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

• Published in: Clinics and research in hepatology and gastroenterology Vol. 43; no. 2; pp. 140 - 147
• Main Authors: Alves, Bruna Cherubini, Bruch-Bertani, Juliana Paula, Galinatti, Clara Belle Manfroi, Garbin, Claudia Czarnobay, Álvares-da-Silva, Mário Reis, Dall'Alba, Valesca
• Format: Journal Article
• Language: English
• Published: France 01.04.2019
• Subjects: 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; nutritional assessment; atherosclerotic plaque; carotid intima-media thickness; liver transplantation; metabolic profile; dynapenia
• ISSN: 2210-7401; 2210-741X
• DOI: 10.1016/j.clinre.2018.09.005

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. 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. 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/m 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). 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.