title: Resting energy expenditure, body composition, and dietary intake: a longitudinal study before and after liver transplantation.
abstract: BACKGROUND
  The loss of hepatic innervations after liver transplantation (LTx) might affect the energy metabolism of the patients. The aim of this study was to assess the resting energy expenditure (REE), body composition, and dietary intake before and during the first year after the LTx.
  
  
  METHODS
  The REE was measured by indirect calorimetry. Nutritional status was assessed by anthropometric assessment, bioimpedance, handgrip strength, and dietary intake (before and 30, 90, 180, 270, and 370 days after LTx). Social, clinical, and nutritional variables were assessed as being potentially associated with REE or hypermetabolism and hypometabolism after LTx.
  
  
  RESULTS
  Seventeen patients were included. REE was elevated at 30 days and reduced at the end of the study (P<0.05). Hypermetabolism/hypometabolism were low but present at the end of the study (11.8% of each). Increases in body weight and fat mass were observed (P<0.05). Handgrip strength and phase angle improved after LTx (P<0.05). Energy balance was positive at all times after LTx, and an increase in fat intake occurred (P<0.05). After multivariate analyses (P<0.05), the REE before transplantation and triceps skinfold thickness were positively associated and the cumulative dose of prednisone was negatively associated with REE after LTx. The presence of hypermetabolism was significantly associated with the presence of hypermetabolism before LTx and the cumulative dose of prednisone. Percentage of fat intake and fat mass before LTx was associated with hypometabolism.
  
  
  CONCLUSIONS
  Some potential modifiable factors are related to resting energy metabolism in patients undergoing LTx. Adequate and individualized nutritional guidance should be started before LTx.
authors.affiliation: 1 Surgery Postgraduate Program, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. 2 Nutrition Course, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. 3 Adult Health Postgraduate Program, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. 4 Alfa Institute of Gastroenterology, Hospital of Clinics, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. 5 Address correspondence to: Maria Isabel T.D. Correia, PhD, RD, Alfa Institute of Gastroenterology, Hospital of Clinics, Medical School, Universidade Federal de Minas Gerais, Avenida Alfredo Balena 110, Sala 208, 31270-901 Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Lívia G
authors.initials: LG
authors.lastname: Ferreira
authors.forename: Laís F
authors.initials: LF
authors.lastname: Santos
authors.forename: Lucilene R
authors.initials: LR
authors.lastname: Anastácio
authors.forename: Agnaldo S
authors.initials: AS
authors.lastname: Lima
authors.forename: Maria Isabel T D
authors.initials: MI
authors.lastname: Correia
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D001823:Body Composition / Q000187:drug effects; D002153:Calorimetry, Indirect; D004032:Diet; D017097:Electric Impedance; D002149:Energy Intake / Q000187:drug effects; D004734:Energy Metabolism / Q000187:drug effects; D005260:Female; D018737:Hand Strength; D006304:Health Status; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016014:Linear Models; D016031:Liver Transplantation / Q000009:adverse effects; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009752:Nutritional Status; D016017:Odds Ratio; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents