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Background <p>Liver transplant (LT) recipients are at high risk of cardiometabolic disease and mortality. However, routinely employed clinical risk tools have sub-optimal diagnostic performance due to transplant related biological changes. Metabolic vulnerability index (MVX) is a serum-based composite biomarker comprised of nutritional risk [metabolic malnutrition index or MMX] and chronic inflammation [inflammatory vulnerability index or IVX]. MVX is a predictor of cardiovascular risk and all-cause mortality in the general population, however, the effect of LT on MVX is unknown.</p> Methods <p>To better quantify MVX after transplantation, LT recipients (n = 181) prospectively enrolled in a natural history study were matched with non transplant controls from the MESA study of healthy individuals. All controls were matched 1:1 regarding age and gender. Additionally, lean controls were identified as those with BMI &lt; 25&#xa0;kg/m<sup>2</sup> and BMI-matched controls who were propensity matched for BMI.</p> Results <p>Compared to matched controls, LT recipients had significantly higher MVX (56.9 ± 10.1 vs. 45.8 ± 9.4 vs. 44.8 ± 9.3, p &lt; 0.001), IVX [53.1 ± 12 vs. 39.3 ± 11.2 vs. 40.2 ± 10.9, p &lt; 0.001), and MMX (58.7 ± 8.2 vs. 55.4 ± 6.5 vs. 53.1 ± 6.0, p &lt; 0.001). No significant differences were noted in MVX in LT recipients who developed metabolic dysfunction associated steatotic liver disease (MASLD) after LT. In a multivariate analysis, MVX scores were positively associated with female gender, diabetes, serum AST and BMI, and negatively with dyslipidemia.</p> Conclusion <p>LT is associated with a significant increase in MVX and its components, suggesting a heightened risk in LT recipients that is above that of the non-LT population. Future well designed prospective studies are required to calibrate MVX to clinical outcomes in LT patients.</p>

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Liver Transplantation and Metabolic Dysfunction Associated Steatotic Liver Disease Is Associated with Markers of Metabolic Risk and Inflammation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月24日

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  • Rehan Razzaq,
  • Madison Nguyen,
  • Margery A. Connelly,
  • Alok Baral,
  • Hiba Khan,
  • Shreya Garg,
  • Audrey Ang,
  • Alexis Kim,
  • Geneva Roache,
  • Kavish R. Patidar,
  • Idris Yakubu,
  • Irina Shalaurova,
  • Stephan J. L. Bakker,
  • Robin P. F. Dullaart,
  • Vinay Kumaran,
  • Anh T. Bui,
  • Vaishali Patel,
  • Mohammad Shadab Siddiqui

摘要

Background

Liver transplant (LT) recipients are at high risk of cardiometabolic disease and mortality. However, routinely employed clinical risk tools have sub-optimal diagnostic performance due to transplant related biological changes. Metabolic vulnerability index (MVX) is a serum-based composite biomarker comprised of nutritional risk [metabolic malnutrition index or MMX] and chronic inflammation [inflammatory vulnerability index or IVX]. MVX is a predictor of cardiovascular risk and all-cause mortality in the general population, however, the effect of LT on MVX is unknown.

Methods

To better quantify MVX after transplantation, LT recipients (n = 181) prospectively enrolled in a natural history study were matched with non transplant controls from the MESA study of healthy individuals. All controls were matched 1:1 regarding age and gender. Additionally, lean controls were identified as those with BMI < 25 kg/m2 and BMI-matched controls who were propensity matched for BMI.

Results

Compared to matched controls, LT recipients had significantly higher MVX (56.9 ± 10.1 vs. 45.8 ± 9.4 vs. 44.8 ± 9.3, p < 0.001), IVX [53.1 ± 12 vs. 39.3 ± 11.2 vs. 40.2 ± 10.9, p < 0.001), and MMX (58.7 ± 8.2 vs. 55.4 ± 6.5 vs. 53.1 ± 6.0, p < 0.001). No significant differences were noted in MVX in LT recipients who developed metabolic dysfunction associated steatotic liver disease (MASLD) after LT. In a multivariate analysis, MVX scores were positively associated with female gender, diabetes, serum AST and BMI, and negatively with dyslipidemia.

Conclusion

LT is associated with a significant increase in MVX and its components, suggesting a heightened risk in LT recipients that is above that of the non-LT population. Future well designed prospective studies are required to calibrate MVX to clinical outcomes in LT patients.