title: [Factors modulating food intake and energy expenditure prior to liver transplantation].
abstract: BACKGROUND
  There is a high prevalence of nutritional disorders in patients with liver cirrhosis (LC). This study was designed to assess the relationships between liver function, IFG-I/IGFBP-3, nutritional status, leptin, ghrelin and glucagon in 21 patients waiting for liver transplantation (LT).
  
  
  METHODS
  We studied 21 men aged 56±2.1 years who were on the LT list. They were classified according to Child-Pugh(CP) score from low to high liver dysfunction in CPA (n=4),CPB (n=11) and CPC (n=6). Body mass index (BMI) was calculated and body fat (%) was measured by air-displacement plethysmography. Resting energy expenditure (REE) and its variation over Harris-Benedict values (GER%) were assessed by indirect calorimetry. Fasting serum samples were taken to measure albumin, glucose, insulin, HbA1c, leptin, total ghrelin,glucagon, IGF-I and IGFBP3.
  
  
  RESULTS
  There were no differences in fat % and leptin values in the three groups according to CP classification. The CPC group showed higher ghrelin values than CPA and CPB(p<0.05). All groups displayed high glucagon levels and GER%values superior to 100%. Positive correlations were found between glucagon and GER% (r=0.56; p<0.01) and between glucagon and ghrelin values (r=0.66; p<0.01). IGF-I and IGFBP3 were low in all groups and showed a positive correlation with plasma albumin (r=0.52; p<0.05 and r=0.45; p<0.05 respectively).
  
  
  CONCLUSIONS
  These results show an increase in ghrelin plasma values in patients with severe liver dysfunction. Hyperglucagonemia was correlated with GER%, supporting a role of glucagon in the hypermetabolic state associated to LC,raising the possibility of becoming a therapeutic target. The measurement of IGF-I/IGFBP3 represents a good marker of liver function in patients with LC.
authors.affiliation: Hospital Universitario de Burgos. esantos@alumni.unav.es.
authors.forename: E
authors.initials: E
authors.lastname: Santos
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez
authors.forename: C
authors.initials: C
authors.lastname: Prieto
authors.forename: M J
authors.initials: MJ
authors.lastname: Gil
authors.forename: G
authors.initials: G
authors.lastname: Frühbeck
authors.forename: J
authors.initials: J
authors.lastname: Quiroga
authors.forename: J I
authors.initials: JI
authors.lastname: Herrero
authors.forename: J
authors.initials: J
authors.lastname: Salvador
mesh_terms: D000368:Aged; D004435:Eating; D004734:Energy Metabolism; D054439:Ghrelin; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I; D020738:Leptin; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged
chemical_list: D054439:Ghrelin; C515497:IGFBP3 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D020738:Leptin; D007334:Insulin-Like Growth Factor I