Body Composition and Leptin in Renal Transplantation.

Venkata Ramana Raju, S (2008) Body Composition and Leptin in Renal Transplantation. Masters thesis, Christian Medical College, Vellore.


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INTRODUCTION : Weight gain is common after renal transplantation, influenced by improved appetite and a reversal of the uremic state. Renal transplant patients are at risk for increased weight, centripetal obesity and muscle atrophy because of their long-term glucocorticoid requirements. Such changes in body composition are associated with an increased risk of cardiovascular complications, which is a major cause of morbidity and mortality in renal transplantation since infective complications have decreased with newer immunosuppressive medication and therapeutic drug level monitoring. Body composition data might provide insight in to the relation with outcome, survival and post transplant complications and it might affect approaches to nutritional therapy and to therapy in the field of physical activity.1 AIM : To assess the changes in body composition and leptin in the early post transplant period and to validate anthropometry in renal allograft recipients. PATIENTS AND METHODS : Consecutive renal allograft recipients were assessed prospectively at baseline, 3 & 6 months post-transplant by anthropometry, DEXA and serum leptin levels. RESULTS : 62 recipients (M:F=3:1, mean age 33.4±11.2 years), had a mean weight of 52±10.1, 56.8±9.3 and 57.7±9.6 kg at baseline, 3 & 6 months, respectively (p<0.01). The mean body fat at baseline, 3 & 6 months were 11.1±5.7, 13.9±5.7 and 14.5±6.2 kg respectively (p<0.001). The fat increment in arms, legs and trunk were 37.4%, 31.6% and 36.6% respectively. Skin fold thickness correlated well with fat (measured by DEXA) at all times (ICC=0.9, p<0.001). There was a 3.8% increase in lean body mass by 6 months (p<0.01) predominantly in legs. Anthropometry underestimated lean body mass. Total bone mineral content decreased from 1.92±0.34 to 1.85±0.31 kg (p=0.001) by 6 months, with significant reductions in spine (6.7%). The mean leptin levels at baseline, 3 and 6 months were 5.3±7.9, 6.0±8.4 and 15.4±17.4ng/ml respectively (p<0.05). At all times, leptin levels positively correlated with total body and regional fat content (p<0.01). CONCLUSIONS : Post renal transplant, patients gain significant amount of weight, mostly due to accumulation of the fat, especially around arms & trunk .There is overall decrease in bone mineral content, predominantly in the spine. Anthropometric measurements for fat assessment are a reasonable substitute for DXA. Leptin levels correlate with body fat content.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Body Composition ; Leptin ; Renal Transplantation.
Subjects: MEDICAL > Nephrology
Depositing User: Kambaraman B
Date Deposited: 11 Jul 2017 07:11
Last Modified: 11 Jul 2017 07:11

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