title: Leptin, insulin resistance, and metabolic changes 5 years after renal transplantation.
abstract: OBJECTIVE
  To evaluate leptin, insulin resistance (IR), and changes in body composition and lipid profile within 5 years after renal transplantation.
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  Hospital de Clínicas de Porto Alegre/RS, Brazil.
  
  
  METHODS
  Thirty-two renal transplant recipients were followed up for 5 years after transplantation.
  
  
  METHODS
  Data were collected at transplantation time (T₁) and after 3 months (T₂), 1 year (T₃), and 5 years (T₄). Leptin serum levels, IR assessed by homeostasis model assessment (HOMA) index, lipid profile, and anthropometric measurements were analyzed. Data were compared with a control group at baseline.
  
  
  RESULTS
  At T₁, pretransplant patients had leptin levels (ng/mL) (11.9 [9.2 to 25.2]) higher than the control group (7.7 [5.2 to 9.9]; P < .0001). After transplantation, levels decreased at T₂ and T₃, but increased at T₄ to values similar to those seen at T₁ (T₄: 9.2 [5.7 to 21]; P = 1). HOMA also decreased at T₂, but increased at T₄ to identical levels (T₁: 2.1 [1.63 to 2.23], T₄: 2.1 [1.6 to 2.85]; P = 1). No significant changes in body fat percentage (BF%) were observed; however, the arm muscle circumference increased significantly at T₄ (P < .0001). At T₂, total cholesterol, triglycerides, and low-density lipoprotein cholesterol increased, whereas at T₄, lipid profile moved toward T₁ levels. By linear regression analysis, gender, BF%, and HOMA were independent predictors of leptin levels. A trend toward higher body mass index was observed in woman who also presented higher leptin and lower HOMA levels.
  
  
  CONCLUSIONS
  Leptin levels and HOMA decrease in the immediate posttransplant period and remain reduced for at least 1 year. Five years post transplantation, leptin, IR, BF%, and lipids have a profile similar to those in the pretransplant period. This metabolic profile is possibly associated with the elevated incidence of cardiovascular diseases observed in the late posttransplant period.
authors: Nutrition Course, School of Medicine, Federal University of Rio Grande do Sul-UFRGS, Porto Alegre, Rio Grande do Sul, Brazil.
authors: Bruna Bellincanta
authors: BB
authors: Nicoletto
authors: Gabriela Corrêa
authors: GC
authors: Souza
authors: Luiz Felipe
authors: LF
authors: Gonçalves
authors: César
authors: C
authors: Costa
authors: Ingrid S
authors: IS
authors: Perry
authors: Roberto Ceratti
authors: RC
authors: Manfro
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D016030:Kidney Transplantation; D020738:Leptin / Q000097:blood*; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D055442:Metabolome; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D020738:Leptin; D014280:Triglycerides