Received January 17, 2006
Accepted on August 20, 2006

ORIGINAL ARTICLES

Cardiorespiratory Fitness Is Related to Physical Inactivity, Metabolic Risk Factors, and Atherosclerotic Burden in Glucose-Intolerant Renal Transplant Recipients

Kirsten Armstrong ^*1, Dhrubo Rakhit , Leanne Jeffriess , David Johnson ^*, Rodel Leano , John Prins , Luke Garske , Thomas Marwick , and Nicole Isbel ^*

Departments of *Nephrology, Endocrinology, and Respiratory Medicine and School of Medicine, University of Queensland at Princess Alexandra Hospital, Brisbane, Queensland, Australia

¹ To whom correspondence should be addressed. E-mail: kirsty{at}ascom.net.

	Abstract

The mechanisms of reduced cardiorespiratory fitness (CF) in renal transplant recipients (RTR) have not been studied closely. This study evaluated the relationships between CF and specific cardiovascular risk factors (metabolic syndrome [MS], physical inactivity, myocardial ischemia, and atherosclerotic burden) in glucose-intolerant RTR. Data were recorded on 71 glucose-intolerant RTR (mean age 55 yr; 55% male; median transplant duration 5.7 yr). MS was defined using National Cholesterol Education Programme Adult Treatment Panel III criteria. Resting and exercise stress echocardiography were performed, and myocardial ischemia was identified by new or worsening wall motion abnormalities. Cardiorespiratory fitness was determined using peak oxygen uptake (VO₂) by expired gas analysis. Atherosclerotic burden was assessed by carotid intima-media thickness (IMT). Mean peak VO₂ was 19 ± 7 ml/kg per min and was significantly lower than predicted peak VO₂ (29 ± 6 ml/kg per min; P < 0.001). Patients with MS (63%) had reduced CF (17 ± 6 versus 22 ± 8 ml/kg per min; P = 0.001) and were more likely to be physically inactive (76 versus 48%; P = 0.02). CF was reduced in 14 patients with myocardial ischemia (15 ± 3 versus 20 ± 7 ml/kg per min; P = 0.05). CF was positively correlated with male gender, height, and physical activity and inversely correlated with number of MS risk factors and IMT (adjusted R² = 0.66). Carotid IMT added incremental value to clinical variables in determining VO₂ (adjusted R² = 0.65 versus 0.63; P = 0.04). Reduced CF is associated with physical inactivity, MS, and atherosclerotic burden in glucose-intolerant RTR. Further studies should address whether increasing exercise and modifying MS risk factors improve CF in RTR.