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. 1997 Sep;52(9):780–785. doi: 10.1136/thx.52.9.780

Total daily energy expenditure relative to resting energy expenditure in clinically stable patients with COPD

E M Baarends, A M Schols, K R Westerterp, E F Wouters
PMCID: PMC1758652  PMID: 9371208

Abstract

BACKGROUND: An elevated resting energy expenditure (REE) commonly occurs in patients with chronic obstructive pulmonary (COPD). The purpose of this study was to investigate the effect of an increased REE on total daily energy expenditure (TDE) in 20 patients with COPD (19 men) with mean (SD) forced expiratory volume in one second of 37 (14)% predicted. METHODS: TDE was measured over a two week interval using doubly labelled water. Fat-free mass (FFM) was calculated from total body water assessed by deuterium dilution. REE was measured by indirect calorimetry using a ventilated hood system. RESULTS: The patients (10 men) with a significantly higher REE than those with a normal REE (median difference 205 kcal/ 24 h, p < 0.05) had a comparable TDE (hypermetabolic at rest: median 2593; range 2127-3083 kcal/24 h, normometabolic at rest: median 2629; range 2032-3179 kcal/ 24 h). There was no difference in mean daily heart rate (HR) between the groups (hypermetabolic at rest: median 92 (range 82-98), normometabolic at rest: median 98 (range 75-116) beats/min) or in the variation in the heart rate during the day. By means of multiple regression analysis it was shown that REE did not correlate significantly with TDE when FEM was taken into account. CONCLUSIONS: This study shows that there is no significant difference in free living TDE between clinically stable patients with COPD with a normal REE and those with an increased REE. The variation in TDE in patients with COPD appears to reflect differences in energy expenditure for activities, but not differences in REE. 




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Selected References

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  1. Amoroso P., Wilson S. R., Moxham J., Ponte J. Acute effects of inhaled salbutamol on the metabolic rate of normal subjects. Thorax. 1993 Sep;48(9):882–885. doi: 10.1136/thx.48.9.882. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Baarends E. M., Schols A. M., Pannemans D. L., Westerterp K. R., Wouters E. F. Total free living energy expenditure in patients with severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1997 Feb;155(2):549–554. doi: 10.1164/ajrccm.155.2.9032193. [DOI] [PubMed] [Google Scholar]
  3. Belman M. J., Botnick W. C., Shin J. W. Inhaled bronchodilators reduce dynamic hyperinflation during exercise in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1996 Mar;153(3):967–975. doi: 10.1164/ajrccm.153.3.8630581. [DOI] [PubMed] [Google Scholar]
  4. Carpenter W. H., Poehlman E. T., O'Connell M., Goran M. I. Influence of body composition and resting metabolic rate on variation in total energy expenditure: a meta-analysis. Am J Clin Nutr. 1995 Jan;61(1):4–10. doi: 10.1093/ajcn/61.1.4. [DOI] [PubMed] [Google Scholar]
  5. Dash A., Agrawal A., Venkat N., Moxham J., Ponte J. Effect of oral theophylline on resting energy expenditure in normal volunteers. Thorax. 1994 Nov;49(11):1116–1120. doi: 10.1136/thx.49.11.1116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Goldstein S., Askanazi J., Weissman C., Thomashow B., Kinney J. M. Energy expenditure in patients with chronic obstructive pulmonary disease. Chest. 1987 Feb;91(2):222–224. doi: 10.1378/chest.91.2.222. [DOI] [PubMed] [Google Scholar]
  7. Goldstein S., Askanazi J., Weissman C., Thomashow B., Kinney J. M. Energy expenditure in patients with chronic obstructive pulmonary disease. Chest. 1987 Feb;91(2):222–224. doi: 10.1378/chest.91.2.222. [DOI] [PubMed] [Google Scholar]
  8. Gray-Donald K., Gibbons L., Shapiro S. H., Martin J. G. Effect of nutritional status on exercise performance in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1989 Dec;140(6):1544–1548. doi: 10.1164/ajrccm/140.6.1544. [DOI] [PubMed] [Google Scholar]
  9. Hugli O., Frascarolo P., Schutz Y., Jéquier E., Leuenberger P., Fitting J. W. Diet-induced thermogenesis in chronic obstructive pulmonary disease. Am Rev Respir Dis. 1993 Dec;148(6 Pt 1):1479–1483. doi: 10.1164/ajrccm/148.6_Pt_1.1479. [DOI] [PubMed] [Google Scholar]
  10. Hugli O., Schutz Y., Fitting J. W. The daily energy expenditure in stable chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1996 Jan;153(1):294–300. doi: 10.1164/ajrccm.153.1.8542132. [DOI] [PubMed] [Google Scholar]
  11. Muers M. F., Green J. H. Weight loss in chronic obstructive pulmonary disease. Eur Respir J. 1993 May;6(5):729–734. [PubMed] [Google Scholar]
  12. O'Donnell D. E., Webb K. A. Exertional breathlessness in patients with chronic airflow limitation. The role of lung hyperinflation. Am Rev Respir Dis. 1993 Nov;148(5):1351–1357. doi: 10.1164/ajrccm/148.5.1351. [DOI] [PubMed] [Google Scholar]
  13. Schoeller D. A., Ravussin E., Schutz Y., Acheson K. J., Baertschi P., Jéquier E. Energy expenditure by doubly labeled water: validation in humans and proposed calculation. Am J Physiol. 1986 May;250(5 Pt 2):R823–R830. doi: 10.1152/ajpregu.1986.250.5.R823. [DOI] [PubMed] [Google Scholar]
  14. Schols A. M., Buurman W. A., Staal van den Brekel A. J., Dentener M. A., Wouters E. F. Evidence for a relation between metabolic derangements and increased levels of inflammatory mediators in a subgroup of patients with chronic obstructive pulmonary disease. Thorax. 1996 Aug;51(8):819–824. doi: 10.1136/thx.51.8.819. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Schols A. M., Fredrix E. W., Soeters P. B., Westerterp K. R., Wouters E. F. Resting energy expenditure in patients with chronic obstructive pulmonary disease. Am J Clin Nutr. 1991 Dec;54(6):983–987. doi: 10.1093/ajcn/54.6.983. [DOI] [PubMed] [Google Scholar]
  16. Schols A. M., Mostert R., Soeters P. B., Greve L. H., Wouters E. F. Nutritional state and exercise performance in patients with chronic obstructive lung disease. Thorax. 1989 Nov;44(11):937–941. doi: 10.1136/thx.44.11.937. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Schols A. M., Schoffelen P. F., Ceulemans H., Wouters E. F., Saris W. H. Measurement of resting energy expenditure in patients with chronic obstructive pulmonary disease in a clinical setting. JPEN J Parenter Enteral Nutr. 1992 Jul-Aug;16(4):364–368. doi: 10.1177/0148607192016004364. [DOI] [PubMed] [Google Scholar]
  18. Schols A. M., Soeters P. B., Mostert R., Saris W. H., Wouters E. F. Energy balance in chronic obstructive pulmonary disease. Am Rev Respir Dis. 1991 Jun;143(6):1248–1252. doi: 10.1164/ajrccm/143.6.1248. [DOI] [PubMed] [Google Scholar]
  19. Spicher V., Roulet M., Schutz Y. Assessment of total energy expenditure in free-living patients with cystic fibrosis. J Pediatr. 1991 Jun;118(6):865–872. doi: 10.1016/s0022-3476(05)82196-1. [DOI] [PubMed] [Google Scholar]
  20. Sridhar M. K., Carter R., Lean M. E., Banham S. W. Resting energy expenditure and nutritional state of patients with increased oxygen cost of breathing due to emphysema, scoliosis and thoracoplasty. Thorax. 1994 Aug;49(8):781–785. doi: 10.1136/thx.49.8.781. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Vandenbergh E., Van de Woestijne K. P., Gyselen A. Weight changes in the terminal stages of chronic obstructive pulmonary disease. Relation to respiratory function and prognosis. Am Rev Respir Dis. 1967 Apr;95(4):556–566. doi: 10.1164/arrd.1967.95.4.556. [DOI] [PubMed] [Google Scholar]
  22. Wilson D. O., Rogers R. M., Wright E. C., Anthonisen N. R. Body weight in chronic obstructive pulmonary disease. The National Institutes of Health Intermittent Positive-Pressure Breathing Trial. Am Rev Respir Dis. 1989 Jun;139(6):1435–1438. doi: 10.1164/ajrccm/139.6.1435. [DOI] [PubMed] [Google Scholar]
  23. Wouters E. F., Schols A. M. Prevalence and pathophysiology of nutritional depletion in chronic obstructive pulmonary disease. Respir Med. 1993 Aug;87 (Suppl B):45–47. doi: 10.1016/0954-6111(93)90126-k. [DOI] [PubMed] [Google Scholar]

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