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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Jan 5, 2021; 12(1): 1-12
Published online Jan 5, 2021. doi: 10.4292/wjgpt.v12.i1.1
Resting energy expenditure in cirrhotic patients with and without hepatocellular carcinoma
Ana Cristhina Henz, Claudio Augusto Marroni, Daniella Miranda da Silva, Joise Munari Teixeira, Thiago Thomé Silveira, Shaiane Ferreira, Andresa Thomé Silveira, Natalia Perin Schmidt, Jessica Taina Stein, Roberta Goulart Rayn, Sabrina Alves Fernandes
Ana Cristhina Henz, Sabrina Alves Fernandes, Department of Nutrition, Centro Universitário Metodista (IPA), Porto Alegre 90420-060, RS, Brazil
Claudio Augusto Marroni, Department of Gastroenterology and Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 91760470, RS, Brazil
Daniella Miranda da Silva, Postgraduate Program in Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90050170, RS, Brazil
Joise Munari Teixeira, Postgraduate Program in Medicine, Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90050170, RS, Brazil
Thiago Thomé Silveira, Shaiane Ferreira, Andresa Thomé Silveira, Natalia Perin Schmidt, Jessica Taina Stein, Roberta Goulart Rayn, Hepatology Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90050170, RS, Brazil
Author contributions: Henz AC participated in the creation, elaboration, data collection, tabulation, statistical analysis and writing of the scientific article, Da Silva DM contributed to the creation, elaboration, tabulation, data collection and writing of the scientific article, Teixeira JM assisted in data collection, Silveira TT assisted in data collection, Ferreira S assisted in data collection, Silveira AT assisted in data collection, Schmidt NP assisted in data collection, Stein JT assisted in data collection, Rayn RG assisted in data collection, Marroni CA and Fernandes SA contributed to the creation, elaboration, data collection, tabulation, statistical analysis and writing and revision of the scientific article.
Institutional review board statement: This project was approved by the Research Ethics Committee of Irmandade Santa Casa de Misericórdia de Porto Alegre (number 2.387.800).
Informed consent statement: Patients who agreed to participate in the study signed an informed consent form.
Conflict-of-interest statement: All authors declare that there are no conflicts of interest related to this article.
Data sharing statement: No additional data are available for sharing.
STROBE statement: The authors have read the STROBE Statement checklist of items, and the manuscript was prepared and revised according to the STROBE Statement checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Sabrina Alves Fernandes, PhD, Professor, Department of Nutrition, Centro Universitário Metodista (IPA), Porto Alegre 90420-060, RS, Brazil.
sabrinaafernandes@gmail.com
Received: June 30, 2020
Peer-review started: June 30, 2020
First decision: September 12, 2020
Revised: September 26, 2020
Accepted: November 12, 2020
Article in press: November 12, 2020
Published online: January 5, 2021
Processing time: 188 Days and 21 Hours
BACKGROUND
The diagnosis of malnutrition in patients with independent hepatocellular carcinoma (HCC) varies from 20% to 50%, is related to important complications and has a direct impact on the prognosis. Determination of the resting energy expenditure (REE) has become an important parameter in this population, as it allows therapeutic adjustments to recover their nutritional status. The REE in cirrhosis, with and without HCC, is not clearly defined, and requires the identification and definition of the best nutritional approach.
AIM
To evaluate the REE of patients with cirrhosis, with and without HCC.
METHODS
This is a prospective observational study evaluating the REE of 118 patients, 33 with cirrhosis and hepatocellular carcinoma and a control group of 85 patients with cirrhosis without HCC, using indirect calorimetry (IC), bioimpedance, and predictive formulas.
RESULTS
The REE determined by IC in cirrhotic patients with HCC was 1643 ± 364 and in those without HCC was 1526 ± 277 (P = 0.064). The REE value as assessed by bioimpedance was 1529 ± 501 for those with HCC and 1660 ± 385 for those without HCC (P = 0.136). When comparing the values of REE determined by IC and predictive formulas in cirrhotics with HCC, it was observed that only the formulas of the Food and Agriculture Organization (FAO)/World Health Organization (WHO) (1985) and Cunningham (1980) presented values similar to those determined by IC. When comparing the REE values determined by IC and predictive formulas in cirrhotics without HCC, it was observed that the formulas of Schofield (1985), FAO/WHO (1985), WHO (2000), Institute of Medicine (IOM) (2005) and Katch and McArdie (1996) presented values similar to those determined by IC.
CONCLUSION
The FAO/WHO formula (1985) could be used for cirrhotic patients with or without HCC; as it is the one with the values closest to those obtained by IC in these cirrhotic patients.
Core Tip: This prospective study was conducted to evaluate the resting energy expenditure in 118 patients with and without hepatocellular carcinoma. Indirect calorimetry is considered the golden standard for determining resting energy expenditure; however, when this is impossible, use of the FAO/WHO formula (1985) in this population is indicated.
