Abstract 16721: Cardiovascular and Metabolic Risk Profile of Nonalcoholic Fatty Liver Disease Patients and Liver Transplant Recipients

Abstract

Introduction: Cardiovascular disease (CVD) mortality is a growing concern in chronic liver disease (CLD) patients. Although prevention of CVD should target the whole spectrum of CLD, earlier CLD such as nonalcoholic fatty liver disease (NAFLD) vs. advanced CLD such as liver transplant recipients (LTR) may have different risk profiles. Yet, the differences in CVD and metabolic risk profiles between NAFLD and LTR patients have not been investigated. Hypothesis: We hypothesize that, between NAFLD and LTR patients, there are differences in (1) global CVD risk measured by Framingham Risk Score (FRS), (2) systemic inflammatory biomarker of hsCRP, and (3) metabolic risk factors, such as blood pressure (BP), glucose, lipid profile, and anthropometric indices including body mass index (BMI) and waist circumference. Methods: 27 adult LTR who exhibited no history or current CVD or rejection of transplantation were compared to 23 biopsy-confirmed NAFLD patients. Global CVD risk was calculated using the FRS equation. Plasma level of hsCRP, fasting glucose, lipid profile including total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), and triglycerides(TG) were analyzed using ELISA. Anthropometric analysis was conducted to assess obesity. Results: LTR compared to NAFLD patients had (1) lower FRS (7.15±6.15 vs. 15.88±11.39%, p<0.001), (2) higher level of hsCRP (36.85±40.60 vs. 4.38±4.73 mg/L, p<0.001), (3) higher systolic BP (132.48±15.18 vs. 123.30±11.24mmHg, p<0.05) and diastolic BP (80.41±9.30 vs. 72.52±6.90 mmHg, p<0.01), higher HDL in both men (46.20±14.72 vs. 38.50±3.62 mg/dl, p=0.044) and women (61.57±11.20 vs. 49.76±11.63mg/dl, p=.042). There were no differences between groups in metabolic dysfunction indices such as fasting glucose, TC, LDL, or waist circumference. Conclusion: The liver transplantation does not increase the global CVD risk or the metabolic risks. However, systemic inflammation and suboptimal BP indicate LTR at risk of CVD. Reducing obesity is critical target to both LTR and NAFLD patients. Maintaining BP at optimal level should be the target in LTR whereas improving lipid profile is critical in NAFLD to prevent CVD. Large scale study will inform clinicians with the specific targets of CVD prevention for patients in diverse phases on CLD spectrum.