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Published on: April 13, 2021
Malnutrition Risk in Kidney Recipients Treated With Mycophenolate Mofetil Is Associated With IMPDH1 rs2278294
J Pazik1, Z Lewandowski2, E Nowacka Cieciura1
1Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
Genetic variants in IMPDH1 may influence weight gain in kidney transplant recipients treated with mycophenolic acid (MPA). Specific IMPDH1 variants are linked to slower BMI gain and reduced underweight risk, suggesting personalized MPA therapy.
Area of Science:
- Nephrology
- Immunology
- Genetics
Background:
- Malnutrition increases morbidity and mortality in renal transplant recipients.
- Inosine monophosphate dehydrogenase (IMPDH) regulates fat accumulation and is targeted by mycophenolic acid (MPA).
- Genetic predisposition to low body mass index (BMI) in transplant recipients is poorly understood.
Purpose of the Study:
- To investigate the association between IMPDH1/IMPDH2 genetic variants and BMI changes in kidney transplant recipients.
- To explore the potential influence of MPA on fat tissue formation and weight gain.
- To determine if specific IMPDH1 or IMPDH2 single nucleotide polymorphism (SNP) variants modify MPA's effect on BMI.
Main Methods:
- Observational longitudinal study of 190 kidney transplant recipients treated with mycophenolate mofetil.
- Genotyping of IMPDH1 (rs2278294, rs2278293) and IMPDH2 (rs11706052) allelic variants.
- Primary outcome: time-dependent change in BMI; Secondary outcomes: occurrence of BMI < 18.5 or 20 kg/m².
Main Results:
- No association between BMI changes and IMPDH1 (rs2278293) or IMPDH2 (rs11706052) variants.
- IMPDH1 rs2278294, allele G, was associated with significantly slower BMI gain.
- G allele carriers had a higher incidence of being underweight and having BMI < 20 kg/m² post-transplant compared to AA carriers.
Conclusions:
- MPA derivatives may influence post-transplant BMI and body fat content.
- Genotyping the IMPDH1 rs2278294 variant could enable personalized MPA treatment strategies.
- This finding may help optimize nutritional management and prevent malnutrition in kidney transplant recipients.
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