title: Visceral fat is better related to impaired glucose metabolism than body mass index after kidney transplantation.
abstract: The role of visceral adipose tissue (VAT) in post-transplant hyperglycaemia is not known. We evaluated 167 patients without diabetes 8-10 weeks after kidney transplantation, performing oral glucose tolerance tests and measuring VAT content from dual-energy X-ray absorptiometry scans. Median VAT weight in normal glucose tolerance patients was 0.9 kg, impaired fasting glucose patients 1.0 kg, impaired glucose tolerance patients 1.3 kg and patients with post-transplant diabetes (PTDM) 2.1 kg (P = 0.004, indicating a difference between groups). Percentage VAT of total body fat was associated with fasting (R(2) = 0.094, P < 0.001) and 2-h glucose concentration (R(2) = 0.062, P = 0.001), while BMI was only associated with 2-h glucose concentration (R(2) = 0.029, P = 0.028). An association between BMI and 2-h glucose concentration was lost in adjusted models, as opposed to the associations between VAT as percentage of total body fat and glucose concentrations (R(2) = 0.132, P < 0.001 and R(2) = 0.097, P = 0.001, respectively for fasting and 2-h glucose concentration). In conclusion, VAT is more closely related to impaired glucose metabolism than BMI after kidney transplantation. The association with central obesity should encourage additional studies on lifestyle interventions to prevent PTDM.
authors.affiliation: Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Marit Elizabeth
authors.initials: ME
authors.lastname: von Düring
authors.affiliation: Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Trond
authors.initials: T
authors.lastname: Jenssen
authors.affiliation: Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.|Department of Endocrinology, Section of Specialized Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Jens
authors.initials: J
authors.lastname: Bollerslev
authors.affiliation: Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Norwegian Renal Registry, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|School of Pharmacy, University of Oslo, Oslo, Norway.
authors.forename: Anders
authors.initials: A
authors.lastname: Åsberg
authors.affiliation: Department of Endocrinology, Section of Specialized Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Kristin
authors.initials: K
authors.lastname: Godang
authors.affiliation: Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Ivar Anders
authors.initials: IA
authors.lastname: Eide
authors.affiliation: Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Dag Olav
authors.initials: DO
authors.lastname: Dahle
authors.affiliation: Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Anders
authors.initials: A
authors.lastname: Hartmann
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000139:chemically induced / Q000209:etiology* / Q000378:metabolism; D005947:Glucose / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000378:metabolism*; D016030:Kidney Transplantation; D008055:Lipids / Q000097:blood; D008775:Methylprednisolone / Q000009:adverse effects; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000378:metabolism; D011239:Prednisolone / Q000009:adverse effects; D000069283:Rituximab / Q000627:therapeutic use; D014019:Tissue Donors
chemical_list: D001786:Blood Glucose; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D007328:Insulin; D008055:Lipids; D000069283:Rituximab; D011239:Prednisolone; D005947:Glucose; D008775:Methylprednisolone
keywords: HOMA-IR index; insulin resistance; kidney transplantation; new-onset diabetes mellitus; post-transplant diabetes mellitus; visceral fat