Estudo metabólico e nutricional em pacientes submetidos a transplante hepático

Abstract

Excessive weight gain in patients undergoing liver transplantation has been well documented. However, it is not yet clear which are the causes of this complication, so prevalent in post-transplant patients. It is known that the causes of obesity are multifactorial, one of them being the chronic intake of energy above the needs of the individuals. The reduced energy expenditure could also be involved in the genesis of excessive weight gain. Thus, the measurement of the resting energy expenditure (REE)in this population is of utmost importance. Therefore, from March to October 2011, patients who had undergone liver transplantation had the REE measured by indirect calorimetry (IC) and the REE was associated with demographic, socioeconomic, clinical, anthropometric, dietary and lifestyle variables assessed by uni and multivariate statistical analyses. The REE was also compared to that estimated by the Harris- Benedict formula, and patients were classified as hypo-, normo- and hypermetabolic. We evaluated 42 patients with the average of 6.5 years post-transplant and REE of 1449.7 kcal/day when measured by IC and 1404.5 kcal/day as predicted by the HB formula. There was great correlation between the methods, and the HB formula could predict up to 91% of the GER of these patients. All patients were classified as normometabolic, and the best predictors of REE, accounting for 96.7% of the variability among the individuals were: age, weight, amount of lean mass and amount of total body water.