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Childhood liver transplantation reduced BCM, increased risk for obesity
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Patients who underwent liver transplantation in early childhood had reduced levels of body cell mass after transplantation and could develop obesity later in life, according to recent study results.
Looi Cheng Ee, MBBS, FRACP, of the department of gastroenterology, Royal Children’s Hospital, Australia, and colleagues conducted a cohort of 32 children (20 males) who underwent liver transplantation. All children were aged 3 to 17 years at the time of transplant. The median age at transplant was 2.11 years and follow-up post-transplantation was at a median of 7.23 years, when the children had aged 10.12 years. Researchers gathered total body potassium measurements before and after transplantation, as well as body cell mass (BCM) measurements from total body potassium ones, to determine nutritional status post-transplantation.
Looi Cheng Ee
Pre-transplant BMC/Height was low in all patients (mean z score: –0.5 ± 0.52, P=.04), but reduced even more post-transplant (mean z score: –0.83 ± 1.16, P<.001) despite normalization of height and weight. Weight recovery was likely due to increased fat mass, not BCM, according to the researchers. Linear growth impairment was associated with a reduced BCM/Height z score post-transplant (P=.02).
Patients with BCM/Height z scores post-transplant were subdivided into two groups; BCM/Height for age with a z score <–1.29 or >–1.29. Patients with low BCM had a mean post-transplant BMC/Height z score of –2.15 (± 0.52) compared with normal-leveled patients (–0.18 ± 0.76). Through multivariate analysis, researchers found age at transplant to be associated with post-transplant BCM/Height (P=.02) and pre-transplant BCM/Height (P=.05).
“Long-term survivors of pediatric liver transplantation are at risk of developing obesity because of poor muscle recovery despite normalization of weight and height, even many years after transplant,” Ee told healio.com/Hepatology. “Hence the term ‘skinny fat’ because although they may look slim or normal, they actually have poor muscle mass and have excessive fat mass compared to aged- and sex-matched peers.”
Disclosure: The researchers report no relevant financial disclosures.