Ocena porabe energije v mirovanju z indirektno kalorimetrijo pri otrocih z rakom

Mujakić, Ema (author), Benedik, Evgen (mentor), Kavcic, Marko (comentor)

Rak je eden vodilnih vzrokov smrti v otroški populaciji, čeprav je njegova pojavnost manjša kot pri odraslih. Bolezen in zdravljenje pogosto povzročata spremembe v presnovi, izgubo mišične mase in povečano tveganje za podhranjenost, zato je natančna ocena energijskih potreb ključna. Namen raziskave je bil oceniti porabo energije v mirovanju pri otrocih z rakom z uporabo indirektne kalorimetrije, jo primerjati z napovedanimi vrednostmi po Harris–Benedictovi enačbi, spremljati spremembe v mišični masi in porabi energije v mirovanju med zdravljenjem ter raziskati povezavo med njima. V raziskavo smo vključili 14 otrok z rakom, starih od 7 do 18 let, zdravljenih na Pediatrični kliniki Univerzitetnega kliničnega Ljubljana. Meritve porabe energije v mirovanju so bile izvedene z indirektnim kalorimetrom Q-NRG® (Cosmed, Italija) v dveh časovnih točkah (T0 in T1), v časovnem razmiku 6 tednov, telesna sestava pa ocenjena z bioimpedančno analizo. Rezultati so pokazali, da večina otrok ni bila čezmerno hranjena (N = 9, 69 %), pri čemer se delež čezmerno hranjenih med časovnima točkama T0 in T1 ni bistveno spremenil. Izmerjena poraba energije v mirovanju je bila pri T0 statistično značilno višja od napovedane, medtem ko ob T1 razlike ni bilo več. V šestih tednih spremljanja se poraba energije v mirovanju in mišična masa nista bistveno spremenili, smo pa potrdili pozitivno povezavo med večjo mišično maso in višjo porabo energije v mirovanju v času T0 (p = 0,003) in v času T1 (p < 0,001). Zaključimo lahko, da Harris–Benedictova enačba ne omogoča zanesljive ocene porabe energije v mirovanju pri otrocih z rakom ob začetku zdravljenja. Indirektna kalorimetrija predstavlja natančnejši pristop, a bi za prepoznavanje dolgoročnih sprememb bila potrebna raziskava z daljšim spremljanjem in večjim številom otrok vključenih v raziskavo.

• Language: Slovenian
• Keywords: otroški rak, indirektna kalorimetrija, poraba energije v mirovanju, prehranski status, mišična masa
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: BF - Biotechnical Faculty
• Publisher: [E. Mujakić]
• Year: 2025
• PID: 20.500.12556/RUL-174297
• UDC: 616-006-053.2:613.2
• COBISS.SI-ID: 251704835
• Publication date in RUL: 01.10.2025

Secondary language

• Language: English
• Title: Assessment of resting energy expenditure by indirect calorimetry in children with cancer

Abstract

Cancer is one of the leading causes of death in the pediatric population, although its incidence is lower than in adults. The disease and its treatment often cause changes in metabolism, loss of muscle mass, and an increased risk of malnutrition, so an accurate assessment of energy requirements is crucial. The aim of the study was to assess resting energy expenditure in children with cancer using indirect calorimetry, compare it with predicted values according to the Harris–Benedict equation, monitor changes in muscle mass and resting energy expenditure during treatment, and investigate the relationship between them. We included 14 children with cancer, aged 7 to 18 years, treated at the Pediatric Clinic of the University Medical Center Ljubljana in the study. Resting energy expenditure was measured using a Q-NRG® indirect calorimeter (Cosmed, Italy) at two time points (T0 and T1) over a period of 6 weeks, and body composition was assessed using bioimpedance analysis. The results showed that most children were not overweight (N = 9, 69 %), with no significant change in the proportion of overweight children between time points T0 and T1. The measured resting energy expenditure at T0 was statistically significantly higher than predicted, while at T1 there was no longer any difference. During the six weeks of monitoring, resting energy expenditure and muscle mass did not change significantly, but we confirmed a positive correlation between greater muscle mass and higher resting energy expenditure at T0 (p = 0.003) and at T1 (p < 0,001). We can conclude that the Harris–Benedict equation does not allow for a reliable estimate of resting energy expenditure in children with cancer at the start of treatment. Indirect calorimetry is a more accurate approach, but identifying long-term changes would require a study with longer follow-up and a larger number of children included in the study.

• Keywords: childhood cancer, indirect calorimetry, resting energy expenditure, nutritional status, muscle mass