Pro-atherosclerotic markers and cardiovascular risk factors one year after liver transplantation

Table 1 Demographic and clinical data from liver transplant recipients included n (%)

Variable	Results (n = 44)
Recipient age (yr)1	50.8 ± 14.3
Donor age (yr)1	41.9 ± 17.6
Gender
Male	29 (65.9)
Female	15 (34.1)
Etiology of liver disease1
HCV-related	16 (36.4)
Non-HCV-related	28 (63.6)
Patients with NAFLD	4 (9.1)
Patients with hepatocellular carcinoma	15 (34.1)
Pre-transplant MELD1	19.3 ± 9.4
Donor liver weight (g)1	1374.3 ± 311.3
Recipient liver weight (g)1	1399 ± 725.9
Cold ischemia time (min)1	400.9 ± 137.9
Warm ischemia time (min)1	47.2 ± 8.9
Intraoperative blood requirements1
Packed red cells (Units)	1.09 ± 1.6
Plasma (Units)	0.71 ± 1.8
Platelets (Units)	1.03 ± 3.53
Intraoperative albumin infusion (10 g bottles)1	4.32 ± 4.8
Tacrolimus-based immunosuppression	44 (100)
Steroids withdrawal (d)1	208.5 ± 106.8
Pre-transplant diabetes mellitus	16 (36.4)
Diabetes mellitus 1 yr after transplant	17 (38.6)
Pre-transplant BMI1	25.1 ± 5.3
BMI 1 yr after transplant1	24.3 ± 4.3
Abdominal circumference 1 yr after transplant (cm)1	89.4 ± 8.7
Tobacco consumption	8 (18.2)
Arterial hypertension	16 (36.4)
Sedentarism	28 (66.3)
Metabolic syndrome	10 (22.7)
Framingham risk score (10-yr)2	2.0 (1.0-8.75)

¹Mean and standard deviation;

²Median and 25^th-75^th percentiles. BMI: Body mass index.

Table 2 Demographic and clinical characteristics of the studied population

Variable (mean ± SEM) otherwise indicated	NASH (n = 22)	LT (n = 44)	Controls (n = 20)	P1
Age	58.5 ± 6.511	50.8 ± 14.3	51.2 ± 9.31	< 0.001
Sex %male/female	36.3/63.7	65.9/34.1	53.4/46.7
BMI	31.7 ± 4.351	24.3 ± 4.3	25.1 ± 2.7	< 0.001
Fasting glucose	139.7 ± 60.6	118.1 ± 46.8	NA	< 0.001
Fasting insulin	17.6 ± 8.68	12.15 ± 7.7	NA	0.03
HOMA-IR	6.173 ± 6.68	3.43 ± 2.4	NA	< 0.001
AST	45.5 ± 28.5	23 ± 18.1	NA	0.002
ALT	58.8 ± 45.5	23 ± 15.3	NA	< 0.001
Total cholesterol	199.5 ± 44.3	171.27 ± 26.8	NA	NS
HDL cholesterol	50.1 ± 12.3	49.6 ± 15.9	NA	NS

¹LT vs NASH. SEM: Standard error of the mean; NS: Non-significant; NA: Not applied; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; HDL: High-density lipoprotein.

Table 3 Inflammatory cytokines in liver transplant recipients, non-alcoholic steatohepatitis and controls

Variable (median - 25th-75th percentile)	NASH (n = 22)	LT (n = 44)	1Controls (n = 20)	P
TNFα (pg/mL)	13.4 (8.85-22.2)	12.1 (8.58-26.6)	10.1 (5.0 -13.6)	0.121
IFNγ (pg/mL)	411.9 (192.3-1361.7)	626.1 (286.9-1572.3)	67.9 (42.2-100.6)	< 0.001
IL-8 (pg/mL)	57.8 (43.8-70.2)	36.5 (31.2-44.9)	40.7 (36.5-53.3)	< 0.001
IL-10 (pg/mL)	32.3 (22.5-49.8)	32.3 (25.8-62.5)	62.5 (34.4-85.3)	0.019

¹Comparisons: IFNγ (NASH = LT-P = 0.3; NASH and LT > controls - P < 0.001); IL-8 (NASH > LT - P < 0.001; NASH > controls - P = 0.04; LT = controls - P = 0.11); IL-10 (NASH = LT - P = 0.84; NASH < controls - P = 0.02; LT < controls - P = 0.04).

Table 4 Comparison among liver transplant recipients, non-alcoholic steatohepatitis and controls regarding endothelial biomarkers

Variable (pg/mL)	NASH (n = 22)	LTR (n = 44)	Controls (n = 10)	P3
sVCAM-11	1692.4 ± 457.4	1820.6 ± 443.9	1167.2 ± 121.8	< 0.001
sICAM-11	259.7 ± 101	230.3 ± 96.3	152.9 ± 33.9	0.015
MPO1	198.3 ± 116.2	93.7 ± 60.9	409.2 ± 204.9	< 0.001
Adiponectin1	23789.1 ± 12040.4	47965.3 ± 33140.8	32683.2 ± 25065.4	0.008
PAI-11	149.2 ± 63.1	40.4 ± 28.7	132.3 ± 58.4	< 0.001
SAP1	59031.5 ± 17024.2	29174.5 ± 20175.2	40452.8 ± 18557.44	< 0.001
SAA2	21303 (8723.6-30583.2)	5390.9 (2567.4-18562.04)	9008.6 (3230.7-13977.4)	< 0.001
E-selectin2	90.03 (69.5-137.1)	48.5 (36.04-70.9)	35.7 (28.4-47.04)	< 0.001
MMP-92	289.3 (107.6-410.4)	50.5 (35.2-99.5)	411.5 (241.2-587.4)	0.002
HsCRP2	1.78 (0.70-3.51)	0.53 (0.21-1.13)	0.29 (0.16-0.55)	0.009

¹Mean ± SD;

²Median (25^th-75^th percentiles); ³Comparisons: sVCAM-1 (LTR = NASH - P = 0.5; LTR > controls - P < 0.001); s-ICAM-1 (LTR = NASH - P = 0.48; LTR > controls - P = 0.05; MPO (LTR < NASH - P = 0.02; LTR < controls - P < 0.001); Adiponectin (LTR > NASH - P = 0.007; LTR = controls - P = 0.27); PAI-1 (LTR < NASH and controls - P < 0.001); SAP (LTR < NASH - P < 0.001; LTR = controls - P = 0.22); SAA (LTR < NASH - P = 0.006; LTR = controls - P = 0.91); E-selectin (LTR < NASH - P = 0.001; LTR > controls - P = 0.04); MMP-9 (LTR < NASH and controls - P < 0.001); CRP (LTR < NASH - P = 0.007; LTR = controls - P = 0.41). sVCAM-1: Soluble vascular cell adhesion molecule-1; sICAM-1: Soluble intracellular cell adhesion molecule-1; PAI-1: Plasminogen activator inhibitor 1; SAP: Serum amyloid P; SAA: Serum amyloid A; MMP-9: Matrix metallopeptidase 9; HsCRP: High-sensitivity C-reactive protein; LTR: Liver transplant recipients; NASH: Non-alcoholic steatohepatitis.