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Sarcopenic obesity with metabolic syndrome: a newly recognized entity following living donor liver transplantation
Author(s) -
Choudhary Narendra S.,
Saigal Sanjiv,
Saraf Neeraj,
Mohanka Ravi,
Rastogi Amit,
Goja Sanjay,
Me Palat B.,
Mishra Sunil,
Mittal Ambrish,
Soin Arvinder S.
Publication year - 2015
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12505
Subject(s) - medicine , body mass index , transplantation , sarcopenic obesity , liver transplantation , obesity , calcineurin , gastroenterology , metabolic syndrome , immunosuppression , tacrolimus , bioelectrical impedance analysis , etiology
Objective There are limited data about sarcopenic obesity in liver transplant recipients. Methods Living donor liver transplant recipients with at least 12 months of follow‐up were included. Metabolic syndrome ( MS ) was defined as ≥3 ATP III criteria. Body composition was assessed by bioelectrical impedance. Immunosuppression protocol included short‐term steroids, mycophenolate and calcineurin inhibitors (mainly tacrolimus). Data are shown as percentage, mean ± SD , or median (25–75 IQR ). Results The study comprised 82 patients (males 69), aged 50.5 ± 10.65 yr, and follow‐up 24 (12–38.5) months. Etiology for cirrhosis was alcohol 29%, hepatitis C 22%, hepatitis B 17%, cryptogenic 24%, and others 7%. Post‐transplant sarcopenic obesity was present in 72 (88%), and MS was present in 43 (52%) of recipients with no significant difference among etiologies. There were significant differences between pre‐ and post‐transplant body mass index, triglycerides, high‐density lipoprotein, low‐density lipoprotein (p = 0.000 for all), prevalence of hypertension (18% vs. 39%), and diabetes (20% vs. 56%). Patients with sarcopenic obesity had significantly higher body mass index, waist circumference, and MS (57% vs. 20%, p = 0.041) when compared to patients without sarcopenic obesity. Conclusion Despite resuming routine activities, the majority of liver transplant recipients develop sarcopenic obesity and MS . The importance and role of appropriate nutrition and exercise after transplantation merits further investigation.