New-onset obesity after liver transplantation-outcomes and risk factors: the Swiss Transplant Cohort Study.

Beckmann, Sonja; Denhaerynck, Kris; Stampf, Susanne; Saigi-Morgui, Nuria; Binet, Isabelle; Koller, Michael; Boely, Elsa; De Geest, Sabina; Swiss Transplant, Cohort Study (2018). New-onset obesity after liver transplantation-outcomes and risk factors: the Swiss Transplant Cohort Study. Transplant international, 31(11), pp. 1254-1267. Wiley-Blackwell 10.1111/tri.13308

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Weight gain after liver transplantation (LTx) facilitates development of new-onset obesity; however, its risk factors and outcomes are poorly understood. We identified the impact of new-onset obesity on cardiovascular events (CVEs) and patient survival, and risk factors for new-onset obesity. Multiple Cox regression models examined risk factors for CVEs, patient survival, and new-onset obesity in 253 adults (mean age 52.2 ± 11.6 years, male gender 63.6%, mean follow up 5.7 ± 2.1 years). Cumulative incidence of post-LTx CVE was 28.1%; that of new-onset obesity was 21.3%. Regardless of CVE at LTx, post-LTx CVEs were predicted by new-onset obesity [Hazard Ratio (HR), 2.95; P = 0.002] and higher age at LTx (HR, 1.05; P < 0.001). In patients without known pre-LTx CVEs (n = 214), risk factors for post-LTx CVEs were new-onset obesity (HR, 2.59; P = 0.014) and higher age (HR, 1.04; P = 0.001). Survival was not associated with new-onset obesity (P = 0.696). Alcoholic liver disease predicted new-onset obesity (HR, 3.37; P = 0.025), female gender was protective (HR, 0.39; P = 0.034). In 114 patients with available genetic data, alcoholic liver disease (HR, 12.82; P = 0.014) and hepatocellular carcinoma (HR, 10.02; P = 0.048) predicted new-onset obesity, and genetics remained borderline significant (HR, 1.07; P = 0.071). Early introduction of post-LTx weight management programs may suggest a potential pathway to reduce CVE risk.

Item Type:

 Journal Article (Original Article)

Division/Institute:

 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery

Subjects:

 600 Technology > 610 Medicine & health

ISSN:

 0934-0874

Publisher:

 Wiley-Blackwell

Language:

 English

Submitter:

 Lilian Karin Smith-Wirth

Date Deposited:

 17 Sep 2019 12:40

Last Modified:

 04 Nov 2019 07:51

Publisher DOI:

 10.1111/tri.13308

PubMed ID:

 29984844

Additional Information:

Stirnimann, Guido; Banz Wüthrich, Vanessa sind Mitglieder der Swiss Transplant cohort Study

Uncontrolled Keywords:

 alcoholic liver disease cardiovascular genetics obesity survival

BORIS DOI:

 10.7892/boris.125779

URI:

 https://boris.unibe.ch/id/eprint/125779

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