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Clinical nutrition

Liver steatosis in adult patients on home parenteral nutrition

European Journal of Clinical Nutrition volume 74, pages 255–260 (2020)Cite this article

Subjects

Abstract

Background

In patients with chronic intestinal failure (CIF) and long-term home parenteral nutrition (HPN), liver steatosis is a known late complication, which can progress to intestinal failure-associated liver disease (IFALD). Magnetic resonance imaging (MRI) provides a qualitative and quantitative assessment of liver steatosis. The aim of our study was to assess the prevalence of liver steatosis and find possible new factors that could be connected to liver steatosis in CIF patients on HPN therapy.

Methods

Patients diagnosed with CIF and undergoing long-term HPN therapy were enrolled in a prospective cohort study. Clinical, laboratory and body composition data were collected from their medical records between January 2017 and November 2018. Liver steatosis was diagnosed using 3 Tesla Siemens MRI scanner. The associations between various risk factors and liver steatosis were calculated using uni- and multivariate logistic regression.

Results

In our study, we included 63 adult patients with CIF on HPN therapy. The median HPN therapy duration was 70 weeks (IQR 22–203). The prevalence of liver steatosis was 28.6%. Serum cholesterol level, CRP and FFMI were statistically significantly associated with liver steatosis.

Conclusion

The results of our study indicate that CIF patients on HPN therapy experience a low risk of liver disease if they adhere to a well-controlled treatment regime. We found that MRI is an appropriate diagnostic tool for monitoring liver steatosis in patients on long-term PN. With respect to already known risk factors for liver steatosis, we did find a newly described association between FFMI and liver steatosis.

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Acknowledgements

This study would not be possible without the help from our nursing staff. Special thanks goes to Laura Petrica and Nizra Palamar.

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Authors and Affiliations

  1. Institute of Radiology, UMC Ljubljana, Ljubljana, Slovenia

    Taja Jordan & Peter Popovič

  2. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

    Taja Jordan & Peter Popovič

  3. Department for Clinical Nutrition, Institute of Oncology Ljubljana, Ljubljana, Slovenia

    Nada Rotovnik Kozjek

Authors
  1. Taja Jordan
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Contributions

TJ, PP and NRK. TJ contributed to the data collection, analyzed the data and drafted the manuscript. PP contributed to conception of the study, data interpretation and reviewed/edited the paper. NRK was responsible for the concept/ design of the study, and contributed to the data analysis and interpretation, and revised the paper. All authors read and approved the final paper and agree to be accountable for all aspects of work ensuring integrity and accuracy.

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Correspondence to Taja Jordan.

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Jordan, T., Popovič, P. & Rotovnik Kozjek, N. Liver steatosis in adult patients on home parenteral nutrition. Eur J Clin Nutr 74, 255–260 (2020). https://doi.org/10.1038/s41430-019-0455-4

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