Portanto, o manejo adequado dos aspectos metodológicos da calorimetria indireta e sua posterior interpretação nos distúrbios metabólicos é fundamental para garantir a qualidade dos resultados. Conclusão: Os conceitos de gasto energético e as bases metodológicas da calorimetria indireta são relevantes para fornecer uma atenção individualizada aos pacientes com distúrbios metabólicos. As descrições desta revisão podem ser utilizadas como um guia prático, auxiliando a compreensão da aplicação correta da técnica de calorimetria indireta, em estudos relacionados ao gasto energético com ênfase nos distúrbios metabólicos.
Downloads
Referências
Rattanachaiwong S, Singer P. Indirect calorimetry as point of care testing. Clin Nutr. 2019;1-14. https://doi.org/10.1016/j.clnu.2018.12.035.
Fassini PG, Silva JH, Lima CM, Cunha SF, Wichert-Ana L, Marchini JS, et al. Indirect calorimetry: from expired CO2 production, inspired O2 consumption to energy equivalent. J Obes Weight Loss Ther. 2015;s5(001):8–10. https://doi:10.4172/2165-7904.S5-001.
Levine JA. Non-exercise activity thermogenesis (NEAT). Nutr Rev. 2004;62(2):82-97. https://doi.org/10.1111/j.1753-4887.2004.tb00094.x.
Trexler ET, Smith-Ryan AE, Norton LE. Metabolic adaptation to weight loss: Implications for the athlete. J Int Soc Sports Nutr. 2014;11(1):1-7. https://doi.org/10.1186/1550-2783-11-7.
del Re MP, de Melo CM, dos Santos MV, Tufik S, de Mello MT. Applicability of predictive equations for resting energy expenditure in obese patients with obstructive sleep apnea. Arch Endocrinol Metab. 2017;61(3):257-62.5. http://dx.doi.org/10.1590/2359-3997000000228.
Redondo RB. Gasto energético en reposo; métodos de evaluación y aplicaciones. Nutr Hosp. 2015;31:245-54. https://doi.org/10.14642/RENC.2015.21.sup1.5071.
Fullmer S, Benson-Davies S, Earthman CP, Frankenfield DC, Gradwell E, Lee PSP, et al. Evidence analysis library review of best practices for performing indirect calorimetry in healthy and non-critically ill individuals. J Acad Nutr Diet. 2015;115(9):1417-46. https://doi.org/10.1016/j.jand.2015.04.003.
von Loeffelholz C, Birkenfeld A. The role of non-exercise activity thermogenesis in human obesity. 2018 Apr 9. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dungan K, et al., editors. Endotext. South Dartmouth (MA): MDText.com, Inc.; 2000–. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25905303.
McManus AM. Physical activity - a neat solution to an impending crisis. J Sports Sci Med. 2007;6(3):368-73. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3787287/.
Lam YY, Ravussin E. Analysis of energy metabolism in humans: a review of methodologies. Mol Metab. 2016;5(11):1057-71. https://doi.org/10.1016/j.molmet.2016.09.005.
Segal KR, Pi-Sunyer FX. Exercise and obesity. Med Clin North Am. 1989;73(1):217-36.
Psota T. Measuring energy expenditure in clinical populations: rewards and challenges. Eur J Clin Nutr. 2013;67(5):436-42. https://doi.org/10.1038/ejcn.2013.38.
Kinabo JL, Durnin JVGA. Thermic effect of food in man: effect of meal composition, and energy content. Br J Nutr. 1990;64(1):37-44. https://doi.org/10.1079/BJN19900007.
Jaquier E. Human Whole Body direct calorimetry. IEEE Eng Med Biol Mag. 1986;5(2):12-4. https://doi.org/10.1109/MEMB.1986.5006277.
Melanson EL, Dykstra JC, Szuminsky N. A novel approach for measuring energy expenditure in free-living humans. Annu Int Conf IEEE Eng Med Biol Soc. 2009;2009:6873-7. doi: 10.1109/IEMBS.2009.5333124.
Schoeller DA, Webb P. Five-day comparison of the doubly labeled water method with respiratory gas exchange. Am J Clin Nutr. 1984;40(1):153-8. https://doi.org/10.1093/ajcn/40.1.153.
International Atomic Energy Agency. Assessment of body composition and total energy expenditure in humans using stable isotope technique.. IAEA, Vienna: IAEA; 2009. (Human Health Series No. 3). Available from: https://www-pub.iaea.org/MTCD/Publications/PDF/Pub1370_web.pdf.
Speakman JR, Thomson SC. Validation of the labeled bicarbonate technique for measurement of short-term energy expenditure in the mouse. Z Ernahrungswiss. 1997;36(4):273-7. https://doi.org/10.1007/BF01617797.
Westerterp KR. Doubly labelled water assessment of energy expenditure: principle, practice, and promise. Eur J Appl Physiol. 2017;117(7):1277-85. https://doi.org/10.1007/s00421-017-3641-x.
Wu XY, Han LH, Zhang JH, Luo S, Hu JW, Sun K. The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: a systematic review. PLoS One. 2017;12(11):e0187668. https://doi.org/10.1371/journal.pone.0187668.
Brandao CFC, Carvalho FG, Souza A de O, Junqueira‐Franco MVM, Batitucci G, Couto‐Lima CA, et al. Physical training, UCP1 expression, mitochondrial density, and coupling in adipose tissue from women with obesity. Scand J Med Sci Sports. 2019;29(11):1699-706. https://doi.org/10.1111/sms.13514.
Corder K, Ekelund U, Steele RM, Wareham NJ, Brage S. Assessment of physical activity in youth. J Appl Physiol. 2008;105(3):977-87. https://doi.org/10.1152/japplphysiol.00094.2008.
Hills AP, Mokhtar N, Byrne NM. Assessment of physical activity and energy expenditure: an overview of objective measures. Front Nutr. 2014;1:5. https://doi.org/10.3389/fnut.2014.00005.
Marchini JS, Fett CA, Fett WC, Suen VM. Calorimetria: aplicações práticas e considerações críticas. Fit Perform J. 2005;4(2):90-6. doi: 10.3900/fpj.4.2.90.p.
Achten J, Jeukendrup AE. Heart Rate Monitoring. Sport Med. 2003;33(7):517-38. https://doi.org/10.2165/00007256-200333070-00004.
Tudor-Locke C, Bassett DR. How many steps/day are enough? Sport Med. 2004;34(1):1-8. https://doi.org/10.2165/00007256-200434010-00001.
Le-Masurier GC, Sidman CL, Corbin CB. Accumulating 10,000 steps: does this meet current physical activity guidelines? Res Q Exerc Sport. 2003;74(4):389-94. https://doi.org/10.1080/02701367.2003.10609109.
Tharion WJ, Yokota M, Buller MJ, DeLany JP, Hoyt RW. Total energy expenditure estimated using a foot-contact pedometer. Med Sci Monit. 2004;10(9):CR504-9.
Ridgers ND, Fairclough S. Assessing free-living physical activity using accelerometry: practical issues for researchers and practitioners. Eur J Sport Sci. 2011;11(3):205-13. https://doi.org/10.1080/17461391.2010.501116.
Bouten C V, Sauren AA, Verduin M, Janssen JD. Effects of placement and orientation of body-fixed accelerometers on the assessment of energy expenditure during walking. Med Biol Eng Comput. 1997;35(1):50-6. https://doi.org/10.1007/BF02510392.
de Oliveira BAP, Nicoletti CF, de Oliveira CC, Pinhel MA de S, Quinhoneiro DCG, Noronha NY, et al. A new resting metabolic rate equation for women with class III obesity. Nutrition. 2018;49:1-6. https://doi.org/10.1016/j.nut.2017.11.024.
Willis EA, Herrmann SD, Ptomey LT, Honas JJ, Bessmer CT, Donnelly JE, et al. Predicting resting energy expenditure in young adults. Obes Res Clin Pract. 2016;10(3):304–14. https://doi.org/10.1016/j.orcp.2015.07.002.
Brúsik M, Štrbová Z, Petrášová D, Pobeha P, Kuklišová Z, Tkáčová R, et al. Increased resting energy expenditure and insulin resistance in male patients with moderate to severe obstructive sleep apnoea. Physiol Res. 2016;65(6):969-77. doi: 10.33549/physiolres.933277.
Huang KC, Kormas N, Steinbeck K, Loughnan G, Caterson ID. Resting metabolic rate in severely obese diabetic and nondiabetic subjects. Obes Res. 2004;12(5):840-5. https://doi.org/10.1038/oby.2004.101.
Branson RD, Johannigman JA. The Measurement of Energy Expenditure. Nutr Clin Pract. 2004;19(6):622-36. https://doi.org/10.1177/0115426504019006622.
da Rocha EEMM, Alves VGF, Da Fonseca RB V. Indirect calorimetry: methodology, instruments and clinical application. Curr Opin Clin Nutr Metab Care. 2006;9(3):247-56. https://doi.org/0.1097/01.mco.0000222107.15548.f5.
Arch JRS, Hislop D, Wang SJY, Speakman JR. Some mathematical and technical issues in the measurement and interpretation of open-circuit indirect calorimetry in small animals. Int J Obes. 2006;30(9):1322-31. https://doi.org/10.1038/sj.ijo.0803280.
Birnbaumer P, Müller A, Tschakert G, Sattler MC, Hofmann P. Performance enhancing effect of metabolic pre-conditioning on upper-body strength-endurance exercise. Front Physiol. 2018;9:1-10. https://doi.org/10.3389/fphys.2018.00963.
Lusk G. Animal calorimetry. J Biol Chem. 1924;59(1):41-2. Available from: https://www.jbc.org/content/59/1/41.full.pdf.
Weir JB d. DB V. New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol. 1949;109(1–2):1-9. https://doi.org/10.1113/jphysiol.1949.sp004363.
Consolazio CF, Johnson RE, Pecora LJ. Physiological measurements of metabolic functions in man. New York: McGraw-Hill; 1963. [Resenha de Kleiber M. Science. 1963;141(3575):35]. Availabe from: https://science.sciencemag.org/content/141/3575/35.1.
Pupim LB, Martin CJ, Ikizler TA. Assessment of protein and energy nutritional status. Nutr Manag Ren Dis. 2013;137-58. https://doi.org/10.1016/j.semnephrol.2005.09.010.
Petersen MC, Vatner DF, Shulman GI. Regulation of hepatic glucose metabolism in health and disease. Nat Rev Endocrinol. 2017;13(10):572-87. https://doi.org/10.1038/nrendo.2017.80.
Simonson DC, DeFronzo RA. Indirect calorimetry: Methodological and interpretative problems. Am J Physiol Endocrinol Metab. 1990 258(321-3):E399-412. https://doi.org/10.1152/ajpendo.1990.258.3.E399.
Jequier E, Acheson K, Schutz Y. Assessment of energy expenditure and fuel utilization in man. Annu Rev Nutr. 1987;7(1):187-208. https://doi.org/10.1146/annurev.nu.07.070187.001155.
Frayn KN. Calculation of substrate oxidation rates in vivo from gaseous exchange. J Appl Physiol. 1983;55(2):628-34. doi: https://doi.org/10.1152/jappl.1983.55.2.628.
Westenskow DR, Schipke CA, Raymond JL, Saffle JR, Becker JM, Young EW, et al. Calculation of metabolic expenditure and substrate utilization from gas exchange measurements. J Parenter Enter Nutr. 1988;12(1):20-4. https://doi.org/10.1152/jappl.1983.55.2.628.
Ferrannini E. The theoretical bases of indirect calorimetry: a review. Metabolism. 1988;37(3):287-301. https://doi.org/10.1016/0026-0495(88)90110-2.
Cathcart EP, Cuthbertson DP. The composition and distribution of the fatty substances of the human subject. J Physiol. 1931;72(3):349-60. https://doi.org/10.1113/jphysiol.1931.sp002779.
Folin O. Laws governing the chemical composition of unine. Am J Physiol. 1905;(13):66-115. Available from: https://journals.physiology.org/doi/pdf/10.1152/ajplegacy.1905.13.1.66.
Reid CL, Carlson GL. Indirect calorimetry--a review of recent clinical applications. Curr Opin Clin Nutr Metab Care. 1998;1(3):281-6. https://doi.org/10.1097/00075197-199805000-00008.
Compher C, Frankenfield D, Keim N, Roth-Yousey L. Best practice methods to apply to measurement of resting metabolic rate in adults: a systematic review. J Am Diet Assoc. 2006;106(6):881-903. https://doi.org/10.1016/j.jada.2006.02.009
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2020 Rocio San Martin, Camila Fernanda Cunha Brandao, Marcia Varella Morandi Junqueira-Franco, Gizela Pedroso Junqueira, Fernando Bahdur Chueire, Joyce Cristina Santos de Oliveira, Selma Freire Carvalho da Cunha, Vivian Marques Miguel Suen, Julio Sergio Marchini
Este trabalho está licenciado sob uma licença Creative Commons Attribution-ShareAlike 4.0 International License.
Como Citar
Dados de financiamento
-
Conselho Nacional de Desenvolvimento Científico e Tecnológico
Números do Financiamento 303563/2018-4, 420753/2018-4 e 154169/2018-8
