Recurrence of non-alcoholic steatohepatitis and cryptogenic cirrhosis following orthotopic liver transplantation in the context of the metabolic syndrome

2012 ◽  
Vol 26 (5) ◽  
pp. E505-E512 ◽  
Author(s):  
Mazen M. El Atrache ◽  
Marwan S. Abouljoud ◽  
George Divine ◽  
Atsushi Yoshida ◽  
Dean Y. Kim ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Cryptogenic Cirrhosis ◽  
Alcoholic Steatohepatitis ◽  
The Metabolic Syndrome

Risk of Development of the Metabolic Syndrome After Orthotopic Liver Transplantation

2010 ◽  
Vol 42 (2) ◽  
pp. 663-665 ◽  
Author(s):  
M.L. Ruiz-Rebollo ◽  
G. Sánchez-Antolín ◽  
F. García-Pajares ◽  
P. Fernández-Orcajo ◽  
M. González-Sagrado ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
The Metabolic Syndrome

scholarly journals Cardiovascular and Metabolic Consequences of Liver Transplantation: A Review

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 489
Author(s):  
Plotogea ◽  
Ilie ◽  
Sandru ◽  
Chiotoroiu ◽  
Bratu ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Liver Transplantation ◽  
De Novo ◽  
Current Knowledge ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Term Survival ◽  
The Metabolic Syndrome ◽  
Acute Liver Disease

Liver transplantation (LT) is considered the curative treatment option for selected patients who suffer from end-stage or acute liver disease or hepatic malignancy (primary). After LT, patients should be carefully monitored for complications that may appear, partially due to immunosuppressive therapy, but not entirely. Cardiovascular diseases are frequently encountered in patients with LT, being responsible for high morbidity and mortality. Patients with underlying cardiovascular and metabolic pathologies are prone to complications after the transplant, but these complications can also appear de novo, mostly associated with immunosuppressants. Metabolic syndrome, defined by obesity, hypertension, dyslipidemia, and hyperglycemia, is diagnosed among LT recipients and is aggravated after LT, influencing the long-term survival. In this review, our purpose was to summarize the current knowledge regarding cardiovascular (CV) diseases and the metabolic syndrome associated with LT and to assess their impact on short and long-term morbidity and mortality.

scholarly journals MON-673 Use of Metabolic Syndrome Severity to Assess Treatment with Vitamin-E and Pioglitazone for Non-Alcoholic Steatohepatitis

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Mark Daniel DeBoer ◽  
Jasmine A Mack ◽  
Matthew J Gurka
Keyword(s):  
Metabolic Syndrome ◽  
Vitamin E ◽  
Successful Treatment ◽  
Effect Size ◽  
Continuous Measure ◽  
Z Score ◽  
Metabolic Derangement ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Steatohepatitis ◽  
The Metabolic Syndrome

Abstract BACKGROUND: Non-alcoholic steatohepatitis (NASH) represents inflammatory and fibrotic changes in the setting of non-alcoholic fatty liver disease (NAFLD) and can progress to cirrhosis. While clinical management of NASH has proven difficult, the Pioglitazone, Vitamin E or Placebo NASH study (PIVENS) demonstrated that treatment with either pioglitazone or vitamin-E increased odds of NASH-resolution. NASH is strongly associated with insulin resistance and the metabolic syndrome (MetS) as both a predictor and an outcome, though this has only been studied using dichotomous MetS criteria (e.g. ATP-III). We previously formulated a sex- and race/ethnicity-specific MetS severity Z-score (MetS-Z) that serves as a continuous measure of metabolic dysregulation. We hypothesized: 1) there would be a decrease in severity of MetS over the course of intervention in PIVENS and 2) the degree of decrease in MetS-Z early in the course of treatment would be a predictor of future NASH resolution. METHODS: Participants in PIVENS (n=201) had biopsy-confirmed NASH at baseline and were randomized to receive pioglitazone, vitamin E or placebo for 96 weeks, when they received repeat biopsy to assess for NASH resolution. We compared levels of MetS-Z and its standardized effect size (the absolute observed difference in MetS-Z for an individual divided by the overall baseline standard deviation of MetS-Z) at baseline, 48 weeks and 96 weeks and used logistic regression to determine associations between baseline MetS and the change in MetS from 0–48 weeks on ultimate NASH resolution—both overall and by intervention group. RESULTS: During the 96 weeks of intervention, 73 participants (363%) exhibited NASH resolution. Baseline MetS-Z was inversely associated with odds of NASH resolution, such that those with higher MetS severity at baseline were less likely to experience NASH resolution (odds ratio [OR] per 1-SD of MetS-Z-score: 0.54, 95% confidence interval [CI] 0.33,0.88). Of the three intervention groups, the decrease in MetS-Z during initial 48 weeks of intervention was greatest for pioglitazone treatment (effect-size: -0.31, CI -0.15,-0.48). During treatment with vitamin E, those with significant 48-week changes in MetS-Z tended to be those with vs. without ultimate NASH resolution (-0.18 vs. -0.05). In the group overall, 48-week change in MetS-Z was inversely associated with NASH resolution (OR of per 1-SD change: 0.56, CI 0.35,0.88). CONCLUSION: Individuals with more severe metabolic derangement at baseline were less likely to exhibit NASH resolution, suggesting that individuals may have a threshold of MetS-severity beyond which successful treatment is unlikely. As hypothesized, a decrease in MetS-Z over time was associated with improved odds of NASH resolution. As an integrated marker of metabolic abnormalities, MetS-Z may be a new way non-invasively follow for successful treatment of NASH.

Prevalence and Predictors of the Metabolic Syndrome Post Liver Transplantation

2016 ◽  
Vol 64 (2) ◽  
pp. S545
Author(s):  
L. De Luca ◽  
M. Kalafateli ◽  
S. Bianchi ◽  
N. Alasaker ◽  
E. Buzzetti ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Liver Transplantation ◽  
The Metabolic Syndrome
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