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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2016; 70(4): 325–330. doi:10.14735/amgh2016325.

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

Irena Hejlová1, Monika Dezortová2, Petr Šedivý2, Miloslav Drobný2, Milan Hájek2, Monika Cahová3, Helena Daňková3, Eva Sticová4, Věra Lánská5, Pavel Trunečka6

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Summary


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.

Keywords

NAFLD, inzulinová rezistence, magnetic resonance, metabolic syndrome, mitochondrial capacity


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