肝移植受者身体组成、饮食行为、饮食摄入与代谢功能障碍相关的脂肪变性肝病之间的关系

IF 7.4 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2025-07-21 DOI:10.1016/j.clnu.2025.07.014

ACC Cardoso , SC Ferreira , MA Araújo , RPF Mendes , LO do Carmo , LHO Moreira , LMV Ferreira , CA Couto , IA Reis , LR Anastácio , LC Faria

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引用次数: 0

摘要

代谢功能障碍相关脂肪变性肝病（MASLD）是代谢综合征的肝脏表现，可在肝移植（LT）后以多因素方式发生。饮食行为、饮食摄入、体成分等方面可能与肝移植术后MASLD的发病机制有关。目的探讨肝移植术后合并与不合并MASLD患者的饮食行为、人体测量特征、体成分、肌力、饮食习惯、体力活动等方面的差异，并进行比较。方法对年龄≥18岁且接受肝移植至少12个月的患者进行横断面研究。评估人体测量数据、身体组成（生物电阻抗）、膳食摄入量（24小时膳食回忆）和饮食行为（三因素饮食问卷- r21）。结果共评估了138名参与者（59.4%为男性），中位年龄为60（46-80）岁，术后持续时间为11.3±6.4年。术后MASLD的发生率为26.1%。MASLD组的所有人体测量值和体脂值均较高。在年龄、性别和移植后时间调整后的单变量logistic回归中，MASLD组的瘦肉质量百分比也显著降低(OR 0.926；95% ci 0.881-0.972；P = 0.002)。在饮食行为方面，MASLD患者的认知限制得分显著高于非MASLD患者(OR 1.021；95% ci 1.005-1.036；P = 0.008)。结论：移植后MASLD与肥胖增加和认知性饮食限制水平升高呈正相关，而较高的瘦体重百分比与该疾病的存在呈负相关。

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Association between body composition, eating behavior, dietary intake, and metabolic dysfunction-associated steatotic liver disease in liver transplant recipients

Background

Metabolic dysfunction-associated steatotic liver disease (MASLD), the hepatic manifestation of metabolic syndrome, can occur after liver transplantation (LT) in a multifactorial way. Eating behavior, dietary intake, body composition and other aspects may contribute to the pathogenesis of MASLD after LT.

Objective

To investigate and compare eating behavior, anthropometric profile, body composition, muscle strength, dietary habits, and physical activity in post-liver transplant (LT) patients with and without MASLD.

Methods

Cross-sectional study with patients ≥18 years old who have undergone LT for at least 12 months. Anthropometric data, body composition (bioelectrical impedance), dietary intake (24-h Dietary Recall) and eating behavior (Three Factor Eating Questionnaire-R21) were evaluated.

Results

A total of 138 participants were evaluated (59.4 % men), with a median age of 60 (46–80) years and a post-LT duration of 11.3 ± 6.4 years. The prevalence of MASLD post-LT was 26.1 %. The MASLD group showed higher values of all anthropometric measures and body fat. In the univariate logistic regression adjusted for age, sex and time since transplant, the MASLD group also had a significantly lower percentage of lean mass (OR 0.926; 95 % CI 0.881–0.972; p = 0.002). Regarding eating behavior, patients with MASLD presented significantly higher scores for cognitive restriction compared to those without the condition (OR 1.021; 95 % CI 1.005–1.036; p = 0.008).

Conclusion

Post-transplant MASLD was positively associated with increased adiposity and higher levels of cognitive dietary restraint, whereas a greater percentage of lean body mass was inversely associated with the presence of the disease.

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.