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

Alves, Bruna Cherubini; Bruch-Bertani, Juliana Paula; Galinatti, Clara Belle Manfroi; Garbin, Claudia Czarnobay; Álvares‐da‐Silva, Mário Reis; Dall’Alba, Valesca

doi:10.1016/j.clinre.2018.09.005

Cited by 13 publications

(11 citation statements)

References 36 publications

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“…From a functional perspective, Lai et al recently determined that frailty worsens in the 3 months following liver transplant and improves modestly by 12 months, but with fewer than 40% achieving robustness (16). In a study of 69 posttransplant patients followed for a median of 2.8 years, there was ongoing evidence of sarcopenia in 45% by arm muscle area, with an even higher incidence of poor muscle function as measured by handgrip strength (71% with <30 kg) (17).…”

Section: Post-transplant Outcomesmentioning

confidence: 99%

Implications of pre-transplant sarcopenia and frailty in patients with non-alcoholic steatohepatitis and alcoholic liver disease

Redman¹,

Kaspar²,

Puri³

2022

Transl Gastroenterol Hepatol

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Frailty manifesting as sarcopenia is an independent risk factor for mortality in cirrhosis, and often presents in low model for end-stage liver disease (MELD) patients. Its etiology is multifactorial, but key physiologic changes culminate in altered energy utilization in the fasting state, preferentially utilizing muscle amino acids for gluconeogenesis thereby promoting sarcopenia. Hyperammonemia alters the circulating amino acid profile, diminishing pro-muscle branched-chain amino acids like leucine. The metabolic syndrome worsens sarcopenia through multi-tissue insulin resistance. Alcohol also exacerbates sarcopenia as a direct muscle toxin and inhibitor of growth signaling. Therapy is aimed at alcohol cessation, frequent highprotein meals, branched-chain amino acid supplementation, and diminished time spent fasting. Moderate exercise can improve muscle mass and muscle quality, though precise exercise regimens have not yet been explicitly determined. Studies are ongoing into the effects of myostatin antagonists and insulin sensitizers.The Liver Frailty Index can predict patients most at risk of poor outcome and should be considered in the management of all cirrhotic patients. Specialty testing like dual-energy X-ray absorptiometry (DEXA) scanning and cross-sectional estimates of muscle mass are areas of active research and may play a future role in clinical risk-stratification.

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Section: Post-transplant Outcomesmentioning

confidence: 99%

Implications of pre-transplant sarcopenia and frailty in patients with non-alcoholic steatohepatitis and alcoholic liver disease

Redman¹,

Kaspar²,

Puri³

2022

Transl Gastroenterol Hepatol

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“…Assim sendo, observa-se que os declínios de força muscular são os principais fatores presentes na dinapenia, e para identificá-los são necessários o emprego de métodos para medir a força de preensão dos músculos superiores ou inferiores (SCOTT et al, 2015). Para avaliar esta condição, utilizam-se dinamômetros mecânicos que conseguem quantificar a força aplicada sobre eles, podendo ser a força de preensão palmar através da mão não dominante (ALVES et al, 2019), ou por meio da realização da dinamometria a partir da avaliação da força muscular dos membros inferiores, onde deve-se aplicar força isométrica de quadríceps e extensores de quadril sobre o dinamômetro (SCOTT et al, 2016).…”

Section: Diagnósticounclassified

Revisando Os Motivos Para a Prática Das Lutas, Artes Marciais E Modalidades Esportivas De Combate

Duarte¹,

Claudino²,

Oliveira³

et al. 2022

Ciências Do Esporte E Educação Física: Saúde E Desempenho 2

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Editora Direitos para esta edição cedidos à Atena Editora pelos autores. Open access publication by Atena Editora Todo o conteúdo deste livro está licenciado sob uma Licença de Atribuição Creative Commons. Atribuição-Não-Comercial-NãoDerivativos 4.0 Internacional (CC BY-NC-ND 4.0). O conteúdo dos artigos e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores, inclusive não representam necessariamente a posição oficial da Atena Editora. Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterála de nenhuma forma ou utilizá-la para fins comerciais.Todos os manuscritos foram previamente submetidos à avaliação cega pelos pares, membros do Conselho Editorial desta Editora, tendo sido aprovados para a publicação com base em critérios de neutralidade e imparcialidade acadêmica.A Atena Editora é comprometida em garantir a integridade editorial em todas as etapas do processo de publicação, evitando plágio, dados ou resultados fraudulentos e impedindo que interesses financeiros comprometam os padrões éticos da publicação. Situações suspeitas de má conduta científica serão investigadas sob o mais alto padrão de rigor acadêmico e ético.

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“…The presence of early atherosclerosis assessed by either cIMT or by the presence of carotid plaques in patients undergoing LT has been recently documented not only in adults but also in pediatric patients. Indeed, endothelial damage has been demonstrated to onset very early after LT, with increase in carotid IMT and stiffness after 6 months from transplant [36,37], both in children and adolescents [38]. In adults, presence of subclinical atherosclerosis was associated with an increased prevalence of features of MS, namely diabetes, hypertension and dyslipidemia [37].…”

Section: Early Atherosclerosis Post Ltmentioning

confidence: 99%

Cardiovascular involvement after liver transplantation: role of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis

Lombardi

Pisano

Fracanzani

2021

Exploration of Medicine

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Patients submitted to liver transplantation (LT) are exposed to high risk of cardiovascular (CV) complications which are the main determinants of both short-term and long-term morbidity and mortality in LT. Non-alcoholic fatty liver disease (NAFLD) is a very frequent condition in general population and is associated with a high risk of cardiovascular disease (CVD) which represents the first cause of death of these patients. NAFLD is predicted to become the first indication to LT and nowadays is also frequently detected in patients submitted to LT for other indications. Thus, the risk of CVD in patients submitted to LT is forecasted to increase in the next years. In this review the extent of CV involvement in patients submitted to LT and the role of NAFLD, either recurring after transplantation or as de novo presentation, in increasing CV risk is analysed. The risk of developing metabolic alterations, including diabetes, hypertension, dyslipidemia and weight gain, all manifestations of metabolic syndrome, occurring in the first months after LT, is depicted. The different presentations of cardiac involvement, represented by early atherosclerosis, coronary artery disease, heart failure and arrhythmias in patients with NAFLD submitted to LT is described. In addition, the tools to detect cardiac alterations either before or after LT is reported providing the possibility for an early diagnosis of CVD and an early therapy able to reduce morbidity and mortality for these diseases. The need for long-term concerted multidisciplinary activity with dietary counseling and exercise combined with drug treatment of all manifestations of metabolic syndrome is emphasized.

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

Cited by 13 publications

References 36 publications

Implications of pre-transplant sarcopenia and frailty in patients with non-alcoholic steatohepatitis and alcoholic liver disease

Implications of pre-transplant sarcopenia and frailty in patients with non-alcoholic steatohepatitis and alcoholic liver disease

Revisando Os Motivos Para a Prática Das Lutas, Artes Marciais E Modalidades Esportivas De Combate

Cardiovascular involvement after liver transplantation: role of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis

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