New Onset Diabetes and Non-Alcoholic Fatty Liver Disease after Liver Transplantation
Journal Title: Annals of Hepatology - Year 2017, Vol 16, Issue 6
Abstract
Background & Aims. Non-alcoholic fatty liver disease (NAFLD) is an emerging cause of graft dysfunction after liver transplantation (LT) frequently related to the development of new onset diabetes after LT (NODAT). This study was undertaken to evaluate the frequencies of NODAT and NAFLD after LT, to investigate their major risk factors and the impact of de novo or recurrent NAFLD in graft function. Material and methods. 119 patients submitted to LT were prospectively evaluated. Results. After 4 ± 1 years, NODAT, recurrent and de novo NAFLD were observed in 31%, 56% and 43% of the subjects, respectively. Only 3 patients had non-alcoholic steatohepatitis (NASH) without fibrosis. Other risk factors for NAFLD such as arterial hypertension (AHT), metabolic syndrome (MS), hypertriglyceridemia and obesity were seen in 51%, 50%, 35% and 24% of the subjects, respectively. In addition, insulin resistance (IR), assessed by HOMA-IR and β-cell dysfunction, determined by HOMA-β, were observed in 16% and 94% of the patients, respectively. Occurrence of NODAT was associated with male gender, higher waist circumference, higher HOMA-IR and lower HOMA-β values. No correlation was found between NAFLD and NODAT, MS, hypertriglyceridemia, obesity and HOMAIR and HOMA-β levels. Conclusions. NODAT, recurrent and de novo NAFLD are common after LT but are not associated with signs of graft dysfunction, possibly due to the low frequency of IR and NASH. No correlation is observed between NAFLD and NODAT, MS, hypertriglyceridemia, obesity and IR. β-cell dysfunction and diabetes, however, are seen in most of the patients, possibly due to calcineurin inhibitor toxicity.
Authors and Affiliations
Antônio R. Andrade, Paulo L. Bittencourt, Liana Codes, Maria A. Evangelista, Alessandra O. Castro, Ney Boa Sorte, Carolina G Almeida, Jorge A. Bastos, Helma P. Cotrim
Atherosclerosis and chronic hepatitis C
Noninvasive assessment of hepatic fibrosis using gadoxetate-disodium-enhanced 3T MRI
Introduction. Gadoxetate-disodium is a liver-specific MR contrast agent absorbed by hepatocytes via organic anion transporting polypeptide 1B3 and is excreted into the biliary system by multidrug resistance-associated pr...
SALLuting a new biomarker in hepatocellular carcinoma
The impact of bacterial infections on survival of patients with decompensated cirrhosis
Introduction. Bacterial infection in cirrhotic patients is a severe complication that requires early recognition and specific therapeutic care. Material and methods. In this review the various aspects of diagnosis and ma...
Management of gastroesophageal varices in cirrhotic patients: current status and future directions
Bleeding from gastroesophageal varices (GEV) is a serious event in cirrhotic patients and can cause death. According to the explosión theory, progressive portal hypertension is the primary mechanism underlying variceal...