Energy expenditure in chronic alcoholics with and without liver disease

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Abstract
Chronic alcoholism activates metabolic pathways, resulting in wasteful expenditure of energy (Pirola and Lieber, J Nutr 1975; 105:1544–8). To study this hypothesis, we measured oxygen consumption (VO2), carbon dioxide production (VCO2), and resting energy expenditure (MREE) utilizing indirect calorimetry in 8 chronic alcoholics with (group I) and 11 chronic alcoholics without (group II) clinical or biochemical evidence of alcoholic liver disease. Seven healthy volunteers served as controls. A statistically increased MREE was observed in group II subjects (p < 0.05, MREE 999.7 ± 111.4 kcal · day · m2) as compared to normals (MREE 842.3 ± 42.1 kcal · day · m2) and group I subjects (MREE 813.4 ± 101.4 kcal · day · m2). VO2 and VCO2 were also significantly higher (p < 0.05) in group II than in group I and normals. The predicted resting energy expenditure as calculated by the Harris-Benedict equation was similar in both groups and normals. Theories to explain the increased MREE in group II subjects are presented.