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                  <title>Congrès des Journées Francophones de Nutrition (JFN)</title>
                  <date type="start">2017-12-13</date>
                  <date type="end">2017-12-15</date>
                  <settlement>Nantes</settlement>
                  <country key="FR">France</country>
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                  <name>Société Française de Nutrition (SFN) et la Société Francophone de Nutrition Clinique et Métabolisme (SFNEP)</name>
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                  <biblScope unit="serie">Nutrition Clinique et Métabolisme</biblScope>
                  <biblScope unit="volume">32</biblScope>
                  <biblScope unit="issue">4</biblScope>
                  <biblScope unit="pp">289-290</biblScope>
                  <date type="datePub">2018-11-15</date>
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              <p>Introduction et but de l’étudeL’hypermétabolisme (HM) est défini par une variation (Δ) &gt; + 10 % entre la dépense énergétique de repos mesurée (DERm) et calculée. L’objectif principal de l’étude était de confirmer l’existence de l’HM lors de la SLA par rapport à des témoins sains. Les objectifs secondaires étaient de préciser s’il existait une augmentation de DER chez les patients en l’absence d’HM, et quel était le niveau de ΔDER par rapport aux témoins.Matériel et méthodesLes patients et les témoins avaient des mesures de la DER par calorimétrie indirecte (DERm), de la DER par la formule d’Harris et Benedict de 1919 et de la masse maigre [MM] par impédancemétrie. L’analyse statistique utilisait les tests t de Student, de Mann–Withney et du Chi2. L’analyse multivariée comportait une régression logistique, et des modèles linéaires généralisés.Résultats et analyse statistiqueTrois-cent-quinze patients et 80 témoins étaient comparés. Un HM était retrouvé chez 55,2 % des patients SLA versus 13,7 % chez les témoins (p &lt; 0,0001). L’HM était fortement et positivement associé à la présence d’une SLA (Odds Ratio ajusté = 9,50 [4,49–20,10], p &lt; 0,0001). Le DERm médiane était plus élevée chez les patients SLA à 1503 kcal/j [1290–1696] vs 1220 kcal/j [938–1450] chez les témoins (p &lt; 0,0001), même en l’absence d’HM (1339 kcal/j [1154–1543] vs 1200 kcal/j [1005–1461], p &lt; 0,0001). La ΔDER et le rapport DERm/MM étaient plus élevés chez les patients avec ou sans HM par rapport aux témoins (p &lt; 0,0001). En l’absence d’HM, l’effet du groupe sur la ΔDER ne concernait que les sujets de plus de 67 ans (βajusté &gt; 0 et p &lt; 0,05) et l’élévation du ratio DERm/MM n’intéressait que les hommes (différence de moyenne du rapport DERm/MM entre SLA et témoins à 1,99 kcal/kg/j [0,22–3,75] ; p = 0,027).ConclusionL’HM concerne plus d’un patient sur deux et est fortement associé à la SLA. Après ajustement en modèle multivarié, ce travail confirme une très fréquente altération métabolique lors de cette maladie et ce même en l’absence d’HM. Des études métaboliques plus approfondies sont nécessaires pour étudier ces perturbations au cours de la SLA.</p>
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