Abstract: TH-PO521

Body Fat and Phase Angle, Rather Than Lean Mass, Show the Strongest Correlations with VO2 Peak in Stage 3 and 4 CKD Patients

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 305 CKD: Clinical Trials and Tubulointerstitial Disorders

Authors

  • Taylor, Jacob M., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Bian, Aihua, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Stewart, Thomas G., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Himmelfarb, Jonathan, University of Washington, Seattle, Washington, United States
  • Ikizler, Talat Alp, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Alsouqi, Aseel, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Robinson-Cohen, Cassianne, University of Washington, Seattle, Washington, United States
  • Ellis, Charles D., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Headley, Sam A., Springfield College, Wilbraham, Massachusetts, United States
  • Tuttle, Katherine R., University of Washington, Seattle, Washington, United States
  • Evans, Elizabeth E., Springfield College, Wilbraham, Massachusetts, United States
  • Germain, Michael J., Renal and Transplant Assoc of New England, Hampden, Massachusetts, United States
  • Limkunakul, Chutatip, Srinakharinwirot University, Nonthaburi, Thailand
Background

VO2 peak is a measure of aerobic fitness and is a good indicator of cardiovascular health. Understanding how body composition measures are correlated with VO2 peak is important for developing targeted interventions aimed at improving health.

Methods

We performed a post-hoc analysis of a pilot randomized 4-arm trial examining the effects of diet and exercise (dietary restriction of 10%-15% reduction in caloric intake, exercise three times/week, combined diet and exercise and control)(NCT01150851). A total of 122 participants were consented, 111 were randomized, and 108 completed baseline VO2 peak testing. Body composition metrics were measured via dual energy x-ray absorptiometry, including total mass, fat mass, lean mass, and fat free mass, body fat percentage (including android and gynoid fat percentage), body mass index, weight, and waist to hip ratio. In addition, body cell mass and phase angle were measured by bioelectrical impedance analysis. The primary outcome was to determine whether body composition measurements were correlated with VO2 peak at baseline. Correlations were adjusted for age, gender, diabetes status, and site of study visits in the model.

Results

Most participants were male (57%), white (68%), and had 24% diabetes. Median (IQR) for age was 57 (49-63) years, with baseline VO2 peak 19.6 (16.2-22.6) mL/kg/min. At baseline, body fat percentage (rs=-0.38), android (rs=-0.336) and gynoid fat percentage (rs=-0.313), body mass index (rs=-0.372), weight (rs=-0.282), and phase angle (rs=0.278) were all significantly correlated with VO2 peak after adjustment (p<0.03 for each individual variable). Holding other covariates at the mean, the difference in VO2 peak between the 25th and 75th percentiles of lean mass was 1.9 (-0.5,4.2) mL/kg/min, whereas the same difference comparing the 25th and 75th percentiles of fat mass was -3.6 (-5.5,-1.3) mL/kg/min.

Conclusion

Our findings indicated that body fat composition and phase angle, rather than lean mass, show the strongest correlations to VO2 peak. An intervention aimed at reducing body fat or improving phase angle may prove effective at improving VO2 peak in future research.

Funding

  • Other NIH Support