title: Energy expenditure, spontaneous physical activity and with weight gain in kidney transplant recipients.
abstract: OBJECTIVE
  Alterations in energy metabolism could trigger weight gain after renal transplantation.
  
  
  METHODS
  Nineteen transplanted non-diabetic men, 53 ± 1.6 years old, receiving calcineurin inhibitors but no corticosteroids were studied. They were compared with nine healthy men matched for height, age and lean body mass. Daily energy expenditure and its components (sleeping, basal and absorptive metabolic rates) were analyzed for 24 h in calorimetric chambers and for 4 days in free living conditions using calibrated accelerometry. Other variables known to influence energy expenditure were assessed: body composition, physical activity, 4-day food intake, drug consumption, serum C-reactive protein, interleukin-6, thyroid and parathyroid hormones, and epinephrine. Transplant recipients who gained more than 5% body weight after transplantation (n = 11, +11.0 ± 1.5 kg) were compared with those who did not (n = 8) and with the controls.
  
  
  RESULTS
  Weight gain compared with non-weight gain patients and controls exhibited higher fat mass without change in lean body mass. Daily, sleeping and resting energy expenditure adjusted for lean body mass was significantly higher in non-weight gain (167.1 ± 4.2 kJ/kg/lean body mass/24 h, P < 0.05) compared with weight gain patients (147.4 ± 3.6) and controls (146.1 ± 4.6). Weight gain compared with controls and non-weight gain subjects had lower free living physical activity and a higher consumption of antihypertensive drugs and β-blockers.
  
  
  CONCLUSIONS
  After kidney transplantation, weight gain patients were characterized by lower adjusted energy expenditure, reduced spontaneous physical activity but a more sedentary life style and a trend toward a higher energy intake explaining the reason they gained weight. The nWG KTR had increased resting and sleeping EE which protected them from weight gain. Such hypermetabolism was also observed in 24-h EE measurements. By comparison with the nWG patients, the WG transplant recipients were characterized by higher β-blocker consumption. These data could be helpful in the prevention of weight gain in kidney transplant recipients.
authors.affiliation: CHU Clermont-Ferrand, Service de Néphrologie, Pôle REUNNIRH, F-63003 Clermont-Ferrand, France; INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France. Electronic address: aheng@chu-clermontferrand.fr.
authors.forename: Anne-Elisabeth
authors.initials: AE
authors.lastname: Heng
authors.affiliation: INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Montaurier
authors.affiliation: INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; CHU Clermont-Ferrand, Service de Nutrition Clinique, Pôle REUNNIRH, F-63003 Clermont-Ferrand, France.
authors.forename: Noël
authors.initials: N
authors.lastname: Cano
authors.affiliation: NRC Medical, F-63450 Saint Saturnin, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Caillot
authors.affiliation: INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France.
authors.forename: A
authors.initials: A
authors.lastname: Blot
authors.affiliation: INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Meunier
authors.affiliation: CHU Clermont-Ferrand, Biostatistics Unit, Délégation Recherche Clinique et Innovation, F-63000 Clermont-Ferrand, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pereira
authors.affiliation: CHU Clermont-Ferrand, Laboratoire de Biochimie, F-63003 Clermont-Ferrand, France.
authors.forename: Geoffroy
authors.initials: G
authors.lastname: Marceau
authors.affiliation: CHU Clermont-Ferrand, Laboratoire de Biochimie, F-63003 Clermont-Ferrand, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Sapin
authors.affiliation: INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Jouve
authors.affiliation: INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; CHU Clermont-Ferrand, Service de Nutrition Clinique, Pôle REUNNIRH, F-63003 Clermont-Ferrand, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Boirie
authors.affiliation: CHU Clermont-Ferrand, Service de Néphrologie, Pôle REUNNIRH, F-63003 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Deteix
authors.affiliation: INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Morio
mesh_terms: D001481:Basal Metabolism; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000097:blood; D002149:Energy Intake; D004734:Energy Metabolism; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007668:Kidney / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009638:Norepinephrine / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood; D011228:Prealbumin / Q000378:metabolism; D057185:Sedentary Behavior; D012709:Serum Albumin / Q000378:metabolism; D011795:Surveys and Questionnaires; D013963:Thyroid Hormones / Q000097:blood; D066027:Transplant Recipients; D014280:Triglycerides / Q000097:blood; D015430:Weight Gain
chemical_list: D006454:Hemoglobins; D015850:Interleukin-6; D010281:Parathyroid Hormone; D011228:Prealbumin; D012709:Serum Albumin; D013963:Thyroid Hormones; D014280:Triglycerides; D002097:C-Reactive Protein; D002784:Cholesterol; D003404:Creatinine; D009638:Norepinephrine
keywords: Metabolism; Nutrition; Obesity; Transplant outcome