Metabolic profile of liver transplant recipient with respect to the development of NAFLD – results of a pilot study


Authors: I. Hejlová 1;  M. Dezortová 2;  P. Šedivý 2;  M. Drobný 2;  M. Hájek 2;  M. Cahová 3;  H. Daňková 3;  E. Sticová 4;  V. Lánská 5;  P. Trunečka 6
Authors‘ workplace: Klinika hepatogastroenterologie, Transplantcentrum, IKEM, Praha 1;  Pracoviště radiodia­gnostiky a intervenční radiologie, Komplement, IKEM, Praha 2;  Centrum experimentální medicíny, IKEM, Praha 3;  Pracoviště klinické a transplantační patologie, Transplantcentrum, IKEM, Praha 4;  Lékařská statistika, IKEM, Praha 5;  Transplantcentrum, IKEM, Praha 6
Published in: Gastroent Hepatol 2016; 70(4): 325-330
Category: Hepatology: Original Article
doi: 10.14735/amgh2016325

Overview

Aims:
Non-alcoholic fatty liver disease (NAFLD) of liver grafts occurs in 31–56% of liver transplant recipients, and its prevalence increases with time after transplantation. The aim of this prospective study was to analyze metabolic profile of liver transplant recipients with respect to development of NAFLD.

Methods:
The pilot part of the prospective study included 31 patients at 1–16 years after liver transplantation who underwent a protocol liver biopsy. We performed laboratory investigations of glucose and lipid metabolism, and determined liver fat content and subcutaneous and visceral fat volume by 1H MR spectroscopy and imaging. We determined the maximal mitochondrial capacity in musculus gastrocnemius by dynamic 31P MR spectroscopy.

Results:
In the liver biopsies, we found steatosis grade 2–3 in 12 (38.7%) patients, steatosis grade 1 in 13 (41.9%) patients, and no steatosis in six (19.4%) patients. With increasing steatosis grade, a positive correlation was found between BMI (p = 0.002), waist circumference (p = 0.004), subcutaneous fat volume (p = 0.023), visceral fat volume (p = 0.034), occurrence of metabolic syndrome (p = 0.006), fasting glucose (p = 0.043), glycated haemoglobin (p = 0.048) and C-peptide (p = 0.026). The proportion of smokers was lower in patients with steatosis than in those without steatosis (p = 0.001). Increases in the HOMA index (p = 0.10) and decreases in the QUICKI index (p = 0.10) did not reach statistical significance. With increasing steatosis grade, we found a trend towards a decrease in maximal mitochondrial capacity of skeletal muscles measured by 31P MR spectroscopy, but the differences were not statistically significant (p = 0.23). Histological grade of steatosis correlated well with steatosis grade measured by 1H MR spectroscopy (p = 0.0002).

Conclusions:
In this pilot study, we identified significant clinical, laboratory and MR parameters that could contribute to predicting NAFLD in liver transplant recipients.

Key words:
insulin resistance – magnetic resonance – metabolic syndrome – mitochondrial capacity – NAFLD – liver transplantation

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
11. 7. 2016

Accepted:
1. 8. 2016


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Paediatric gastroenterology Gastroenterology and hepatology Surgery

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