Physical Activity and the Development of Post-Transplant Diabetes Mellitus, and Cardiovascular- and All-Cause Mortality in Renal Transplant Recipients

Oyuntugs Byambasukh; Maryse  C. J. Osté; António  W. Gomes-Neto; Else van den Berg; Gerjan Navis; Stephan  J. L. Bakker; Eva Corpeleijn

doi:10.3390/jcm9020415

Journal of Clinical Medicine (Feb 2020)

Physical Activity and the Development of Post-Transplant Diabetes Mellitus, and Cardiovascular- and All-Cause Mortality in Renal Transplant Recipients

Oyuntugs Byambasukh,
Maryse C. J. Osté,
António W. Gomes-Neto,
Else van den Berg,
Gerjan Navis,
Stephan J. L. Bakker,
Eva Corpeleijn

Affiliations

Oyuntugs Byambasukh: Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
Maryse C. J. Osté: Department of Nephrology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
António W. Gomes-Neto: Department of Nephrology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
Else van den Berg: Department of Nephrology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
Gerjan Navis: Department of Nephrology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
Stephan J. L. Bakker: Department of Nephrology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
Eva Corpeleijn: Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands

DOI: https://doi.org/10.3390/jcm9020415
Journal volume & issue: Vol. 9, no. 2
p. 415

Abstract

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(1) Background: Little is currently known about the health impacts of daily-life moderate-to-vigorous physical activity (MVPA) in relation to the development of post-transplant diabetes mellitus (PTDM) and the long-term survival of renal transplant recipients (RTRs). (2) Methods: We analyzed self-reported data on MVPA within non-occupational and occupational domains, estimated with the SQUASH questionnaire, from a prospective cohort study of RTRs (n = 650) with a functioning graft exceeding 1 year. PTDM diagnoses were based on plasma glucose levels (≥126 mg/dL), HbA1c (≥6.5%), and the use of antidiabetic medication. Mortality data were retrieved from patient files up to the end of September 2015. (3) Results: During a median follow-up period of 5.3 years, 50 patients (10%) developed PTDM and 129 (19.8%) died. Of these deaths, 53 (8.9%) were caused by cardiovascular disease. Cox regression analyses showed that higher MVPA levels among patients were associated with a lower risk of PTDM (hazard ratio (HR); 95% confidence interval (95%CI) = 0.49; 0.25−0.96, p = 0.04), cardiovascular- (0.34; 0.15−0.77, p = 0.01), and all-cause mortality (0.37; 0.24−0.58, p < 0.001) compared with No-MVPA patients, independently of age, sex, and kidney function parameters. Associations of MVPA with cardiovascular and all-cause mortality remained significant and materially unchanged following further adjustments made for transplant characteristics, lifestyle factors, metabolic parameters, medication use, and creatinine excretion (muscle mass). However, the association between MVPA and PTDM was no longer significant after we adjusted for metabolic confounders and glucose levels. (4) Conclusion: Higher MVPA levels are associated with long-term health outcomes in RTRs.

Published in Journal of Clinical Medicine

ISSN: 2077-0383 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine
Website: http://www.mdpi.com/journal/jcm

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