Obesity, dynapenia and high cardiovascular risk co-exist in post-liver transplant setting: results of a cross-sectional study

Clin Res Hepatol Gastroenterol. 2019 Apr;43(2):140-147. doi: 10.1016/j.clinre.2018.09.005. Epub 2018 Oct 6.

Abstract

Background: Cardiovascular disease is a major cause of death in post-liver transplantation (LT). The aim of this study was to evaluate LT patients as to the carotid intima-media thickness (CIMT) and its association with nutritional status, dietary intake, metabolic profile and cardiovascular risk factors.

Methods: In this cross-sectional study, adult patients with more than 12 months of post-transplant follow-up underwent clinical, laboratory, functional and nutritional evaluation by 3-day-diet-record, anthropometry and dynamometry. CIMT was evaluated by Doppler ultrasonography.

Results: Sixty-nine post-LT patients [males 61%, median of age 59 (51-64) years were included; median time post-liver transplantation 2.8 (1.4-6.3) years]. High prevalence of malnutrition was found (45% of arm muscle area < p15 and 71% of handgrip strength < p30). Excess weight was present in 72% of patients, body mass index ≥ 30 kg/m2 in 35% and metabolic syndrome in 51%. Abnormal CIMT was found in 54% of the sample. Patients with abnormal CIMT presented higher cardiovascular risk Score, LDL cholesterol, higher prevalence of high-sensitive C-reactive protein ≥ 1 mg/L and higher intake of saturated and trans fatty acids (P < 0.05 for all).

Conclusions: Abnormal IMT was commonly found in LT patients presenting at the same time with overweight and dynapemia. These results were associated with higher LDL-cholesterol levels, high-sensitive C-reactive protein ≥ 1 mg/L and higher intake of saturated and trans fatty acids. Preventive measures, including dietary advice, are required for all post-liver transplantation patients to minimize cardiovascular risk.

Keywords: atherosclerotic plaque; carotid intima-media thickness; dynapenia; liver transplantation; metabolic profile; nutritional assessment.

MeSH terms

  • Aged
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Cardiovascular Diseases / etiology*
  • Carotid Intima-Media Thickness*
  • Cholesterol, LDL / blood
  • Cross-Sectional Studies
  • Diet Records
  • Fatty Acids / administration & dosage
  • Female
  • Hand Strength
  • Humans
  • Liver Transplantation*
  • Male
  • Malnutrition / diagnosis
  • Malnutrition / epidemiology
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / epidemiology
  • Middle Aged
  • Muscle Weakness / diagnosis
  • Muscle Weakness / epidemiology
  • Muscle Weakness / etiology*
  • Nutritional Status
  • Obesity
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Trans Fatty Acids / administration & dosage

Substances

  • Cholesterol, LDL
  • Fatty Acids
  • Trans Fatty Acids
  • C-Reactive Protein