Equation to estimate resting energy expenditure in adolescents with sickle cell anemia.
BACKGROUND
Basal energy requirements are higher in adolescents with sickle cell anemia (SCA) than in healthy control subjects. However, no equation is available to accurately predict their energy needs.


OBJECTIVE
Our objective was to develop a clinically useful equation to estimate resting energy expenditure (REE) in adolescents with SCA.


METHODS
REE and other components of total energy expenditure were measured in adolescents with SCA (n = 37) and in control subjects (n = 23) for 24 h in a whole-room indirect calorimeter. Multiple linear regression analysis was used to describe the relations of REE with independent variables such as sex, weight, height, fat-free mass, fat mass, age, and hemoglobin concentration in adolescents with SCA. The Bland-Altman comparison technique was used to compare values predicted by existing equations with measured REE values.


RESULTS
Mean (+/-SD) measured REEs were 7746 +/- 974 and 6332 +/- 869 kJ/d in the male and female subjects with SCA, respectively, and these values were 16% higher than those in the healthy control subjects. Standard equations underestimated REE by 12% (P </= 0.001) in adolescents with SCA and overestimated REE by 4% in control subjects (P = 0.01-0.29). Several REE regression equations for SCA were developed. The most parsimonious equation for males was REE (kJ/d) = 5461 + 77.7.weight (kg) - 233.2.hemoglobin (g/dL), or REE (kcal/d) = 1305 + 18.6.weight (kg) - 55.7.hemoglobin (g/dL). For females, the most parsimonious equation was REE (kJ/d) = 4603 + 55.6.weight (kg) - 126.2.hemoglobin (g/dL), or REE (kcal/d) = 1100 + 13.3.weight (kg) - 30.2.hemoglobin (g/dL).


CONCLUSIONS
The new equations have better agreement with the basal metabolic needs of adolescents with SCA than do standard predictive equations.
Buchowski
Maciej S
MS
Center for Nutrition and Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA. maciej.buchowski@mcmail.vanderbilt.edu
Chen
Kong Y
KY
Byrne
Daniel
D
Wang
Winfred C
WC
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000378:metabolism*; D001835:Body Weight; D002153:Calorimetry, Indirect; D002149:Energy Intake; D004734:Energy Metabolism; D005188:False Negative Reactions; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D016014:Linear Models; D008297:Male; D008433:Mathematics; D009751:Nutritional Requirements; D012146:Rest
D006454:Hemoglobins