Department of Surgery, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
World J Gastroenterol. 2020 May 21;26(19):2374-2387. doi: 10.3748/wjg.v26.i19.2374.
Post-transplant dyslipidemia (PTDL) is a common complication in liver recipients and can cause morbidity and threaten graft function. The crosstalk between metabolic inflammation and dyslipidemia has been recently revealed. However, the role of grafts' and recipients' metabolic status in the development of PTDL has not been evaluated.
To investigate the association of recipients' metabolic inflammation status with PTDL and construct a predictive model.
A total of 396 adult patients who received primary liver transplantation between 2015 and 2017 were enrolled. Metabolomics and cytokines were analyzed using recipients' pre-transplant peripheral blood in a training set ( = 72). An integrated prediction model was established according to the clinical risk factors and metabolic inflammation compounds and further verified in a validation set ( = 144).
The serum lipid profile took 3 mo to reach homeostasis after liver transplantation. A total of 278 (70.2%) liver recipients developed PTDL during a follow-up period of 1.78 (1.00, 2.97) years. The PTDL group showed a significantly lower tumor-free survival and overall survival than the non-PTDL group in patients with hepatocellular carcinoma ( = 169). The metabolomic analysis showed that metabolic features discriminating between the PTDL and non-PTDL groups were associated with lipid and glucose metabolism-associated pathways. Among metabolites and cytokines differentially expressed between the two groups, interleukin-12 (p70) showed the best diagnostic accuracy and significantly increased the predictive value when it was incorporated into the clinical model in both training and validation sets.
Recipients' pre-transplant serum interleukin-12 (p70) level is associated with the risk of PTDL and has potential clinical value for predicting PTDL.
肝移植后血脂异常（PTDL）是肝移植受者的常见并发症，可导致发病率增加，并威胁移植物功能。代谢性炎症与血脂异常之间的相互作用最近已经被揭示。然而，移植物和受者的代谢状态在 PTDL 发展中的作用尚未得到评估。
探讨受者代谢性炎症状态与 PTDL 的关系，并构建预测模型。
共纳入 2015 年至 2017 年期间接受原发性肝移植的 396 例成年患者。采用受者移植前外周血进行代谢组学和细胞因子分析，建立训练集（=72）。根据临床危险因素和代谢性炎症化合物建立综合预测模型，并在验证集（=144）中进一步验证。
肝移植后 3 个月血清脂质谱才能达到平衡。在 1.78（1.00，2.97）年的随访期间，共有 278（70.2%）例肝移植受者发生 PTDL。与无 PTDL 组相比，肝细胞癌患者的 PTDL 组无肿瘤生存率和总生存率显著降低（=169）。代谢组学分析表明，区分 PTDL 组和非 PTDL 组的代谢特征与脂质和葡萄糖代谢相关途径有关。在两组间差异表达的代谢物和细胞因子中，白细胞介素-12（p70）显示出最佳的诊断准确性，当它被纳入训练和验证集的临床模型中时，显著提高了预测价值。
受者移植前血清白细胞介素-12（p70）水平与 PTDL 风险相关，对预测 PTDL 具有潜在的临床价值。
