Abstract: TH-PO444

Effects of Diet and Exercise on Adipocytokine Levels in Patients with Moderate to Severe CKD

Session Information

Category: Nutrition, Inflammation, and Metabolism

  • 1401 Nutrition, Inflammation, Metabolism

Authors

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

Obesity is a pro-inflammatory risk factor for progression of CKD and cardiovascular disease. We hypothesized that implementation of caloric restriction and aerobic exercise improves adipocytokine profiles in patients with moderate to severe CKD.

Methods

We enrolled patients with moderate to severe CKD through a multi-center pilot randomized trial of diet and exercise in a 4-arm design (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 (42% female, 25% diabetic, and 91% hypertensive), 104 started intervention and 92 completed the study. Adipocytokines (adiponectin, leptin and resistin) were measured at the beginning and end of the study period as secondary outcomes. Treatment effect was analyzed in a multivariable model adjusted for baseline outcome values, age, gender, site and diabetes.

Results

Adiponectin and resistin levels increased statistically significantly in response to diet whereas leptin levels did not change by either treatment (Figure-1). Leptin-Adiponectin Ratio (LAR) decreased statistically significantly in response to both interventions (Figure-2).

Conclusion

Our data suggest that dietary caloric restriction improves adiponectin and resistin levels in Stage 3-4 CKD patients with limited effect on leptin levels. LAR improved in response to both interventions indicating a potential beneficial effect of exercise intervention to the overall metabolic milieu.

Effect of diet and exercise on Adiponectin and LAR levels in study groups compared to usual care.

Funding

  • Veterans Affairs Support