P377
ASSESSING RESTING ENERGY EXPENDITURE IN ADULT ACUTE LEUKEMIA PATIENTS: INDIRECT CALORIMETRY VS. PREDICTIVE EQUATIONS
T. Nantes Guiráo1,*, J. M. Faccioli Sicchieri1,2, G. Vendruscolo Pizo1, P. Nogueira Bezan1, J. Micheletti1, L. Carvalho Palma2, L. Lôbo de Figueiredo Pontes2, A. Marliere Navarro1,2
1University of São Paulo, 2Hospital das Clínicas de Ribeirão Preto - FMRP USP, Ribeirão Preto, Brazil
Rationale: Diseases such as leukemia have the potential to alter resting energy expenditure (REE). Indirect calorimetry (IC) is recognized for its accuracy in measuring REE; however, its accessibility remains limited. Predictive equations offer a more readily available alternative, but their reliability in patients with these conditions varies, highlighting the need for further investigation in this area. This study aims to compare IC and predictive methods to better understand their variability and reliability in this population.
Methods: This study focused on adult patients beginning treatment for acute leukemia. REE was assessed using IC and calculated using the Harris-Benedict, Cunningham, Schofield, Mifflin-St. Jeor and FAO/WHO/UNU equations. The fat-free mass was determined using bioelectrical impedance spectroscopy. Statistical analysis was performed using t-tests, with the significance level set at p < 0.05.
Results: 16 patients were evaluated, with a mean age of 35 years (standard deviation ±12.8). The REE mean, measured using IC, was 1775 kcal. The predicted REE values from the various equations were as follows: Harris-Benedict (1625 kcal), Cunningham (1365 kcal), Schofield (1684 kcal), and Mifflin-St. Jeor (1604 kcal) and FAO/WHO/UNU (2332 kcal). The Cunningham equation underestimated the REE by 23% (p = 0.00), the Mifflin-St. The Jeor equation underestimated it by 10% (p = 0.034), while the FAO/WHO/UNU equation overestimated it by 31% (p = 0.00).
Image:
Conclusion: Among the five most frequently employed formulas in clinical practice, two underestimated and one overestimated the REE values in these patients. This highlights the need for a more accurate assessment of REE to prevent patients from receiving either excessive or insufficient caloric intake, which can significantly affect their nutritional management.
Disclosure of Interest: None declared