Clinical Food Addiction Is Not Associated with Development of Metabolic Complications in Liver Transplant Recipients

Abstract

Background and Aims: Given the increased risk of post-transplant metabolic syndrome (PTMS; defined by hypertension, diabetes mellitus and hyperlipidemia), we aimed to identify the potential role of food addiction in the development of metabolic complications in the post-liver transplant population.Methods: Inclusion criteria included adult liver transplant recipients followed at our institution between June 2016 and November 2016. Participants were administered a demographic survey as well as the Yale Food Assessment Scale 2.0, a 35-item questionnaire used to assess frequency of food addiction in accordance with the DSM-V guidelines of substance use disorders. Demographic and clinical data were collected.Results: Our study included 236 liver transplant recipients (139 males, 97 females). The median (interquartile range [IQR]) BMI of participants was 26.8 kg/m2 (24.2, 30.4), and median (IQR) time since transplantation was 50.9 months (19.6, 119.8). The prevalence rates of hypertension, hypercholesterolemia and diabetes mellitus were 54.7%, 25.0% and 27.1%, respectively. Twelve participants (5.1%) were found to have a diagnosis of food addiction. A diagnosis of food misuse was made in 94 (39.8%) of the transplant recipients.Conclusions: Our findings are consistent with prior data that indicate high prevalence of metabolic complications among liver transplant recipients. Food addiction was not predictive of metabolic complications within this population. Nevertheless, we found that this population was at high risk of demonstrating symptoms of food misuse, and they were not likely to appreciate the risks of pathologic patterns of eating. Given the increasing risk of cardiovascular morbidity and mortality in this population, efforts should be made to identify risk factors for the development of PTMS.

Leptin receptor-expressing pericytes mediate access of hypothalamic feeding centers to circulating leptin

“…Pericytic CypA has been found to promote BBB breakdown by endothelial junction degradation (Bell et al, 2012), which could be seen as further support of a role for LepR pericytes in paracellular pathway regulation. Intriguingly, the CypA inhibiting drug cyclosporine, which is widely used to counter transplant rejections, has been linked to weight gain (Ersoy et al, 2008;Lo ´pez-Vilella et al, 2015;Neal et al, 2001;Saab et al, 2017), an association that has been interestingly also reported for imatinib (Aduwa et al, 2012;Breccia et al, 2013;Jeyaraman and Naithani, 2020). Sparc (secreted protein acidic and rich in cysteine), a secreted factor that is produced by pericytes and increases vessel permeability by the opening of endothelial junctions (Goldblum et al, 1994), was also found enriched in LepR pericytes (Figure S7A).…”

From Listing to Recovery: A Review of Nutritional Status Assessment and Management in Liver Transplant Patients

“…A study evaluating food addiction and abuse in 236 LT recipients found that 5.1% of LT patients were food-addicted, and 39.8% were food abusers [ 205 ]. On the other hand, some authors curiously did not find an association between weight gain and stress or depressive feelings, as 69% of the patients gaining weight did not show depressive feelings or eating disorders [ 184 ].…”