Department of Urology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
Department of Cardiology, Pulmonology, and Nephrology, Faculty of Medicine, Yamagata University, Yamagata, Japan.
Clin Exp Nephrol. 2024 Sep;28(9):943-952. doi: 10.1007/s10157-024-02492-9. Epub 2024 Apr 24.
Kidney transplantation (KT) leads to body composition change, particularly increasing the fat mass. However, limited researches have focused on the long-term follow-up of these changes and factors influencing body composition after KT.
This study evaluated body composition in 31 adult KT recipients, measuring body mass index (BMI), the psoas muscle mass index (PMI) representing muscle mass, visceral and subcutaneous adipose tissue (VAT and SAT) representing fat mass, and skeletal muscle radiodensity (SMR) representing muscle quality before KT and at 2, 4, and 6 years posttransplantation using computed tomography. Linear mixed models (LMM) analyzed temporal changes and contributing factors, while growth curve models assessed influence of these factors on body composition changes posttransplantation.
Following KT, BMI, and PMI remained stable, while SAT increased significantly, revealing a 1.30-fold increase from baseline 2 years after transplantation. Similarly, a substantial increase in VAT was observed, with a 1.47-fold increase from baseline 2 years after transplantation with a further 1.75-fold increase 6 years after transplantation. In contrast, SMR decreased with a 0.86-fold decrease from baseline after 2 years. VAT increase was significantly influenced by the interaction between posttransplantation and dialysis duration. Growth curve models confirmed this interaction effect persistently influenced VAT increase posttransplantation.
The study revealed that KT promoted significant alterations in body composition characterized by increase in the VAT and SAT and a decline in SMR. Notably, dialysis duration and its interaction with posttransplantation duration emerged as significant factors influencing VAT increase.
肾移植（KT）会导致身体成分发生变化，尤其是增加脂肪量。然而，关于这些变化的长期随访以及影响 KT 后身体成分的因素的研究有限。
本研究通过计算机断层扫描（CT）评估了 31 名成年 KT 受者的身体成分，测量了身体质量指数（BMI）、代表肌肉量的腰大肌质量指数（PMI）、代表脂肪量的内脏和皮下脂肪组织（VAT 和 SAT）以及代表肌肉质量的骨骼肌放射密度（SMR），在 KT 前以及移植后 2、4 和 6 年进行测量。线性混合模型（LMM）分析了时间变化和影响因素，而生长曲线模型评估了这些因素对移植后身体成分变化的影响。
KT 后，BMI 和 PMI 保持稳定，而 SAT 显著增加，从移植后 2 年的基线增加了 1.30 倍。同样，VAT 也显著增加，从移植后 2 年的基线增加了 1.47 倍，6 年后进一步增加了 1.75 倍。相比之下，SMR 在 2 年后从基线下降了 0.86 倍。VAT 的增加受到移植后和透析时间交互作用的显著影响。生长曲线模型证实这种相互作用效应持续影响移植后的 VAT 增加。
该研究表明，KT 导致身体成分发生显著变化，表现为 VAT 和 SAT 增加，SMR 下降。值得注意的是，透析时间及其与移植后时间的相互作用是影响 VAT 增加的重要因素。
