A validated disease specific prediction equation for resting metabolic rate in underweight patients with COPD

Anita Nordenson², Anne Marie Grönberg^1,2, Lena Hulthén¹, Sven Larsson², Frode Slinde<sup>1

1</sup>Department of Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden; ²Department of Internal Medicine/Respiratory Medicine and Allergology, Sahlgrenska Academy at University of Gothenburg, Sweden

Abstract: Malnutrition is a serious condition in chronic obstructive pulmonary disease (COPD). Successful dietary intervention calls for calculations of resting metabolic rate (RMR). One disease-specific prediction equation for RMR exists based on mainly male patients. To construct a disease-specific equation for RMR based on measurements in underweight or weight-losing women and men with COPD, RMR was measured by indirect calorimetry in 30 women and 11 men with a diagnosis of COPD and body mass index <21 kg/m². The following variables, possibly influencing RMR were measured: length, weight, middle upper arm circumference, triceps skinfold, body composition by dual energy x-ray absorptiometry and bioelectrical impedance, lung function, and markers of inflammation. Relations between RMR and measured variables were studied using univariate analysis according to Pearson. Gender and variables that were associated with RMR with a P value <0.15 were included in a forward multiple regression analysis. The best-fit multiple regression equation included only fat-free mass (FFM): RMR (kJ/day) = 1856 + 76.0 FFM (kg). To conclude, FFM is the dominating factor influencing RMR. The developed equation can be used for prediction of RMR in underweight COPD patients.

Keywords: pulmonary disease, chronic obstructive, basal metabolic rate, malnutrition, body composition