Metabolic syndrome after liver transplantation: prevalence and predictive factors

Anastácio, Lucilene Rezende; Ferreira, Lívia Garcia; Ribeiro, Hélio; Liboredo, Juliana Costa; Lima, Agnaldo Soares; Correia, María Isabel Toulson Davisson

doi:10.1016/j.nut.2010.12.017

Cited by 70 publications

(70 citation statements)

References 31 publications

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“…107 Patients with diabetes or coronary artery disease, both commonly associated with obesity, are approximately 40% more likely to die within 5 years of liver transplantation compared to non-diabetics or to patients without coronary artery disease. 108,109 Metabolic syndrome, a disorder in which obesity, insulin resistance, high blood pressure and dyslipidemia coexist, is highly prevalent in liver transplant patients 110 and is predicted by alcoholic etiology of cirrhosis, excessive weight prior to transplantation, as well as reduced intakes of calcium, potassium, fiber and folate. 110 Finally, in line with these observations, despite excellent graft function, many long-term liver transplant survivors manifest a sarcopenic obesity-phenotype characterized by increased body fat but low muscle mass.…”

Section: Malnutrition and Outcome Following Liver Transplantationmentioning

confidence: 99%

“…108,109 Metabolic syndrome, a disorder in which obesity, insulin resistance, high blood pressure and dyslipidemia coexist, is highly prevalent in liver transplant patients 110 and is predicted by alcoholic etiology of cirrhosis, excessive weight prior to transplantation, as well as reduced intakes of calcium, potassium, fiber and folate. 110 Finally, in line with these observations, despite excellent graft function, many long-term liver transplant survivors manifest a sarcopenic obesity-phenotype characterized by increased body fat but low muscle mass. 111 The impact of nutritional status on neurological complications following liver transplantation has recently been reviewed.…”

Section: Malnutrition and Outcome Following Liver Transplantationmentioning

confidence: 99%

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Reprint of: Nutrition in the Management of Cirrhosis and its Neurological Complications

Bémeur

Butterworth

2015

Journal of Clinical and Experimental Hepatology

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Section: Malnutrition and Outcome Following Liver Transplantationmentioning

confidence: 99%

Section: Malnutrition and Outcome Following Liver Transplantationmentioning

confidence: 99%

Reprint of: Nutrition in the Management of Cirrhosis and its Neurological Complications

Bémeur

Butterworth

2015

Journal of Clinical and Experimental Hepatology

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“…In addition, recent studies have reported a significantly higher post-LT prevalence of MS ranging from 40% to 58% at 1 year compared to the general population. 3,4 Interestingly, the higher incidence of MS in LT recipients is not only seen in patients transplanted for nonalcoholic fatty liver disease (NAFLD) but also in patients transplanted for other indications.…”

Section: See Article On Page 889mentioning

confidence: 99%

Cardiovascular diseases after liver transplantation—a still emerging and unsolved problem!

Graziadei

Cárdenas

2015

Liver Transpl

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The outcome of adult liver transplantation (LT) recipients has improved incrementally over the last 4 decades with patient survival rates of approximately 90% at 1 year and 70%-80% at 5 to 10 years. The greatest progress has been mainly achieved in the early postoperative period because of improved selection criteria, advances in surgical techniques, and improvements in immunosuppressive and anti-infective drug therapies. The survival rates beyond 1 year, however, have remained relatively stagnant during the same time period. This fact as well as the growing number of long-term survivors has increased the importance of understanding the underlying mechanisms and risk factors for intermediate and late post-LT complications and death attributed to medical complications. Beside de novo malignancies, cardiovascular diseases (CVDs) have emerged as one the leading causes of non-graftrelated morbidity and mortality in LT recipients, accounting for 12%-16% of deaths. 1Several studies have shown that LT recipients have a significantly increased risk of cardiovascular (CV) events and deaths compared to an age-and sexmatched general population. This elevated CVD rate ranges from 9% at 5 years to up to 25% at 10 years. 2The high prevalence of metabolic syndrome (MS) and its clinical features, in particular insulin-resistant (type 2) diabetes, obesity (body mass index >30 kg/ m 2 ), dyslipidemia, and arterial hypertension, either alone or in combination, are the main contributors to the high risk of CVD in the post-LT period. It has been shown that patients with post-LT MS are approximately 4 times more likely to have a CV event than recipients without MS. In addition, recent studies have reported a significantly higher post-LT prevalence of MS ranging from 40% to 58% at 1 year compared to the general population. 3,4 Interestingly, the higher incidence of MS in LT recipients is not only seen in patients transplanted for nonalcoholic fatty liver disease (NAFLD) but also in patients transplanted for other indications.NAFLD, the hepatic manifestation of MS, is the leading cause of abnormal liver function tests in the Western world. Fatty liver disease leads to a spectrum of liver diseases ranging from simple steatosis to nonalcoholic steatohepatitis (NASH), fibrosis, and ultimately liver cirrhosis. End-stage liver disease secondary to NASH cirrhosis has become the second most common cause for LT and presumably will be the leading indication in the next decade. This is of further importance as current studies have shown that CVDs are especially overrepresented in patients with NASH-related liver disease, 5 independent of common underlying risk factors, such as MS and diabetes. 6 Several studies have determined the cumulative risk of CVD after LT. Independent predictive factors of CVD are older age at transplantation, male sex, preexisting cardiac disease, and components of the MS. [7][8][9]

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“…There are reports on obesity in 40% of the population already in the first post-transplant year 7 , and after three years of operation about 70% of patients have excess body weight 8 . Although no study has been able to demonstrate the relationship between overeating and posttransplant weight gain [9][10][11][12] , it is known that patients undergoing liver transplantation rediscover the appetite and pleasure of old eating habits after months of restrictions 13 . Also, they feel better and are able to feed in appreciable quantities.…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

“…In the study by Anastácio et al 25 , 41.5% of the individuals were thus classified, and 88% had some degree of abdominal obesity (waist circumference greater than 80cm for women and 90cm for men) 25 . FACTORS ASSOCIATED TO FACTORS ASSOCIATED TO FACTORS ASSOCIATED TO FACTORS ASSOCIATED TO WEIGHT GAIN, OVERWEIGHT WEIGHT GAIN, OVERWEIGHT WEIGHT GAIN, OVERWEIGHT WEIGHT GAIN, OVERWEIGHT WEIGHT GAIN, OVERWEIGHT AND OBESITY AND OBESITY AND OBESITY AND OBESITY AND OBESITY The factors described are often older age 8,29 , family history of overweight, high BMI prior to the disease 8,22,30 , post-transplant hypometabolism 8,10 , post-transplant physical inactivity 10 , high donor BMI 22 , being married 22,25 , few hours slept 25 and less dietary calcium intake 25 . Some authors demonstrated greater weight gain in patients undergoing liver transplantation for chronic liver diseases compared with those who were transplanted due to fulminant hepatic failure 8 .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Excesso de peso em pacientes submetidos ao transplante hepático

Anastácio

Angelis-Pereira

Vilela

et al. 2013

Rev. Col. Bras. Cir.

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ABSTRACT ABSTRACT ABSTRACTThis review aims to describe the incidence and prevalence of overweight and obesity after liver transplantation and the consequences associated with it. Literature review consultation was conducted in Medline / PubMed, SciELO, EMBASE and LILACS, with the combination of the following keywords: liver transplantation, overweight, obesity, weight gain. Overweight is incident on more than 60% of patients undergoing liver transplantation and obesity rates exceed 20% in the first year after surgery, during which occurs the largest relative weight gain. Studies have shown that between 60% and 70% of patients undergoing liver transplantation are overweight after the third year, 90% with abdominal obesity. Associated factors are, among others, advanced age, family history of overweight and excess weight prior to liver disease. The contribution of immunosuppressive medication remains controversial. Some of the consequences of overweight are liver steatosis, steatohepatitis, diabetes mellitus, hypertension, dyslipidemia, cardiovascular disease and death.

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Metabolic syndrome after liver transplantation: prevalence and predictive factors

Cited by 70 publications

References 31 publications

Reprint of: Nutrition in the Management of Cirrhosis and its Neurological Complications

Reprint of: Nutrition in the Management of Cirrhosis and its Neurological Complications

Cardiovascular diseases after liver transplantation—a still emerging and unsolved problem!

Excesso de peso em pacientes submetidos ao transplante hepático

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