title: Changes in adipokines after transjugular intrahepatic porto-systemic shunt indicate an anabolic shift in metabolism.
abstract: OBJECTIVE
  Decompressing the portal hypertension by inserting a transjugular intrahepatic porto-systemic shunt (TIPS) in undernourished liver cirrhosis patients results in gains in body weight. It is important to understand whether this reflects an advantageous or unfavourable shift in nutrition status. This to some extent can be judged from the changes in the patients' adipokine patterns. We, therefore, examined the circulating levels of the most important adipokines before and after the TIPS procedure.
  
  
  METHODS
  Twenty-five liver cirrhosis patients were examined before TIPS insertion and followed for six months after the procedure. Their body composition was determined by the bioimpedance technique. The serum concentrations of adiponectin, retinol binding protein 4 (RBP4), and leptin were measured.
  
  
  RESULTS
  The TIPS procedure induced a 12% increase in body cell mass (P = 0.03) but did not change the body fat mass. At six months, serum adiponectin was increased by 60% (mean ± SD, 10.7 ± 6.1 vs. 16.9 ± 8.9 mg/L; P = 0.001), serum RBP4 was decreased by 45% (28.6 ± 20.0 vs. 16.3 ± 9.6 mg/L; P = 0.01), and the leptin levels remained unchanged.
  
  
  CONCLUSIONS
  The TIPS-related tissue build up was accompanied by increased adiponectin and decreased RBP4. Such changes are associated with an anabolic condition where the adipose tissue possesses residual capacity for energy storage. TIPS, therefore, can be considered to be nutritionally beneficial to cirrhosis patients.
authors.affiliation: Department of Medicine V (Hepatology & Gastroenterology), Aarhus University Hospital, 44 Noerrebrogade, DK-8000 Aarhus C, Denmark. karethom@rm.dk
authors.forename: Karen Louise
authors.initials: KL
authors.lastname: Thomsen
authors.forename: Thomas Damgaard
authors.initials: TD
authors.lastname: Sandahl
authors.forename: Peter
authors.initials: P
authors.lastname: Holland-Fischer
authors.forename: Niels
authors.initials: N
authors.lastname: Jessen
authors.forename: Jan
authors.initials: J
authors.lastname: Frystyk
authors.forename: Allan
authors.initials: A
authors.lastname: Flyvbjerg
authors.forename: Henning
authors.initials: H
authors.lastname: Grønbæk
authors.forename: Hendrik
authors.initials: H
authors.lastname: Vilstrup
mesh_terms: D054392:Adipokines / Q000378:metabolism*; D052242:Adiponectin / Q000097:blood; D000273:Adipose Tissue / Q000378:metabolism; D000328:Adult; D000368:Aged; D001823:Body Composition; D017097:Electric Impedance; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery; D020738:Leptin / Q000097:blood; D008103:Liver Cirrhosis / Q000150:complications / Q000378:metabolism* / Q000601:surgery*; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000628:therapy*; D008875:Middle Aged; D009752:Nutritional Status; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D054839:Retinol-Binding Proteins, Plasma / Q000032:analysis / Q000378:metabolism
chemical_list: D054392:Adipokines; D052242:Adiponectin; D020738:Leptin; C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma