Body composition in patients undergoing liver transplantation

Pla Maria Argente; Katherine Garcia-Malpartida; Regina Lopez-Gironas; Silvia Martin-Sanchis; Andrea Mico-Garcia; Eva Gasco; Miguel Angela Dura-De; Lorena Hernandez; Elena Vera; Torres Juan Francisco Merino

doi:10.1530/endoabs.81.P371

Rationale

Liver cirrhosis frequently leads to changes in body composition consisting of a loss of lean mass, increased body water and variable alterations of fat mass. Changes in body composition may occur after liver transplantation (LT). Our aim was to study the changes that occur in body composition after LT (in the postoperative period after LT as well as 1 month later).

Methods: A body composition study was carried out using the bioimpedance InBody S10® in patients undergoing liver transplantation, postoperatively and 1 month after discharge. Several markers were analyzed: appendicular skeletal muscle mass (ASM), percentage of body fat, phase angle (PA) and extracellular water ratio (ECW ratio). Low muscle mass was considered when the ASM/height²was <7 kg/m²in men or <5.5 kg/m²in women; normal PA according to the standardized tables by age and sex and using the cut-off value of 4^o; normal ECW ratio between 0.360–0.390; and normal fat mass in men between 10–20% and in women between 18–28%. Means comparison was carried out using the T-student test for paired samples and the comparison of proportions using the McNemar test.

Results: 60 patients(78.3% men) were included. The age was 60.8(7.5) years. The median stay was 10.5(5–88) days. The time elapsed between both evaluations was 32.8(11.1) days. The assessment of body composition before and 1 month after discharge from transplantation is shown in the following table. Sarcopenia was present in 2.1% and 12.7% of men at the first evaluation and 1 month later, respectively(P<0.001). No women presented sarcopenia in the immediate post-transplant period vs 23% at one month. Table-2 shows SMI and PA.


Variable:	Baseline	1 month	p-value
Body Mass Index(kg/m2)	25.3(3.6)	23.8(3.3)	<0.001
Fat mass(%)	23.2(7.6)	23(7.9)	0.69
Visceral fat area(cm)	79.2(30)	74.2(29.4)	0.07
Extracellular water ratio	0.40(0.1)	0.39(0.1)	<0.001
Body cell mass(kg)	34.3(8)	32.8(5.8)	0.038


	ASM/height²(baseline vs 1 month, P-value)	PA (baseline vs 1 month, P-value)
Men:	8.2(1.4) vs 7.8(1.0), P<0.001	4.2(0.9) vs 4.4(1.4), P<0.001
Women:	7.2(1.2) vs 6.3(0.8), P=0.082	3.5(0.8) vs 4.3(0.6), P=0,02

Conclusion: Alterations in body composition in patients with LT are very frequent. One month after LT, there was a decrease in BMI, ASM, cell mass and body water, and an increase in PA. The worsening of muscle mass indicates that this period is critical in these patients. It would be interesting to assess body composition in the longer term. Since impedance metry is altered by excess extracellular water, these findings could be compared with other techniques for assessing body composition.

Endocrine Abstracts

P371