Samarth S Patel1, Mohammad B Siddiqui2, Anchalia Chadrakumaran3, Masoud Faridnia3, Fei-Pi Lin4, Jose Hernandez Roman3, Salvatore Carbone5, John Laurenzo4, Joseph Clinton4, Danielle Kirkman6, Susan Wolver3, Francesco Celi7, Chandra Bhati8, Mohammad S Siddiqui2. 1. Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University (VCU), MCV Box 980342, Richmond, VA, 23298-0342, USA. patelsamarth@gmail.com. 2. Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University (VCU), MCV Box 980342, Richmond, VA, 23298-0342, USA. 3. Department of Internal Medicine, VCU, Richmond, VA, USA. 4. School of Medicine, VCU, Richmond, VA, USA. 5. Division of Cardiology, Department of Internal Medicine, VCU Pauley Heart Center, VCU, Richmond, VA, USA. 6. Department of Kinesiology and Health Sciences, VCU, Richmond, VA, USA. 7. Division of Endocrinology Diabetes and Metabolism, Department of Internal Medicine, VCU, Richmond, VA, USA. 8. Division of Transplant Surgery, Department of Surgery, VCU, Richmond, VA, USA.
Abstract
BACKGROUND: Weight gain after liver transplantation (LT) is a predictor of major morbidity and mortality post-LT; however, there are no data regarding weight loss following LT. The current study evaluates the effectiveness of standard lifestyle intervention in LT recipients. METHODS: All adult LT recipients with body mass index (BMI) ≥ 25 kg/m2 who followed up in post-LT clinic from January 2013 to January 2016 were given standard lifestyle advice based on societal recommendations which was reinforced at 24 weeks. Patients were followed for a total of 48 weeks to assess the impact of such advice on weight. Primary outcome was achieving weight loss ≥ 5% of the body weight after 48 weeks of follow-up. RESULTS: A total of 151 patients with 86 (56.0%) overweight and 65 (44.0%) obese patients were enrolled in the study. The mean BMI at baseline increased from 30.2 ± 3.7 to 30.9 ± 4.3 kg/m2 at 48-week follow-up (p = 0.001). Over the course of study, 58 (38.4%) patients lost any weight and weight loss greater than 5% and 10% occurred in only 18 (11.9%) and 8 (5.3%) of the entire cohort, respectively. Higher level of education was associated with increased likelihood of weight loss (OR 9.8, 95% CI 2.6, 36.9, p = 0.001), while nonalcoholic steatohepatitis as etiology of liver disease (HR 3.7, 95% CI 1.4, 9.7, p = 0.007) was associated with weight gain. CONCLUSION: The practice of office-based lifestyle intervention is ineffective in achieving clinically significant weight loss in LT recipients, and additional strategies are required to mitigate post-LT weight gain.
BACKGROUND:Weight gain after liver transplantation (LT) is a predictor of major morbidity and mortality post-LT; however, there are no data regarding weight loss following LT. The current study evaluates the effectiveness of standard lifestyle intervention in LT recipients. METHODS: All adult LT recipients with body mass index (BMI) ≥ 25 kg/m2 who followed up in post-LT clinic from January 2013 to January 2016 were given standard lifestyle advice based on societal recommendations which was reinforced at 24 weeks. Patients were followed for a total of 48 weeks to assess the impact of such advice on weight. Primary outcome was achieving weight loss ≥ 5% of the body weight after 48 weeks of follow-up. RESULTS: A total of 151 patients with 86 (56.0%) overweight and 65 (44.0%) obesepatients were enrolled in the study. The mean BMI at baseline increased from 30.2 ± 3.7 to 30.9 ± 4.3 kg/m2 at 48-week follow-up (p = 0.001). Over the course of study, 58 (38.4%) patients lost any weight and weight loss greater than 5% and 10% occurred in only 18 (11.9%) and 8 (5.3%) of the entire cohort, respectively. Higher level of education was associated with increased likelihood of weight loss (OR 9.8, 95% CI 2.6, 36.9, p = 0.001), while nonalcoholic steatohepatitis as etiology of liver disease (HR 3.7, 95% CI 1.4, 9.7, p = 0.007) was associated with weight gain. CONCLUSION: The practice of office-based lifestyle intervention is ineffective in achieving clinically significant weight loss in LT recipients, and additional strategies are required to mitigate post-LT weight gain.
Authors: Chandra Bhati; Michael O Idowu; Arun J Sanyal; Maria Rivera; Carolyn Driscoll; Richard T Stravitz; Divyanshoo R Kohli; Scott Matherly; Puneet Puri; HoChong Gilles; Adrian Cotterell; Marlon Levy; Richard K Sterling; Velimir A Luketic; Hannah Lee; Amit Sharma; Mohammad Shadab Siddiqui Journal: Transplantation Date: 2017-08 Impact factor: 4.939
Authors: Samuel Klein; Lora E Burke; George A Bray; Steven Blair; David B Allison; Xavier Pi-Sunyer; Yuling Hong; Robert H Eckel Journal: Circulation Date: 2004-10-27 Impact factor: 29.690
Authors: Pedro J Teixeira; Marlene N Silva; Sílvia R Coutinho; António L Palmeira; Jutta Mata; Paulo N Vieira; Eliana V Carraça; Teresa C Santos; Luís B Sardinha Journal: Obesity (Silver Spring) Date: 2009-08-20 Impact factor: 5.002
Authors: Laura P Svetkey; Victor J Stevens; Phillip J Brantley; Lawrence J Appel; Jack F Hollis; Catherine M Loria; William M Vollmer; Christina M Gullion; Kristine Funk; Patti Smith; Carmen Samuel-Hodge; Valerie Myers; Lillian F Lien; Daniel Laferriere; Betty Kennedy; Gerald J Jerome; Fran Heinith; David W Harsha; Pamela Evans; Thomas P Erlinger; Arline T Dalcin; Janelle Coughlin; Jeanne Charleston; Catherine M Champagne; Alan Bauck; Jamy D Ard; Kathleen Aicher Journal: JAMA Date: 2008-03-12 Impact factor: 56.272
Authors: Ingrid J Hickman; Amy K Hannigan; Heidi E Johnston; Louise Elvin-Walsh; Hannah L Mayr; Heidi M Staudacher; Amandine Barnett; Rachel Stoney; Chloe Salisbury; Maree Jarrett; Marina M Reeves; Jeff S Coombes; Katrina L Campbell; Shelley E Keating; Graeme A Macdonald Journal: Transplant Direct Date: 2021-02-04