Abstract P046: Cardiometabolic Risk Liver Transplant Survivors
Background: Coronary heart disease (CHD) is an important cause of long-term mortality in liver transplant recipients (LTR). LTR are at increased risk for CHD-related mortality due to exposure to chronic immunosuppression contributing to cardiometabolic risk. Physical activity (PA) and nutrition are important lifestyle management tools used in clinical practice to reduce CHD risk, however, little is known about the long-term effects of these strategies in LTR.
Objective: The aim of this study was to evaluate PA and diet and correlate findings with the atherogenic lipoprofile, obesity and 10-year risk of CHD.
Methods: LTR (≥ 2 years post LT; stable immunosuppression) without documented CHD, diabetes, graft cirrhosis, physical limitations, and malignancy were included. PA was quantitated via International Physical Activity Questionnaire (IPAQ). Anthropometric assessment was used to obtain body mass index (BMI) and waist hip ratio (WHR). NMR Lipoprofile was used to obtain athrogenic lipoprotein concentration and size followed by generic lipid profile. Food preferences were evaluated via Olbrisch Eating Style Questionnaire and Diet History Questionnaire. CHD risk was assessed by Framingham Risk Score (FRS).
Results: Of 122 subjects screened, 27 met entry criteria. Most were overweight (N=11) or obese (N=8) with mean BMI 28.5 kg/m2 (SD=4.05; range=20.2-37.8) and mean WHR= 0.94 (SD=0.22; range=0.65-1.85). According to IPAQ, 20 patients (75%) were sedentary. Eating style and food preference choices suggested that 23 (85.2%) were unable to control portion sizes and 14 (51.9%) preferred sugar, fat, or starches in their diet. Fasting glucose was 98.8mg/dL (SD=14.2, range=78-133) suggesting 7 participants were “pre-diabetes” and 2 undiagnosed type 2 diabetes. Four reported smoking; of these, one was highly nicotine dependent. FRS was 7.15% (SD=6.15, ranged 7-23). While the calculated total cholesterol 166.44 (SD=34.15), HDL 55.19 (SD=15.31), LDL 84.56 (SD=26.58), and TG 143.44 (SD=76.29)(all in mg/dL) were within normal range, numbers and sizes of lipoprotein particles indicate that LTRs were at moderate risk of CHD: LDL-C 1221.48 (SD+447.31)>1000 nmol/L as reference), small LDL-P 799.81 (SD=489.95) >527nmol/L), LDL-size 20.89 (SD=1.12)>20.5nm, Large VLDL-P 2.93 (SD=4.35) >2.7 nmol/L, and VLDL size 51.07(SD=9.74) >46.6 nm. PA (more time sitting) was associated with higher BMI (r=.394, P<0.05) and WHR (r=.535, P<0.01) but not with particle number or density. PA (MET minutes/week) was associated with WHR (r=.535, p<0.01). Neither PA nor nutrition (Kcal/day) was associated with FRS.
Conclusion: LTR are generally inactive and make poor dietary choices which are reflected by the obesity indices and characterized by the atherogenic lipoprofile.
Author Disclosures: J. Salyer: None. K. An: None. S. Siddiqui: None.
- © 2017 by American Heart Association, Inc.