Abstract
ABSTRACTBackground: Dyslipidemia occurs in approximately 70% of all liver transplant (LT) recipients, and no prior control studies have demonstrated any dietary intervention to change it. Aim: To analyze the effects of a dietary intervention on the lipid profile of dyslipidemic LT recipients. Methods: All LT recipients with dyslipidemia on clinical follow-up were enrolled. Anthropometric evaluation, food history, body composition (bioimpedance) and assessment of basal metabolism through indirect calorimetry were performed. Patients met with a dietitian and an individualized diet based on estimate of basal metabolism and consisting of 25% of the total energy value in total fat and <200 mg/day of cholesterol was prescribed. Total cholesterol (TC), HDL-cholesterol (HDL), LDL-cholesterol (LDL), triglycerides (TG) and anthropometric measures were measured at baseline and six months after intervention. Results: Fifty-thee out of 56 patients concluded follow-up; age was 59±10 years; 29 were men (51.8%). The analysis pre- and post-intervention were, respectively: TC 238.9±30 and 165.1±35, p<0.001; LDL 154±33 and 90±29, p<0.001; and TG 168 (IQR=51-200) and 137 (IQR=94-177), p=<0.001. They were all modified at six months following intervention. At baseline, none of the patients had normal TC, and only 12 (22.7%) had optimal/near optimal LDL. Following dietary intervention, 45 patients (84.9%) reached normal TC and 50 (94.4%) had optimal/near optimal LDL. HDL and anthropometric measures were not modified. Conclusions: Dietary counseling with prescription of individualized diet based on estimate of basal metabolism through indirect calorimetry was able to manage dyslipidemia in most LT recipients; so, all dyslipidemic LT recipients must be enrolled on a dietary program.
Highlights
Liver transplantation (LT) is the standard of care in the treatment of patients suffering from acute and chronic end-stage liver disease and selected primary and metastatic cancer to the liver[14]
The aim of this study was to verify the effects of a dietary intervention comprising dietary counseling with prescription of an individualized diet on the lipid profile of post-liver transplantation patients with dyslipidemia
This study evaluated the results of a dietary intervention consisting of dietary counseling with prescription of individualized diet to a cohort of 53 liver transplant patients suffering from dyslipidemia
Summary
Liver transplantation (LT) is the standard of care in the treatment of patients suffering from acute and chronic end-stage liver disease and selected primary and metastatic cancer to the liver[14]. Has acquired a prominent role, for which metabolic syndrome represents an important risk factor[21]. It consists of several metabolic disorders, including visceral obesity, diabetes mellitus, dyslipidemia and hypertension[12]. Dyslipidemia, one of the components of metabolic syndrome, is present in up to 70% of all LT recipients[17], and constitutes an important risk factor for post-transplant cardiovascular morbidity and mortality[29]
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