MP405ETHNIC DIFFERENCES IN ACTIVITY STATUS, FUNCTIONAL CAPACITY AND CARDIOVASCULAR RISK FACTORS IN RENAL TRANSPLANT PATIENTS

Abstract

Introduction and Aims: A renal transplant offers great improvements in health and quality of life for patients with end-stage renal failure, but cardiovascular disease (CVD) remains the largest cause of mortality. Regular exercise has many potential benefits, including reduction of cardiovascular risk, but few UK centres formally offer exercise prescription, advice or support. South Asians (SAs) are known to have additional CVD burden, and evidence suggests reduced activity levels in ethnic minorities. This study aimed to explore ethnic differences in physical activity (PA), functional capacity, body composition and systemic inflammation in RTRs using a survey and objective methods. Methods: 271 RTRs (mean age 52 years, 54% male, 70% White British (WB), 14% SA) completed a survey including 3 validated questionnaires: 1. GP Physical Activity Questionnaire (GPPAQ) to categorise PA status; 2. Duke Activity Status Index (DASI) to measure functional capacity; 3. Stage of Change Questionnaire (SOCQ) to describe readiness to change exercise behaviour. Next, 35 RTRs (mean age 52 years (range 29-70), 66% male, 65.8% WB, 34.2% SA) underwent further objective investigation, including PA/sedentary time measured by accelerometry, physical capacity measured by shuttle walk test (SWT) and body composition by DXA. Plasma IL-6 was measured by ELISA as an assessment of systemic inflammation. Results: The survey showed that SA RTRs have significantly lower functional capacity than WB RTRs (DASI score (METS) 31.6 ± 2.88 vs 40.8 ± 1.25, p=0.03). However, there was no significant difference between the SA and WB ethnic groups in self-reported PA (GPPAQ: 29% active vs 36% active respectively, p=0.37), or the proportion of patients preparing for or contemplating exercise (SOCQ 53% vs 40%, p=0.32). 35 RTRs underwent more detailed objective testing. In both ethnic groups, DASI functional capacity scores were significantly correlated with both percentage body fat (r=-0.44, p=0.008) and plasma IL-6 (r=-0.37, p=0.029). SAs had significantly higher body fat (kg : 38.6 ± 1.36 vs 30.9 ± 1.93, p=0.021), shorter SWT (min: 5.7 ± 1.75 vs 13.9 ± 1.31, p=0.002) and higher sedentary time (min: 4831 ± 158.53 vs 4236 ± 126.14, p=0.011) compared to WB. Conclusions: South Asian RTRs have significantly lower physical function compared to White British RTRs, as demonstrated in our survey and confirmed by objective methods. This was associated with higher adiposity in SAs, and also with systemic inflammation, an important cardiovascular risk factor. Although self-reported PA did not differ in the two groups, objective accelerometry revealed that SAs are more sedentary. However, 53% SAs were contemplating or preparing for engagement in physical activity, indicating openness to behaviour change interventions. Appropriate strategies should be employed to engage South Asian RTRs in exercise, aiming to optimise body composition, improve physical function and reduce cardiovascular risk in this particularly vulnerable population.