Hypometabolism as a potential risk factor for overweight and obesity in liver recipients

Abstract

Objective: The aim of the present study was to identify whether overweight liver recipients are hypometabolic.

Methods: Liver transplantation (LT) recipients (n = 20), who were 18 to 65 y of age, had a body mass index (BMI) ≥25 kg/m², and were 1 to 3 y post-transplant. They were matched with healthy controls in terms of sex, age, BMI, and body composition. Dietary intake data were collected using a 3-d food record. The individuals' daily activities were converted into metabolic equivalents. Resting energy expenditure (REE) was assessed in the morning after an overnight fast (12 h), by indirect calorimetry, using an open-circuit calorimeter.

Results: Total energy and macronutrient intakes were similar among liver recipients and controls. The majority of the individuals from both groups were sedentary (75%; n = 15/group). Patients who underwent LT showed lower REE (1449.15 ± 101.25 kcal) compared with the control group (1768.45 ± 86.94 kcal). Likewise, the ratio of REE to fat-free mass (FFM) was lower in the LT group (28.9 ± 1.7 kcal/ kg) than in the control group (32.9 ± 0.9 kcal/ kg; P < 0.05). The correlation between the FFM and the REE was strong in control participants (r = 0.73; P < 0.01), whereas it was moderate in the LT group (r = 0.45).

Conclusion: The REE of overweight liver recipients is reduced and it might be a risk factor for excessive body weight gain in this population.

Keywords: Body mass index; Liver transplantation; Resting energy expenditure; Tacrolimus; Weight gain.