Vnitr Lek 2012, 58(9):640-646

Regular exercise training decreases asymmetric dimethylarginine after kidney transplantation

V. Teplan^1,2,*, A. Mahrová³, K. Švagrová³, J. Racek⁴, R. Gürlich⁵, V. Teplan jr⁵, L. Šenolt⁶, M. Štollová¹

¹ Klinika nefrologie Transplantcentra IKEM Praha, přednosta prof. MUDr. Ondřej Viklický, CSc.

² Subkatedra nefrologie IPVZ Praha, vedoucí prof. MUDr. Vladimír Teplan, DrSc.

³ Laboratoř sportovní motoriky Fakulty tělesné výchovy a sportu UK Praha, přednosta prof. Ing. Václav Bunc, CSc.

⁴ Ústav klinické biochemie a hematologie Lékařské fakulty UK a FN Plzeň, přednosta prof. MUDr. Jaroslav Racek, DrSc.

⁵ Chirurgická klinika 3. lékařské fakulty UK a FN Královské Vinohrady Praha, přednosta prof. MUDr. Robert Gürlich, CSc.

⁶ Revmatologický ústav Praha, ředitel prof. MUDr. Karel Pavelka, DrSc.

Background:
Levels of the endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine are elevated in patients undergoing kidney transplantation and may contribute to vascular complications. In this study we tested the hypothesis that elevated asymmetric dimethylarginine can be reduced in patients after kidney transplantation by early regular physical exercise. Selected cytokines and metabolic parameters were also analysed.

Methods:
Plasma samples for analysis of asymmetric dimethylarginine, adiponectin, leptin, soluble leptin receptor, resistin, visfatin, CRP, TNFα and selected metabolic parameters were obtained from randomly selected sixty eight patients after kidney transplantation who agreed to participate in a supervised aerobic exercise program for six months. Samples were collected before the training began (one month after surgery with stabilized graft function) and at six months after initiation. Sixty transplant patients matched for age, sex, HLA typing, duration of previous dialysis, history of cardiovascular disease and immunosupression regimen who did not exercise regularly and did not participate in the training program were examined as controls.

Results:
There were no differences in elevated asymmetric dimethylarginine levels between both groups before the training program began. After six months of exercise, asymmetric dimethylarginine concentration in the exercising group I significantly decreased (3.5 ± 0.45 vs 2.11 ± 0.35 μmol/L, P < 0.01) and was also significantly lower comparing to non-exercising group II (2.11 ± 0.23 vs 3.25 ± 0.34 μmol/L, P < 0.01). We found significant changes in exercising group I: adiponectin (15.4 ± 6.6 vs 22.3 ± 6.2 mg/mL, P < 0.01), leptin (51.3 ± 11.2 vs 20.3 ± 9.2 ng/L, P < 0.01), soluble leptin receptor (24.6 ± 8.4 vs 46.1 ± 11.4 U/mL, P < 0.01), resistin (20.8 ± 10.1 vs 14.6 ± 6.4 mg/mL, P < 0.025) and visfatin (1.8 ± 0.2 vs 1.2 ± 0.01 ng/mL, P < 0.05). Blood lipids, HbA_1c, CRP and TNFα were also affected by the training program.

Conclusions:
Elevated asymmetric dimethylarginine level, selected adipocytokines and proinflammatory cytokines in patients after kidney transplantation were significantly influenced by early regular exercise. This regimen may decrease cardiovascular risk in patients after kidney transplantation.

Keywords: renal transplantation; physical exercise; ADMA; adiponectin; leptin; resistin; visfatin

Received: March 30, 2012; Accepted: May 9, 2012; Published: September 1, 2012  Show citation