New research reveals that metabolic syndrome—risk
factors that can lead to heart disease and/or stroke—is common in liver
transplant recipients, with rates highest at one year following the
procedure. Findings published in Liver Transplantation,
a journal of the American Association for the Study of Liver Diseases
and the International Liver Transplantation Society, indicate that
exercise could reduce complications from metabolic disease in patients
The National Heart, Lung, and Blood Institute
suggests that obesity, physical inactivity, and insulin resistance
increase risk of metabolic syndrome. According to the NHLBI, patients
who have three or more of the following metabolic clinical features
would be diagnosed with metabolic syndrome:
- high triglyceride level
- abdominal obesity
- low HDL (good) cholesterol level
- high blood pressure
- high fasting blood sugar
While liver transplantation extends life for those
with liver failure and liver cancer, studies show that transplant
recipients are at increased risk for heart disease and metabolic
abnormalities. In fact, experts suggest that up to 58% of liver
transplant patients have metabolic syndrome.
“Metabolic syndrome is highly prevalent among liver
transplant recipients who also tend to be more physically inactive than
other patient groups,” explains lead author, Dr. Eric Kallwitz from
Loyola University Medical Center in Maywood, Ill. “For this reason, our
study evaluated physical activity and metabolic syndrome in patients
following liver transplantation.”
Researchers recruited 204 liver transplant recipients
to evaluate their metabolic abnormalities, and exercise intensity and
duration following transplantation. There were 112 male and 92 female
participants with a mean age of 57 years. Ethnic composition of the
group was 45% Caucasian, 27% Hispanic, 24% African-American, and 5%
Asian or other background.
Analysis shows metabolic syndrome in 59% of all
subjects and in 64% of recipients more than one year after transplant.
Liver transplant patients exercised an average of 90 minutes with a
mean metabolic equivalent (METS) at 3.6. In all subjects, metabolic
syndrome was significantly higher and was associated with lower exercise
intensity, older age, and pre-transplant diabetes in patients more than
one year following transplant.
Dr. Kallwitz concludes, “Our findings suggest that
exercise could help reduce metabolic syndrome complications in liver
transplant recipients. Given the early onset of metabolic abnormalities
following transplant, an effective intervention such as a structured
exercise program during the first year after surgery, may benefit liver
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Full citation: “Physical Activity and Metabolic
Syndrome in Liver Transplant Recipients.” Eric R Kallwitz, Veronica
Loy, Praveen Mettu, Natasha Von Roenn, Jamie Berkes and Scott J Cotler.
Liver Transplantation; (DOI: 10.1002/lt.23710) Online Publication: July 25, 2013.
Author Contact: Media wishing to speak with Dr. Kallwitz may contact Jim Ritter with Loyola University Medical Center at JRITTER@lumc.edu or at +1-708-216-2445.
About the Journal
Liver Transplantation is published by Wiley on behalf of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.
Since the first application of liver transplantation in a clinical
situation was reported more than twenty years ago, there has been a
great deal of growth in this field and more is anticipated. As an
official publication of the AASLD and the ILTS,
Liver Transplantation delivers current, peer-reviewed articles on
surgical techniques, clinical investigations and drug research — the
information necessary to keep abreast of this evolving specialty. For
more information, please visit http://wileyonlinelibrary.com/journal/lt.
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