Heng Anne-Elisabeth, Montaurier Christophe, Cano Noël, Caillot Nicolas, Blot A, Meunier Nathalie, Pereira Bruno, Marceau Geoffroy, Sapin Vincent, Jouve Christelle, Boirie Yves, Deteix Patrice, Morio Beatrice
CHU Clermont-Ferrand, Service de Néphrologie, Pôle REUNNIRH, F-63003 Clermont-Ferrand, France; INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France.
INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France.
Clin Nutr. 2015 Jun;34(3):457-64. doi: 10.1016/j.clnu.2014.05.003. Epub 2014 May 15.
BACKGROUND & AIMS: Alterations in energy metabolism could trigger weight gain after renal transplantation.
Nineteen transplanted non-diabetic men, 53 ± 1.6 years old, receiving calcineurin inhibitors but no corticosteroids were studied. They were compared with nine healthy men matched for height, age and lean body mass. Daily energy expenditure and its components (sleeping, basal and absorptive metabolic rates) were analyzed for 24 h in calorimetric chambers and for 4 days in free living conditions using calibrated accelerometry. Other variables known to influence energy expenditure were assessed: body composition, physical activity, 4-day food intake, drug consumption, serum C-reactive protein, interleukin-6, thyroid and parathyroid hormones, and epinephrine. Transplant recipients who gained more than 5% body weight after transplantation (n = 11, +11.0 ± 1.5 kg) were compared with those who did not (n = 8) and with the controls.
Weight gain compared with non-weight gain patients and controls exhibited higher fat mass without change in lean body mass. Daily, sleeping and resting energy expenditure adjusted for lean body mass was significantly higher in non-weight gain (167.1 ± 4.2 kJ/kg/lean body mass/24 h, P < 0.05) compared with weight gain patients (147.4 ± 3.6) and controls (146.1 ± 4.6). Weight gain compared with controls and non-weight gain subjects had lower free living physical activity and a higher consumption of antihypertensive drugs and β-blockers.
After kidney transplantation, weight gain patients were characterized by lower adjusted energy expenditure, reduced spontaneous physical activity but a more sedentary life style and a trend toward a higher energy intake explaining the reason they gained weight. The nWG KTR had increased resting and sleeping EE which protected them from weight gain. Such hypermetabolism was also observed in 24-h EE measurements. By comparison with the nWG patients, the WG transplant recipients were characterized by higher β-blocker consumption. These data could be helpful in the prevention of weight gain in kidney transplant recipients.
能量代谢改变可能引发肾移植后体重增加。
对19名接受钙调神经磷酸酶抑制剂但未使用皮质类固醇的非糖尿病男性肾移植受者进行研究，他们的年龄为53±1.6岁。将他们与9名身高、年龄和瘦体重相匹配的健康男性进行比较。使用校准加速度计在热量测定室中对每日能量消耗及其组成部分（睡眠、基础和吸收代谢率）进行24小时分析，并在自由生活条件下进行4天分析。评估其他已知影响能量消耗的变量：身体成分、身体活动、4天食物摄入量、药物消耗、血清C反应蛋白、白细胞介素-6、甲状腺和甲状旁腺激素以及肾上腺素。将移植后体重增加超过5%的受者（n = 11，体重增加11.0±1.5 kg）与未增加体重的受者（n = 8）以及对照组进行比较。
与未体重增加的患者和对照组相比，体重增加者的脂肪量更高，而瘦体重没有变化。调整瘦体重后的每日、睡眠和静息能量消耗，未体重增加者（167.1±4.2 kJ/kg/瘦体重/24小时，P < 0.05）显著高于体重增加患者（147.4±3.6）和对照组（146.1±4.6）。与对照组和未体重增加的受试者相比，体重增加者的自由生活身体活动较低，抗高血压药物和β受体阻滞剂的消耗量较高。
肾移植后，体重增加的患者表现为调整后的能量消耗较低、自发身体活动减少但生活方式更久坐，且能量摄入有增加趋势，这解释了他们体重增加的原因。未体重增加的肾移植受者静息和睡眠能量消耗增加，这使他们免于体重增加。在24小时能量消耗测量中也观察到这种高代谢。与未体重增加的患者相比，体重增加的移植受者的特点是β受体阻滞剂消耗量更高。这些数据可能有助于预防肾移植受者体重增加。
