medigraphic.com
ISSN 1561-2929 (Print)

2013, Number 2

<< Back Next >>

RCAN 2013; 23 (2)

Visceral fat, waist circumference and kidney allograft. Association with metabolic disturbances and kidney allograft

Borroto DG, Quintanilla AM, Barceló AM, Cabrera VL

Language: Spanish
References: 49
Page: 268-283
PDF size: 392.15 Kb.


ABSTRACT

Rationale: Excessive weight gain in kidney transplant happens primarily at the expense of visceral fat. Hence, measurement of visceral fat may alert about metabolic disturbances associated with excessive body weight. Goal: To determine if waist circumference as surrogate of visceral fat can predict metabolic disturbances derived from insulin resistance, as well as failure of kidney graft. Study design: Analytical, cross-sectional. Study serie: Eighty-eight transplanted patients (Males: 57.9%; Ages ≥ 60 years: 7.9%; Transplant average time: 6.1 ± 5.7 years) assisted at the Ambulatory Consult of the Nephrology Service of the “Hermanos Ameijeiras” Clinical surgical Hospital (Havana City, Cuba). Methods: Visceral fat (BF) was measured by means of electrical bioimpedance (BIA). Waist circumference (WC) was measured in centimeters at the level of the umbilicus. Influence of selected demographical and clinical variables upon BF and WC was estimated. In turn, association between weight gain, facets of Metabolic syndrome (MS) and allograft function, on one side, and BF and WC, on the other, was also estimated. Associations of interest were adjusted for the transplant average time. Results: Thirty-four percent of transplanted patients presented with elevated WC values. Study serie was distributed according with BF tercils as follows: First tercile: 0 – 5.9 Kg: 35.0%; Second tercile: 6.0 – 9.9 Kg: 34.0%; Third tercile: ≥ 10.0 Kg: 31.0%, respectively. BF and WC correlated closely between them. Behavior of anthropometric indicator was independent from demographical and clinical variables of the study. BF was associated with a higher presence of MS, pathological proteinuria and diminished glomerular filtration. WC was only associated with an increased presence of pathological proteinuria. Conclusions: BF measured by means of BIA can be useful for prediction of occurrence of MS and glomerular damage resulting in pathological proteinuria. Predictive uselfulness of WC might be affected by other factors proper of history of the transplanted patient.


REFERENCES

  1. Wang Y, Chen X, Song Y, Caballero B. Association between obesity and kidney disease: A systematic review and meta-analysis. Kidney Int 2008; 73:19-33.

  2. Navarro Díaz M, Serra A, López D, Granada M. Obesity, inflammation and kidney disease. Kidney Int 2008;111 (Suppl):S15-S18.

  3. Carrero JJ, Brodin L, Lindholm B. Adiponectin in chronic kidney disease: Dr Jekyll and Mr Hyde. Kidney Int 2009;75:120-1.

  4. Barceló M, Borroto G, Rodríguez H. Insulinorresistencia: Correlación con la distribución de la grasa en el obeso. Rev Cubana Invest Biomed 2002;21: 228-34.

  5. Bayes B, Granada M L, Lauzurica R, Salinas I. Obesity, adiponectin, inflammation and renal disease. Am J Kidney Dis 2007;7:416-22.

  6. Björntorp P. Body fat distribution, insulin resistance, and metabolic diseases. Nutrition 1997;13:795-803.

  7. Young JA, Hwang SJ, Sarnak MJ, Hoffmann U, Massaro JM, Levy D, Benjamin EJ, Larson MG, Vasan RS, O'Donnell CJ, Fox CS. Association of visceral and subcutaneous adiposity with kidney function. Clin J Am Soc Nephrol 2008;3:1786-91.

  8. Cofán F, Vela E, Clèries M; for the Catalan Renal Registry. Obesity in renal transplantation: Analysis of 2691 patients. Transplant Proc 2005; 37:3695-7.

  9. Gore JL, Pham PT, Danovitch GM, Wilkinson AH, Rosenthal JT, Lipshutz GS, Singer JS. Obesity and outcome following renal transplantation. Am J Transplant 2006;6:357-63.

  10. Díaz JM, Sainz Z, Oliver A, Guirado LI, Facundo C, García-Maset R, Solà R. Post-renal transplantation weight gain: Its causes and its consequences. Transplant Proc 2005;37:3839-41.

  11. Borroto Díaz G, Quintanilla Andino M, Barceló Acosta M, Cabrera Valdés L. Ganancia de peso, dismetabolia y función del injerto al año del trasplante renal. RCAN Rev Cubana Aliment Nut 2012;22:196-202.

  12. Kovesdy CP, Czira ME, Rudas A, Ujszaszi A, Rosivall L, Novak M, Kalantar-Zadeh K, Molnar MZ, Mucsi I. Body mass index, waist circumference and mortality in kidney transplant recipients. Am J Tranplant 2010;10:2644-51.

  13. Moreau K, Chauveau P, Martin S, El-Haggan W, Barthe N, Merville P, Aparicio M. Long-term evolution of body composition after renal transplantation: 5-year survey. J Ren Nutr 2006;16:291-9.

  14. Korsić M, Fister K, Ivanković D, Jelcić J. Visceral obesity. Lijec Vjesn 2011; 133:284-7.

  15. American Diabetes Association. Diagnosis and classification of diabetes. Diabetes Care 2010; 33(Suppl):S62-S69.

  16. Weiner JA, Lourie JA. Practical Human Biology. Academic Press. London: 1981.

  17. Lohman TG, Roche A, Martorell R. Anthropometric standardization reference manual. Human Kinetics Books. Primera Edición. Champaign, Illinois: 1988.

  18. Expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Executive summary of the Third Report of the National Cholesterol Education Program (NCEP). JAMA. 2001; 285(19):2486-96.

  19. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976;16:31-41.

  20. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D; for the Modification of Diet in Renal Disease Study Group. A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation. Ann Intern Med 1999; 130:461-70.

  21. Hosmer DW, Lemeshow S. Model building strategies and methods for logistic regression. En: Applied Logistic Regression. Second Edition. John Wiley & Sons. New York: 2000. pp 91-142.

  22. Santana Porbén S, Martínez Canalejo H. Manual de Procedimientos Bioestadísticos. Segunda Edición. EAE Editorial Académica Española. ISBN- 13: 9783659059629. ISBN-10: 3659059625. Madrid: 2012.

  23. Pamela S. Issues of obesity in kidney transplantation. J Renal Nutr 2007;17: 107-13.

  24. Clunk JM, Lin C-Y, Curtis JJ. Variables affecting weight gain in renal transplant recipients. Am J Kidney Dis 2001; 38:349-53.

  25. Zoccali S. Obesity and the epidemiology and prevention of kidney disease: Waist circumference versus index body mass index. Am J Kidney Dis 2011;58:157-9.

  26. Monast L, Batty G D, Cattaneo A, Lutje V. Early-life determinants of overweight and obesity: A review of systematic reviews. Obesity Reviews 2011;11;695-708.

  27. Potluri K, Hou S. Obesity in kidney transplant and candidates. Am J Kidney Dis 2010;56:143-56.

  28. Armstrong K, Campbell S, Hawley C, Johnson W, Isbel N. Impact of obesity on renal outcome. Nephrology 2005; 10:405-13.

  29. Clunk JM, Lin C-Y, Curtis JJ: Variables affecting weight gain in renal transplant recipients. Am J Kidney Dis 2001;38:349-353.

  30. Kent PS. Issues of obesity in kidney transplantation. J Ren Nutr 2007;17: 107-13.

  31. Chaston TB, Dixon JB. Factors associated with percent change in visceral versus subcutaneous abdominal fat during weight loss: Findings from a systematic review. Int J Obes 2008;32:619-28.

  32. Borroto G, Barcelo M, Cordero N, Soto J. Trasplante renal. Asociación entre dislipemia e insulinorresistencia. Rev Cubana Invest Biomed 2002;21: 155-60.

  33. Smith SR, Zachwieja JJ. Visceral adipose tissue: A critical review of intervention strategies. Int J Obes Relat Metab Disord 1999;23:329-35.

  34. Borroto G, Barceló M, Guerrero C, Alonso C. Insulinorresistencia en el trasplante renal. Rev Cubana Invest Biomed 2002;21:241-7.

  35. Yu BL, Zhao SP, Hu JR. Cholesterol imbalance in adipocytes: a possible mechanism of adipocytes dysfunction in obesity. Obesity Reviews 2010;11: 560-7.

  36. Locsey L, Asztzlos L, Kincses ZS, Berczi CS, Paragh GY: The importance of obesity and hyperlipidaemia in patients with renal transplants. Int Urol Nephrol 1998;30:767-75.

  37. Bogaert Y, Linas G. The role of obesity in the pathogenesis of hypertension. Nat Rev Nephrol 2009;5:101-12.

  38. Ponticelli C, Cucchiari D, D, Graziani G. Hypertension in kidney transplant recipients. Transplant Int 2011;24: 523-33.

  39. Borroto G, Batista F, Barcelo M, Guerrero C. Frecuencia y factores de riesgo de la Diabetes mellitus postrasplante renal. Rev Cubana Med 2002;41:207-11.

  40. Borroto Díaz G, Barcelo Acosta M, Rodríguez Alonso H, Guerrero Día C. Aspectos clínicos en la evolución de la diabetes mellitus post-trasplante renal. Rev Cubana Medicina 2002;41:146-51.

  41. Borroto DG, Ibars BE, Guerrero DC. Síndrome de resistencia a la insulina después del trasplante renal. Rev Cubana Medicina 2010;49:242-54.

  42. Ibars BE, Borroto DG, Guerrero DC, Barceló AM. Factores de riesgo para el desarrollo del síndrome de resistencia a la insulina en el trasplante renal. Rev Cubana Med 2012;51:3-14.

  43. Corry DB, Tuck ML. Selective aspects of the insulin resistance syndrome. Curr Opin Nephrol Hipertens 2001;10: 507-14.

  44. PostorinoM,Marino C, Tripepi G, Zoccali C. Abdominal obesity and all-cause and cardiovascular mortality in end-stage renal disease. J Am Coll Cardiol 2009;53:1265-72.

  45. Cacciola RA, Pujar K, Ilham MA, Puliatti C, Asderakis A, Chavez R. Effect of degree of obesity on renal transplant outcome. Transplant Proc. 2008;40:3408-12.

  46. Hevener AL, Febbraio MA. The 2009 Stock Conference Report: Inflamation, obesity and metabolic disease. Obesity Rev 2010;11:635-44.

  47. Jindau MR, Zawada ET. Obesity and kidney transplant. Am J Kidney Dis 2004;43:943-52.

  48. Sancho A, Guirado L, ramos D. Prognostic significance and diagnosis of proteinuria in renal trasnplantation. Transplant Rev 2012;26:30-5.

  49. Melilli E, Crazado J M, Bestard O, Hernández D. Mechanism and risk factors for development of proteinuria after kidney transplantation. Transplant Rev 2012;26:14-9.




2020     |     www.medigraphic.com