title: Disturbed energy metabolism after lung and heart transplantation.
abstract: Overweight, in combination with other cardiovascular risk factors, reduces survival after transplantation. The aim of this prospective study was to observe leptin, adiponectin, and energy intake as predictors of body mass index (BMI) and body composition and as risk factors associated with metabolic syndrome after lung and heart transplantation. After pre-operative baseline investigations, 35 lung and 59 heart recipients were followed and re-investigated two, six, and 12 months after transplantation. Linear regressions were performed to predict BMI and body composition. The lung recipients had a substantial weight gain after transplantation. Leptin increased, especially in the lung recipients and positively predicted BMI. Energy intake predicted BMI before and at two months after transplantation, but not after 12 months. Percentage trunk fat increased and lean mass decreased. Before transplantation, the dominant determinant of lean mass was adiponectin (positively associated), while after it was leptin (negatively associated), controlled for possible confounding variables (including prednisolone). Metabolic syndrome 12 months after transplantation was associated with higher leptin, greater weight gain without increased energy intake. After transplantation, a disturbed energy metabolism is indicated, where adiponectin and especially leptin are involved and a disadvantageous body composition is favored with increased body fat and decreased lean mass.
authors.affiliation: Medical Department, Oslo University Hospital, Rikshospitalet, N-0027 Oslo, Norway. liv.forli@oslo-universitetssykehus.no
authors.forename: Liv
authors.initials: L
authors.lastname: Forli
authors.forename: Jens
authors.initials: J
authors.lastname: Bollerslev
authors.forename: Svein
authors.initials: S
authors.lastname: Simonsen
authors.forename: Gunhild A
authors.initials: GA
authors.lastname: Isaksen
authors.forename: Kristin
authors.initials: K
authors.lastname: Godang
authors.forename: Are H
authors.initials: AH
authors.lastname: Pripp
authors.forename: Oystein
authors.initials: O
authors.lastname: Bjortuft
mesh_terms: D052242:Adiponectin / Q000378:metabolism; D000273:Adipose Tissue; D001823:Body Composition; D015992:Body Mass Index; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D020738:Leptin / Q000378:metabolism; D016040:Lung Transplantation; D008297:Male; D024821:Metabolic Syndrome; D008875:Middle Aged; D012307:Risk Factors; D015430:Weight Gain
chemical_list: D052242:Adiponectin; D020738:Leptin