title: Obesity and adiponectin after kidney transplantation.
abstract: Obesity and hyperlipidaemia are found very frequently after kidney transplantation (Tx) and may represent independent risk factors for development of atherosclerosis and chronic allograft nephropathy. In a prospective metabolic study, we monitored, a total of 68 obese transplant patients [body mass index (BMI) > 30 kg/m2] with dyslipidaemia over a period of 24 months. We compared the findings of a new therapeutic regimen 1 year (start of the study) and 2 years after renal transplantation. Based on a Subjective Global Assessment Scoring Sheet, we started at the end of the first year with an individualized hypoenergic-hypolipidaemic diet (IHHD). Subsequently, after corticoid withdrawal, IHHD was supplemented regularly with statins (atorvastatin 10-20 mg/day)) and followed-up for 2 years. All patients were on a regimen of cyclosporin A or tacrolimus and mycophenolate mofetil. During the study period, there was a significant decrease in BMI (p < 0.025) and an increase of the adiponectin level (p < 0.01). Long-term therapy was associated with a significant decrease in serum leptin (p < 0.01) and lipid metabolism parameters (p < 0.01). Inulin clearance, mean systolic and diastolic blood pressure, proteinuria, lipoprotein(a) and apo-lipoprotein E isoforms did not differ significantly. Based on our results, we assume that obesity and hyperlipidaemia after renal transplantation can be treated effectively by modified immunosuppression (corticosteroid withdrawal), statins and long-term diet (IHHD). The increased level of adiponectin may be a marker of reducing atherosclerotic and chronic allograft nephropathy processes.
authors: Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague 4, Czech Republic. vladimir.teplan@medicon.cz
authors: V
authors: V
authors: Teplan
authors: O
authors: O
authors: Schück
authors: M
authors: M
authors: Stollova
authors: S
authors: S
authors: Vitko
mesh_terms: D052242:Adiponectin / Q000097:blood*; D050197:Atherosclerosis / Q000517:prevention & control; D015992:Body Mass Index; D004038:Diet, Reducing; D006949:Hyperlipidemias / Q000517:prevention & control; D016030:Kidney Transplantation / Q000009:adverse effects*; D020738:Leptin / Q000097:blood; D009765:Obesity / Q000628:therapy*; D011446:Prospective Studies
chemical_list: D052242:Adiponectin; D020738:Leptin