Metabolic profile of liver transplant recipients and its association with abdominal fat distribution

Adults who underwent de novo elective cadaveric-donor Ltx were eligible. Metabolic syndrome (MS) was diagnosed based on the adapted Interna-tional Diabetes Federation, American Heart Association and the National Heart, Lung, and Blood Institute guidelines. Of 100 recruited patients, 54% met the criteria for MS, most of which comprised new-onset cases. Excessive fat ac-cumulation in liver donors was found to be associated with increased metabolic risk in liver recipients. Haemoglobin A1C (OR: 8.962, 95% CI: 2.188–84.545, p = 0.013), ferritin (OR: 1.024, 95% CI: 1.005–1.054, p = 0.038) and de novo hyper-triglycaeridemia (OR 27.957, 95% CI: 2.626–752.121; p = 0.014) were found to be independently associated with post-Ltx MS. After a step-wise multivariate analysis, only anthropometric indices were significantly associated with ab-dominal fat distribution in Ltx recipients. Metabolic complications were common in liver recipients. Both pre- and post-Ltx factors impact MS de-velopment in liver recipients and determine abdominal fat distribution. Appli-cation of recommended metabolic-risk-reducing immunosuppression guidelines was insufficient in mitigating the risk of metabolic complications in the post-Ltx setting.

在本研究中，接受新发选择性尸体捐赠者肝移植术的成年人均有资格纳入。代谢综合征（MS）的诊断依据为改编后的国际糖尿病联盟、美国心脏协会及国家心肺和血液研究所的指南。在招募的100名患者中，54%符合MS的诊断标准，其中大部分为新发病例。研究发现，肝脏捐赠者肝脏中脂肪过度积累与肝脏受者代谢风险增加有关。血红蛋白A1C（比值比：8.962，95%置信区间：2.188–84.545，p = 0.013）、铁蛋白（比值比：1.024，95%置信区间：1.005–1.054，p = 0.038）以及新发高甘油三酯血症（比值比：27.957，95%置信区间：2.626–752.121；p = 0.014）被发现与肝移植术后MS的独立相关性。在逐步多元分析中，仅人体测量指标与肝移植受者的腹部脂肪分布显著相关。代谢并发症在肝脏受者中较为常见。术前和术后因素均影响肝脏受者代谢综合征的发生和发展，并决定了腹部脂肪的分布。在肝移植术后环境中，推荐降低代谢风险免疫抑制剂的指南应用不足，无法有效减轻代谢并发症的风险。