title: Visceral fat is strongly associated with post-transplant diabetes mellitus and glucose metabolism 1 year after kidney transplantation.
abstract: Body composition after kidney transplantation is linked to glucose metabolism, and impaired glucose metabolism is associated with increased risk of cardiovascular events and death. One year after transplantation, we examined 150 patients for post-transplant diabetes performing oral glucose tolerance tests and body composition measurements including visceral adipose tissue (VAT) content from dual-energy X-ray absorptiometry scans. We found that glucose metabolism was generally improved over the first year post-transplant, and that the levels of VAT and percentage VAT of total body fat mass (VAT%totBFM) were lowest in those with normal glucose tolerance and highest in those with post-transplant diabetes mellitus. In a multivariable linear regression analysis, 87.4% of the variability in fasting glucose concentration was explained by insulin resistance (P<.001, HOMA-IR index), beta cell function (P<.001, HOMA-beta), VAT%totBFM(P=.007), and body mass index (BMI; P=.015; total model P<.001), while insulin resistance (P<.001) and beta cell function (P<.001) explained 31.9% of the variability in 2-hour glucose concentration in a multivariable model (total model P<.001). VAT was associated with glucose metabolism to a larger degree than BMI. In conclusion, VAT is associated with hyperglycemia one year after kidney transplantation, and insulin resistance and beta cell function estimates are the most robust markers of glucose metabolism.
authors.affiliation: Section of Nephrology, Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Marit Elizabeth
authors.initials: ME
authors.lastname: von Düring
authors.affiliation: Section of Nephrology, Department of Transplantation Medicine, 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: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.|Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Jens
authors.initials: J
authors.lastname: Bollerslev
authors.affiliation: Section of Nephrology, Department of Transplantation Medicine, 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: Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Kristin
authors.initials: K
authors.lastname: Godang
authors.affiliation: Section of Nephrology, Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Anders
authors.initials: A
authors.lastname: Hartmann
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism*; D001823:Body Composition; D015992:Body Mass Index; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000601:surgery; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin
keywords: body composition; insulin resistance; kidney transplantation; post-transplant diabetes mellitus; visceral fat