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Both overnutrition(營養過剩) and undernutrition(營養不良) affect energy metabolism(代謝),

營養攝取過與不及都會對人體的能量代謝過程造成影響，

 with overnutrition raising energy expenditure(支出) and undernutrition lowering it.

營養過剩造成能量消耗值升高、營養不良則會降低能量消耗值減少。

Fever(發燒) is a powerful stimulator(刺激) of thermogenesis(產熱).

發燒就是人體產熱作用裡的最強效果

In diseases such as cancer, AIDS, diabetes mellitus(糖尿病), and rheumatoid arthritis(類風溼關節炎), whether energy expenditure is increased or decreased often depends on how advanced the disorder is.

在AIDS、糖尿病、類風濕關節炎中，能量消耗的增減取決於疾病造成的混亂程度

Early on, when the greater protein turnover(周轉) characteristic of these conditions is paramount(最重要的), energy expenditure is increased.

在早期過程中，當最重要的條件是蛋白質轉換時，能量消耗會增加

In addition, in diseases such as cancer, AIDS, and rheumatoid arthritis in which cytokines(細胞激素) are released, the cytokines' thermogenic effect initially increases the metabolic rate.

還有，在AIDS、糖尿病、類風濕關節炎中，細胞激素會釋放出來，而細胞激素的產熱效果將會升高代謝率

However, as the disease becomes more advanced and leads to cachexia(惡病質), energy expenditure drops below normal.

無論如何，當疾病越往後面發展將會導致惡質症。

Acute(急性) conditions such as burns(燒傷) and trauma(創傷) significantly raise energy expenditure, primarily by increasing sympathetic(交感) response and the release of catecholamines(兒茶酚胺), which are powerful stimulators of energy expenditure.

如燒傷、嚴重創傷這種急性症狀會馬上增加能量消耗，主要是增加交感反應，釋放兒茶酚胺，可以視為一種強效的能量消耗

註1出現惡質症的病人會有食慾不振、肌肉耗弱及新陳代謝改變而對營養補充或靜脈營養反應變差

註2當交感—腎上腺髓質系統興奮時，兒茶酚胺（CA）大量釋放入血