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Renal function and physical fitness after 12-mo supervised training in kidney transplant recipients

World Journal of Transplantation 2018年第1期8卷 13-22页

作者： Giulio Sergio Roi Giovanni Mosconi Valentina Totti Maria Laura Angelini Erica Brugin Patrizio Sarto Laura Merlo Sergio Sgarzi Michele Stancari Paola Todeschini Gaetano La Manna Andrea Ermolao Ferdinando Tripi lucia andreoli Gianluigi Sella Alberto Anedda Laura Stefani Giorgio Galanti Rocco Di Michele Franco Merni Manuela Trerotola Daniela Storani Alessandro Nanni Costa Department of Education and Research Isokinetic Medical Group Department of Nephrology and Dialysis Morgagni-Pierantoni Hospital Department of Biomedical & Neuromotor Sciences University of Bologna Associazione Nazionale Emodializzati Dialisi e Trapianto Department of Cardiovascular Sports Medicine Sports Medicine ULSS Company 9 Sports Medicine Regional Hospital of Bologna Department of Nephrology and Dialysis S. Orsola Hospital Sports Medicine Unit DIMED Department of Medicine University of Padua Sports Medicine Regional Hospital of Modena Sports Medicine Regional Hospital of Ravenna Sports Medicine Regional Hospital of Parma Department of Experimental and Clinical Medicine School of Sports Medicine University of Florence Sports Medicine Centre Italian National Transplant Centre

AIM To evaluate the effect of a 12-mo supervised aerobic and resistance training, on renal function and exercise capacity compared to usual care *** Ninety-nine kidney transplant recipients(KTRs) were assigned to interventional exercise(Group A; n = 52) and a usual care cohort(Group B; n = 47). Blood and urine chemistry, exercise capacity, muscular strength, anthropometric measures and health-related quality of life(HRQo L) were assessed at baseline, and after 6 and 12 mo. Group A underwent a supervised training three times per week for 12 mo. Group B received only general recommendations about home-based physical *** Eighty-five KTRs completed the study(Group A, n = 44; Group B, n = 41). After 12 mo, renal function remained stable in both groups. Group A significantly increased maximum workload(+13 W, P = 0.0003), V'O2 peak(+3.1 mL/kg per minute, P = 0.0099), muscular strength in plantar flexor(+12 kg, P = 0.0368), height in the countermovement jump(+1.9 cm, P = 0.0293) and decreased in Body Mass Index(-0.5 kg/m^2, P = 0.0013). HRQo L significantly improved in physical function(P = 0.0019), physical-role limitations(P = 0.0321) and social functioning scales(P = 0.0346). Noimprovements were found in Group *** Twelve-month of supervised aerobic and resistance training improves the physiological variables related to physical fitness and cardiovascular risks without consequences on renal function. Recommendations alone are not sufficient to induce changes in exercise capacity of KTRs. Our study is an example of collaborative working between transplant centres, sports medicine and exercise facilities.

关键词： Kidney transplant recipients Renal function Supervised exercise Aerobic exercise Muscle strength

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Role of osteoprotegerin/receptor activator of nuclear factor kappa B/receptor activator of nuclear factor kappa B ligand axis in nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2018年第19期24卷 2073-2082页

作者： lucia Pacifico Gian Marco andreoli Miriam D'Avanzo Delia De Mitri Pasquale Pierimarchi Policlinico Umberto I Hospital Sapienza University of Rome Institute of Translational Pharmacology National Research Council

Concomitantly with the increase in the prevalences of overweight/obesity, nonalcoholic fatty liver disease(NAFLD) has worldwide become the main cause of chronic liver disease in both adults and children. Patients with fatty liver display features of metabolic syndrome(Met S), like insulin resistance(IR), glucose intolerance, hypertension and dyslipidemia. Recently, epidemiological studies have linked obesity, Met S, and NAFLD to decreased bone mineral density and osteoporosis, highlighting an intricate interplay among bone, adipose tissue, and liver. Osteoprotegerin(OPG), an important symbol of the receptor activator of nuclear factor-B ligand/receptor activator of nuclear factor kappa B/OPG system activation, typically considered for its role in bone metabolism, may also play critical roles in the initiation and perpetuation of obesityrelated comorbidities. Clinical data have indicated that OPG concentrations are associated with hypertension, left ventricular hypertrophy, vascular calcification, endothelial dysfunction, and severity of liver damage in chronic hepatitis C. Nonetheless, the relationship between circulating OPG and IR as a key feature of Met S as well as between OPG and NAFLD remains uncertain. Thus, the aims of the present review are to provide the existent knowledge on these associations and to discuss briefly the underlying mechanisms linking OPG and NAFLD.

关键词： Nonalcoholic fatty liver disease Insulin resistance Metabolic syndrome Osteoprotegerin Receptor activator of nuclear factor kappa B Receptor activator of nuclear factor kappa B ligand

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Pancreatic fat and β-cell function in overweight/obese children with nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2015年第15期21卷 4688-4695页

作者： lucia Pacifico Michele Di Martino Caterina Anania Gian Marco andreoli Mario Bezzi Carlo Catalano Claudio Chiesa Department of Pediatrics and Child Neuropsychiatry Sapienza University of Rome Department of Radiological Sciences Sapienza University of Rome Institute of Translational Pharmacology National Research Council

AIM: To analyze the associations of pancreatic fat with other fat depots and β-cell function in pediatric nonalcoholic fatty liver disease(NAFLD).METHODS: We examined 158 overweight/obese children and adolescents, 80 with NAFLD [hepatic fat fraction(HFF) ≥ 5%] and 78 without fatty liver. Visceral adipose tissue(VAT), pancreatic fat fraction(PFF) and HFF were determined by magnetic resonance imaging. Estimates of insulin sensitivity were calculated using the homeostasis model assessment of insulin resistance(HOMA-IR), defined by fasting insulin and fasting glucose and whole-body insulin sensitivity index(WBISI), based on mean values of insulin and glucose obtained from oral glucose tolerance test and the corresponding fasting values. Patients were considered to have prediabetes if they had either:(1) impaired fasting glucose, defined as a fasting glucose level ≥ 100 mg/d L to < 126 mg/d L;(2) impaired glucose tolerance, defined as a 2 h glucose concentration between ≥ 140 mg/d L and < 200 mg/d L; or(3) hemoglobin A1 c value of ≥ 5.7% to < 6.5%.RESULTS: PFF was significantly higher in NAFLD patients compared with subjects without liver involvement. PFF was significantly associated with HFF and VAT, as well as fasting insulin, C peptide, HOMA-IR, and WBISI. The association between PFF and HFF was no longer significant after adjusting for age, gender, Tanner stage, body mass index(BMI)-SD score, and VAT. In multiple regression analysis withWBISI or HOMA-IR as the dependent variables, against the covariates age, gender, Tanner stage, BMI-SD score, VAT, PFF, and HFF, the only variable significantly associated with WBISI(standardized coefficient B,-0.398; P = 0.001) as well as HOMA-IR(0.353; P = 0.003) was HFF. Children with prediabetes had higher PFF and HFF than those without. PFF and HFF were significantly associated with prediabetes after adjustment for clinical variables. When all fat depots where included in the same model, only HFF remained significantly associated

关键词： Nonalcoholic fatty liver disease Pancreaticfat Visceral fat Beta-cell function Children

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