Endocrine Abstracts

Weight gain and obesity are frequent problems after kidney transplantation. Potential causes of weight gain are use of immunosuppressive drugs and changes in life style such as dietary intake and insufficient physical activity. This study aimed to evaluate the different general and abdominal obesity criterias and post-transplant weight changes in kidney transplant recipients.

Methods: This prospective study included consecutive 112 (62 females, 50 males) patients, with a mean age of 41.5±11.1 years who underwent kidney transplantation. Obesity was assessed by calculating body mass index (BMI) for general obesity, and waist (WaC) and hip (HC) circumferences and waist to hip ratio (WHR) for abdominal obesity. Optimal WaC is evaluated and categorized differently by different organizations like International Diabetes Federation (IDF) and World Health Organization (WHO). Obesity classification according to WaC defined by IDF and WHO was ≥94 and ≥102 cm for males and ≥80 and ≥88 cm for females, respectively. WHR was considered as obese if >0.9 for males and >0.8 for females.

Results: The measurements of the patients were obtained during 4 years after transplantation. The median weight gain was 3.6 kg at 1^st year (n=112), 5.6 kg at 2^nd year (n=112), 7.8 kg at 3^rd year (n=112) and 8.5 kg at 4^th year (n=95, 43 males, 52 females). The median values at pre-transplant and post-transplant 1^st, 2^nd, 3^rd and 4^th years were 23.4, 25.0, 25.8, 25.8 and 26.5 kg/m² for BMI; 84, 89, 89, 90 and 90 cm for WaC; 94, 98, 98.5, 100 and 100 cm for HC; 0.9, 0.89, 0.89, 0.92 and 0.91 for WHR, respectively. The increases in these parameters were significant when compared to pretransplant values except WHR (P<0.001). When the obesity criterias were evaluated separately, obese ratios for BMI, WaC-IDF, WaC-WHO and WHR were 7.1%, 42.9%, 20.5% and 75.9% at pre-transplant, 14.3%, 56.3%, 38.4% and 75.9% at 1^st year, 20.5%, 55.4%, 41.1% and 69.6% at 2^nd year, 24.1%, 58%, 40.2% and 68.8% at 3^rd year, and 27.4%, 56.8%, 45.3% and 70.5% at 4^th year, respectively.

Conclusion: We observed a continous weight gain in our kidney transplant patients. When different obesity criterias were taken into account, the ratios of obese patients also varied. The ratios were higher by WHR and lower by BMI. After the second year there was a relative slowdown at the rate of obesity increase. Abdominal obesity seemed to be a more prominent problem compared to general obesity.