Ulivieri Fabio M, Piodi Luca P, Aroldi Adriana, Cesana Bruno M
Servizio di Medicina Nucleare, Ospedale Maggiore di Milano, via F.Sforza 35, 20122 Milan, Italy.
Transplantation. 2002 Feb 27;73(4):612-5. doi: 10.1097/00007890-200202270-00024.
Bone loss is a frequent and well-known complication in the first months after renal transplantation, but there are no data considering body composition variables (bone, fat, and lean mass) together in transplant recipients. This prospective study investigated total body bone density, fat mass, and lean mass before and 1, 2, 3, 4, and 6 months after renal transplantation in male patients who underwent hemodialysis.
Twenty consecutive renal transplant male patients aged 23-64 years (mean, 40 years; median, 41 years) received one of two immunosuppressive therapies (cyclosporine+methylprednisolone, or cyclosporine+methylprednisolone+azathioprine). The bone, fat, and lean mass of the total body and its related subregions were assessed by means of dual X-ray photon absorptiometry. Mixed factorial analysis of variance for repeated measurements was used for the statistical analysis.
During the 6 months after transplantation, there was a reduction in trabecular bone mass in the spine, ribs, and pelvis total body subregions; the reduction was statistically significant in the last two subregions. There was no statistically significant difference in the lean mass of the total body or its subregions over time, but there was a statistically significant increase in the fat mass of the total body and all of its subregions; the increase in total and trunk fat mass seemed to be greater in the patients not receiving azathioprine.
Up to 6 months after renal transplantation in male patients who underwent hemodialysis, there is a marked increase in fat mass, a significant loss of trabecular bone mass, and no change in cortical bone and lean mass.
骨质流失是肾移植后最初几个月常见且广为人知的并发症,但尚无关于移植受者身体成分变量(骨量、脂肪量和瘦体重)综合情况的数据。这项前瞻性研究调查了接受血液透析的男性患者肾移植前以及移植后1、2、3、4和6个月时的全身骨密度、脂肪量和瘦体重。
连续纳入20例年龄在23 - 64岁(平均40岁;中位数41岁)的男性肾移植患者,接受两种免疫抑制治疗方案之一(环孢素+甲泼尼龙,或环孢素+甲泼尼龙+硫唑嘌呤)。通过双能X线吸收法评估全身及其相关子区域的骨量、脂肪量和瘦体重。采用重复测量的混合因子方差分析进行统计分析。
移植后的6个月内,脊柱、肋骨和骨盆全身子区域的小梁骨量减少;后两个子区域的减少具有统计学意义。全身及其子区域的瘦体重随时间无统计学显著差异,但全身及其所有子区域的脂肪量有统计学显著增加;未接受硫唑嘌呤的患者全身和躯干脂肪量的增加似乎更大。
在接受血液透析的男性患者肾移植后的6个月内,脂肪量显著增加,小梁骨量显著减少,皮质骨和瘦体重无变化。