肝移植受者发生异体肝脂肪变性的临床和人口学特征。

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-04-01 DOI:10.1016/j.aohep.2025.101865

Edgar A. Quezada-Cornejo , María F. Hernández-Torres , Pedro A. López-Hernández , Alma L. Kuljacha-Gastelum

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引用次数: 0

摘要

肝脂肪变性（LS）可在肝移植（LT）受者中发生，不同的研究报告患病率为30-60%，我国代谢综合征的组成部分患病率较高。本研究的目的是描述肝移植受者发生脂肪变性的特征。材料和患者回顾性、横向和描述性研究纳入了28例经肝移植后诊断为LS的肝移植患者，数据从患者临床档案中检索，考虑以下数据：年龄、性别、肥胖史、动脉高血压、糖尿病（DM）、血脂异常和代谢综合征（MS）前后。其他数据包括肝硬化的病因、免疫抑制治疗和诊断时的肝脏生化。结果对28例肝移植术后发生LS的患者进行统计分析，其中男性12例（42.9%），女性16例（57.1%），平均年龄52岁（27 ~ 74岁）。lt后诊断年龄的中位数为8年（1-19岁）。肝硬化病因为自身免疫性14例（50%），病毒性6例（21.4%），脂肪变性4例（13.8%），酒精4例（13.8%），影像学诊断15例（53.6%），活检13例（46.4%）。中等体重指数（BMI）为28.6(22-39)，4例（13.8%）患者存在lt前糖尿病，15例（53.6%）患者存在lt后糖尿病，lt前和lt后肥胖分别为5例（10.7%）和15例（53.6%），lt前和lt后动脉高血压分别为3例（10.7%）和11例（39.3%），lt前和lt后血脂异常分别为0（0%）和22 (78.6%)，lt前和lt后MS分别为0（0%）和15（53.6%）。24例（85.7%）患者在诊断时使用强的松，中剂量为11.8毫克（5-30）。诊断前接受他克莫司24例（85.7%），西罗莫司23例（82.1%）。肝脏生化显示：ALT为85.3（16-406）、50.5（14-273）、ALP为139.8（38-519）、GGT为237（11-2296）、TBIL为0.7（0.2-1.5）。结论本研究强调了与肝移植前相比，肝移植后代谢合并症出现的频率，尤其是糖尿病、肥胖和血脂异常。综上所述，肝移植受者应密切监测这些代谢参数，以及时预防LS。

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Clinical and demographic characteristics of liver transplant recipients who develop steatosis in the liver allograft.

Introduction and Objectives

Liver steatosis (LS) can develop in liver transplant (LT) recipients, with different studies reporting prevalence of 30-60%, our country has a high prevalence of the components of metabolic syndrome. The objective of this study is to describe the characteristics of liver transplant recipients who develop steatosis.

Materials and Patients

Retrospective, transversal and descriptive study in which 28 LT recipients with diagnosis of LS after LT were included, data was retrieved from patients clinical file and the following data were considered: age, sex, history of obesity, arterial hypertension, diabetes mellitus (DM), dyslpidemia and metabolic syndrome (MS) prior and after LT. Other data included were etiology of cirrhosis, immunosuppressive treatment and liver biochemistry at the moment of diagnosis.

Results

A statistic sample of 28 LT recipients who developed LS after LT was analyzed, 12 were male (42.9%) and 16 female (57.1%) with a medium age of 52 (27-74). The medium of post-LT years at diagnosis was 8 years (1-19). Etiology of cirrhosis was autoimmune in 14 (50%) patients, viral in 6 (21.4%), steatosis in 4 (13.8%) and alcohol in 4 (13.8%), the diagnostic method was imaging in 15 (53.6%) patients and biopsy in 13 (46.4%). The medium body mass index (BMI) was 28.6 (22-39), presence of pre-LT DM in 4 (13.8%) patients and post-LT DM in 15 (53.6%), pre-LT and post-LT obesity was found in 5(10.7%) and 15 (53.6%) patients, respectively, pre-LT and post-LT arterial hypertension in 3 (10.7%) and 11 (39.3%) patients respectively, pre-LT and post-LT dyslipidemia in 0 (0%) and 22 (78.6%) respectively, pre-LT and post-LT MS in 0 (0%) and 15 (53.6%) respectively. 24 (85.7%) patients used prednisone at diagnosis with a medium dose of 11.8 milligrams (5-30). Previous to diagnosis, 24 (85.7%) received tacrolimus and 23 (82.1%) sirolimus. Liver biochemistry showed the following mediums: ALT 85.3 (16-406), 50.5 (14-273), ALP 139.8 (38-519), GGT 237 (11-2296) and TBIL 0.7 (0.2-1.5).

Conclusions

This study highlights the frequency with which metabolic comorbidities after LT presented in comparison to the ones presented before LT, especially DM, obesity and dyslipidemia. Concluding, LT recipients should be tightly monitored for these metabolic parameters to prevent LS in a timely manner.

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来源期刊

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.