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Respiratory quotient: Carbohydrates, fats and protein
The respiratory quotient (or RQ or respiratory coefficient), is a dimensionless number used in calculations of basal metabolic rate (BMR) when estimated from carbon dioxide production. It is calculated from the ratio of carbon dioxide produced by the body to oxygen consumed by the body. Such measurements, like measurements of oxygen uptake, are forms of indirect calorimetry. It is measured using a respirometer. The Respiratory Quotient value indicates which macronutrients are being metabolized, as different energy pathways are used for fats, carbohydrates, and proteins. A value of 0.7 indicates that lipids are being metabolized, 0.8 for proteins, and 1.0 for carbohydrates. The approximate respiratory quotient of a mixed diet is 0.8. Some of the other factors that may affect the respiratory quotient are energy balance, circulating insulin, and insulin sensitivity.
Carbohydrates: The respiratory quotient for carbohydrate metabolism can be demonstrated by the chemical equation for oxidation of glucose:
C6H12O6 + 6 O2 ? 6 CO2+ 6 H2O 
Because the gas exchange in this reaction is equal, the respiratory quotient for carbohydrates is: RQ = 6 CO2 / 6 O2 = 1.0
Fats: The chemical composition of fats differs from that of carbohydrates in that fats contain considerably fewer oxygen atoms in proportion to atoms of carbon and hydrogen. The substrate utilization of palmitic acid is:
C16H32O2 + 23 O2 ? 16 CO2 + 16 H2O
Thus, the RQ for palmitic acid is approximately 0.7. RQ = 16 CO2 / 23 O2 = 0.696
Proteins: The respiratory quotient for protein metabolism can be demonstrated by the chemical equation for oxidation of albumin:
C72H112N18O22S + 77 O2 ? 63 CO2 + 38 H2O + SO3 + 9 CO(NH2)2
The RQ for protein is approximately 0.8. RQ = 63 CO2/ 77O2 = 0.8
Due to the complexity of the various ways in which different amino acids can be metabolized, no single RQ can be assigned to the oxidation of protein in the diet; however, 0.8 is a frequently utilized estimate.
Applications
Practical applications of the respiratory quotient can be found in severe cases of chronic obstructive pulmonary disease, in which patients spend a significant amount of energy on respiratory effort. By increasing the proportion of fats in the diet, the respiratory quotient is driven down, causing a relative decrease in the amount of CO2 produced. This reduces the respiratory burden to eliminate CO2, thereby reducing the amount of energy spent on respirations.
Respiratory Quotient can be used as an indicator of over or underfeeding. Underfeeding, which forces the body to utilize fat stores, will lower the respiratory quotient while overfeeding, which causes lipogenesis, will increase it. Underfeeding is marked by a respiratory quotient below 0.85, while a respiratory quotient greater than 1.0 indicates overfeeding. This is particularly important in patients with compromised respiratory systems, as an increased respiratory quotient significantly corresponds to increased respiratory rate and decreased tidal volume, placing compromised patients at a significant risk.
Because of its role in metabolism, respiratory quotient can be used in analysis of liver function and diagnosis of liver disease. In patients suffering from liver cirrhosis, non-protein respiratory quotient (npRQ) values act as good indicators in the prediction of overall survival rate. Patients having a npRQ < 0.85 show considerably lower survival rates as compared to patients with a npRQ > 0.85.A decrease in npRQ corresponds to a decrease in glycogen storage by the liver. Similar research indicates that non-alcoholic fatty liver diseases are also accompanied by a low respiratory quotient value, and the non protein respiratory quotient value was a good indication of disease severity.
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