BACKGROUND: Liver transplantation (LT) is the only curative treatment for cirrhosis. However, the presence of complications can impact outcomes following LT. Sarcopenia, or muscle mass loss, is highly prevalent in patients with cirrhosis and is associated with longer hospitalization stays and a higher infection rate post-surgery. We aimed to identify patients at higher risk of early sarcopenia post-LT. METHODS: This retrospective study included 79 cirrhotic patients who underwent LT. Muscle mass was evaluated using the third lumbar spine vertebra skeletal muscle mass index (SMI) and sarcopenia was defined using established cut-off values. Computerized tomography (CT) scans performed within six-month peri-operative period (three months pre- and post-LT) were included in the study. Complications and comorbidities were collected and correlated to SMI post-LT and predictive models for SMI post-LT were constructed. RESULTS: The overall prevalence of sarcopenia was 46% and 62% before and after LT, respectively. Newly developed sarcopenia was found in 42% of patients. Post-LT sarcopenia was associated with longer hospital stays (54±37 vs 29±10 days, p = 0.002), higher number of infection (3±1 vs 1±2, p = 0.027), and greater number of complications (5±2 vs 3±2, p <0.001) compared to absence of sarcopenia. Multivariate analyses showed that the SMI post-LT was independently associated with pre-LT renal function markers, the glomerular filtration rate (GFR) and creatinine (Model 1, GFR: β = 0.33; 95% CI = 0.04–0.17; p = 0.003; Model 2, Creatinine: β = –0.29; 95% CI = –0.10 to –0.02; p = 0.009). CONCLUSIONS: The present study highlights the potential role of renal dysfunction in the development and persistence of sarcopenia after LT.

Background Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that affects approximately 15 % of the worldwide population. It is characterized by recurring abdominal pain and changes in bowel habits. This population is more at risk of suffering from chronic fatigue and psychological distress. Moreover, IBS significantly reduces the quality of life of patients and increases the economic burden on the health system. Many therapies have been developed to try to alleviate the symptoms and improve the lives of people with IBS. Among these is the FODMAP ( Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols) diet which aims to establish a personal tolerance to these nutrients (carbohydrates) that accentuate the symptoms related to IBS. This diet, lasting on average twelve weeks, is separated into three steps: elimination, reintroduction, and personalization. An innovative approach has been developed by the online platform SOSCuisine.com® to allow people with IBS to safely follow the FODMAP diet in a ‘self-service’ way. It consists of using an online service of personalized weekly menus low in FODMAP with tips and instructions for each step of the diet in combination with access to a peer support group, moderated by a specialized registered dietician. Aims The aim of this project is to evaluate the impact of this new online service on the quality of life and the control of the physiological and psychological symptoms of people living with IBS. We hypothesized that this online service improve the quality of life and the control of the symptoms. Methods The participant has to be at least 18 years old, understand French, have access to Internet and a Facebook account (sufficient familiarity to use them) and have an IBS diagnosis (Rome IV criteria) validated or re-validated by a gastroenterologist within three months. People with eating disorders, mental health problems, other chronic gastrointestinal illnesses (except gastroesophageal reflux disease), diabetes and with a pregnancy are excluded. Validated questionnaires are used to assess the quality of life ( IBS-Quality Of Life), physical symptoms ( IBS-Severity Scoring System), state and trait ( State-Trait Anxiety Inventory, Form Y) whereas food intake is assessed with a online 24-hour dietary recall. Results So far, 35 participants have been included in the study (83% female, 45,3±12,8 years old). After the intervention, the severity of symptoms significantly decreased (p&lt;0.001), and quality of life (p=0.041) and state anxiety (p=0.034) significantly improved. Conclusions This study should allow the identification of facilitating elements to adhere to the FODMAP diet and possibly improve the quality of life of this population. Funding Agencies None

La diète cétogène, une diète riche en matières grasses et faible en glucides, originalement développée pour le traitement de l’épilepsie, est de plus en plus considérée pour le traitement de la stéatose hépatique non-alcoolique (SHNA), la maladie chronique du foie la plus prévalente dans les pays développés. Des études animales et humaines ont été menées afin d’élucider l’effet de la diète cétogène sur la perte de poids et la SHNA. Toutefois, la plupart des études sont limitées par leur petite taille d’échantillon et leur courte durée en plus du fait que plusieurs sont observationnelles empêchant ainsi d’établir un lien de causalité. Ainsi, la controverse demeure quant à un effet bénéfique potentiel de la diète cétogène sur les facteurs de risque cardiométaboliques et la SHNA indiquant un besoin d’études supplémentaires. À date, aucun consensus n’a été établi. Dans ce contexte, une intervention au niveau des habitudes de vie, incluant l’alimentation, de type méditerranéen, et l’exercice physique, tout en considérant l’image corporelle, semble être la stratégie de choix. Une perte de poids de 7-10% est la première ligne de traitement pour les gens souffrant de SHNA. Les diététistes professionnels sont essentiels et les mieux placés pour l’éducation et le traitement des patients atteints de SHNA.