title: Serum adipocyte fatty acid binding protein in liver transplant recipients and the metabolic syndrome.
abstract: BACKGROUND
  Liver transplantation is often associated with metabolic derangements. Adipocyte fatty-acid-binding protein 4 (AFABP4) integrates inflammatory and metabolic responses. It has also been associated with metabolic syndrome in animal models and clinical studies in the general population.
  
  
  OBJECTIVE
  To determine the role of AFABP4 in post-transplant metabolic syndrome.
  
  
  METHODS
  Consecutive patients followed for at least 6 months after liver transplantation were tested for insulin resistance by homeostasis model assessment (HOMA). Serum levels of AFABP4 were tested by an enzyme-linked immunosorbent assay.
  
  
  RESULTS
  The study group included 76 patients (64.5% male, mean age 56.3 ± 12.4 years). Hypertension was present in 56.5%, hyperlipidemia in 69.7%, diabetes mellitus in 23.6%. Half of the patients met at least 3 criteria for metabolic syndrome. Serum AFABP4 levels (p < 0.0001), HOMA index ≥ 2.5 vs. < 2.5 (p < 0.0002) and BMI ≥ 30 vs. < 30 (p < 0.0006) were significantly higher in patients with metabolic syndrome. Within the metabolic syndrome subgroup, AFABP4 levels significantly correlated with age, aspartate aminotransaminase level, waist circumference, and HOMA index. High AFABP4 significantly increased the odds of acquiring metabolic syndrome (OR 1.04, 95% CI 1.007-1.074, p = 0.017). On multiple logistic regression analysis, independent predictors of high AFABP4 were cryptogenic liver disease, steroid administration, high HOMA index, and a high degree of fatty infiltration.
  
  
  CONCLUSIONS
  Prevalence of metabolic syndrome is significantly higher in liver transplant recipients than in the general population. AFABP4 may serve as a circulating biomarker in the clinical prediction/diagnosis of metabolic syndrome in patients post-liver transplantation.
authors.affiliation: Gastroenterology Unit, Hasharon Hospital, Rabin Medical Center, Petah Tiqwa, Israel.
authors.forename: Hemda
authors.initials: H
authors.lastname: Schmilovitz-Weiss
authors.forename: Ido
authors.initials: I
authors.lastname: Laish
authors.forename: Zohar
authors.initials: Z
authors.lastname: Levi
authors.forename: Yehudith
authors.initials: Y
authors.lastname: Monsselise
authors.forename: Yael
authors.initials: Y
authors.lastname: Harif
authors.forename: Marius
authors.initials: M
authors.lastname: Braun
authors.forename: Mona
authors.initials: M
authors.lastname: Boaz
authors.forename: Ziv
authors.initials: Z
authors.lastname: Ben-Ari
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D016031:Liver Transplantation; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; C493410:FABP4 protein, human; D050556:Fatty Acid-Binding Proteins