Physical activity in liver transplant recipients: a large multicenter study.
Cardiovascular risk
Liver transplant
Mediterranean diet
Physical activity
Survey
Journal
Internal and emergency medicine
ISSN: 1970-9366
Titre abrégé: Intern Emerg Med
Pays: Italy
ID NLM: 101263418
Informations de publication
Date de publication:
Mar 2024
Mar 2024
Historique:
received:
20
07
2023
accepted:
24
10
2023
pubmed:
21
11
2023
medline:
21
11
2023
entrez:
20
11
2023
Statut:
ppublish
Résumé
Healthy lifestyle and appropriate diet are of critical importance after liver transplant (LT). We provided an analysis of the main patterns of physical activity and found factors associated with physical activity itself. Clinically stable LT recipients were enrolled between June and September 2021. Patients completed a composite questionnaire about physical activity, adherence to Mediterranean Diet (MD), quality of life (QoL), and employment. Correlations were analysed using the Pearson coefficients while different subgroups were compared by t-test for independent samples or ANOVAs. Multivariable logistic regression analysis was conducted to find predictors of inactivity. We enrolled 511 subjects (71% males, mean age 63 ± 10.8 years). One hundred and ninety-three patients reported high level of physical activity, 197 a minimal activity and 121 declared insufficient activity. Among these latter, 29 subjects were totally inactive. Considering the 482 LT recipients performing some kind of physical activity, almost all reported a low-quality, non-structured activity. At multivariate analysis, time from LT (odds ratio 0.94, 95% CI 0.89-0.99, p = 0.017), sedentary lifestyle (odds ratio 0.99, 95% CI 0.19-0.81, p = 0.012), low adherence to MD (odds ratio 1.22, 95% CI 1.01-1.48, p = 0.049), and low level of QoL (physical dimension) (odds ratio 1.13, 95% CI 1.08-1.17, p < 0.001), were independently associated with total inactivity. A large portion of LT recipients report an insufficient level of physical activity or are wholly inactive. Inactivity increases with time from LT and was strongly associated with suboptimal diet and low QoL.
Identifiants
pubmed: 37985618
doi: 10.1007/s11739-023-03474-7
pii: 10.1007/s11739-023-03474-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
343-352Investigateurs
Giovanni Vitale
(G)
Giacomo Bisonti
(G)
Filippo Schepis
(F)
Erica Villa
(E)
Guido Piai
(G)
Francesco Giuseppe Foschi
(FG)
Paolo Magistri
(P)
Paola Carrai
(P)
Stefania Petruccelli
(S)
Marco Corsi
(M)
Edoardo Falconi
(E)
Roberto Palazzo
(R)
Informations de copyright
© 2023. The Author(s).
Références
European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu (2016) EASL clinical practice guidelines: liver transplantation. J Hepatol 64:433–485. https://doi.org/10.1016/j.jhep.2015.10.006
doi: 10.1016/j.jhep.2015.10.006
Beekman L, Berzigotti A, Banz V (2018) Physical activity in liver transplantation: a patient’s and physicians’ experience. Adv Ther 35:1729–1734. https://doi.org/10.1007/s12325-018-0797-7
doi: 10.1007/s12325-018-0797-7
pubmed: 30328060
pmcid: 6223989
Duarte-Rojo A, Ruiz-Margáin A, Montaño-Loza AJ et al (2018) Exercise and physical activity for patients with end-stage liver disease: improving functional status and sarcopenia while on the transplant waiting list. Liver Transpl 24:122–139. https://doi.org/10.1002/lt.24958
doi: 10.1002/lt.24958
pubmed: 29024353
Beyer N, Aadahl M, Strange B et al (1999) Improved physical performance after orthotopic liver transplantation. Liver Transpl Surg 5:301–309. https://doi.org/10.1002/lt.500050406
doi: 10.1002/lt.500050406
pubmed: 10388503
Krasnoff JB, Vintro AQ, Ascher NL et al (2006) A randomized trial of exercise and dietary counseling after liver transplantation. Am J Transplant 6:1896–1905. https://doi.org/10.1111/j.1600-6143.2006.01391.x
doi: 10.1111/j.1600-6143.2006.01391.x
pubmed: 16889545
Gitto S, Falcini M, Marra F, MEDITRA Research Group (2021) Metabolic disorders after liver transplantation. Metab Syndr Relat Disord 19:65–69. https://doi.org/10.1089/met.2020.0068
doi: 10.1089/met.2020.0068
pubmed: 33104408
Harrington CR, Levy P, Cabrera E et al (2023) Evolution of pretransplant cardiac risk factor burden and major adverse cardiovascular events in liver transplant recipients over time. Liver Transpl 29:581–590. https://doi.org/10.1097/LVT.0000000000000013
doi: 10.1097/LVT.0000000000000013
pubmed: 36724875
Kallwitz ER, Loy V, Mettu P et al (2013) Physical activity and metabolic syndrome in liver transplant recipients. Liver Transpl 19:1125–1131. https://doi.org/10.1002/lt.23710
doi: 10.1002/lt.23710
pubmed: 23894084
Fussner LA, Heimbach JK, Fan C et al (2015) Cardiovascular disease after liver transplantation: when, what, and who is at risk. Liver Transpl 21:889–896. https://doi.org/10.1002/lt.24137
doi: 10.1002/lt.24137
pubmed: 25880971
Richards J, Gunson B, Johnson J, Neuberger J (2005) Weight gain and obesity after liver transplantation. Transpl Int 18:461–466. https://doi.org/10.1111/j.1432-2277.2004.00067.x
doi: 10.1111/j.1432-2277.2004.00067.x
pubmed: 15773968
Masala D, Mannocci A, Unim B et al (2012) Quality of life and physical activity in liver transplantation patients: results of a case-control study in Italy. Transpl Proc 44:1346–1350. https://doi.org/10.1016/j.transproceed.2012.01.123
doi: 10.1016/j.transproceed.2012.01.123
Craig CL, Marshall AL, Sjöström M et al (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35:1381–1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB
doi: 10.1249/01.MSS.0000078924.61453.FB
pubmed: 12900694
International Physical Activity Questionnaire:… | Mannocci | Italian Journal of Public Health. https://ijphjournal.it/article/view/5694 . Accessed 13 June 2023
Dasso NA (2019) How is exercise different from physical activity? A concept analysis. Nurs Forum 54:45–52. https://doi.org/10.1111/nuf.12296
doi: 10.1111/nuf.12296
pubmed: 30332516
Physical Activity Guidelines for Americans, 2nd edition
Sofi F, Macchi C, Abbate R et al (2014) Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr 17:2769–2782. https://doi.org/10.1017/S1368980013003169
doi: 10.1017/S1368980013003169
pubmed: 24476641
Gandek B, Ware JE, Aaronson NK et al (1998) Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 51:1171–1178. https://doi.org/10.1016/s0895-4356(98)00109-7
doi: 10.1016/s0895-4356(98)00109-7
pubmed: 9817135
Gitto S, Golfieri L, Sofi F et al (2023) Adherence to Mediterranean diet in liver transplant recipients: a cross-sectional multicenter study. Minerva Gastroenterol (Torino). https://doi.org/10.23736/S2724-5985.22.03290-9
Hosmer DW, Lemeshow S (2000) Applied logistic regression. Wiley, London
doi: 10.1002/0471722146
Nagelkerke NJD (1991) A note on a general definition of the coefficient of determination. Biometrika 78:691–692. https://doi.org/10.1093/biomet/78.3.691
doi: 10.1093/biomet/78.3.691
Bujang MA, Sa’at N, Sidik TMITAB, Joo LC (2018) Sample size guidelines for logistic regression from observational studies with large population: emphasis on the accuracy between statistics and parameters based on real life clinical data. Malays J Med Sci 25:122–130. https://doi.org/10.21315/mjms2018.25.4.12
Goodyear MDE, Krleza-Jeric K, Lemmens T (2007) The declaration of Helsinki. BMJ 335:624–625. https://doi.org/10.1136/bmj.39339.610000.BE
doi: 10.1136/bmj.39339.610000.BE
pubmed: 17901471
pmcid: 1995496
Biddle SJH (2007) Sedentary behavior. Am J Prev Med 33:502–504. https://doi.org/10.1016/j.amepre.2007.08.002
doi: 10.1016/j.amepre.2007.08.002
pubmed: 18022068
Nurwanti E, Uddin M, Chang J-S et al (2018) Roles of sedentary behaviors and unhealthy foods in increasing the obesity risk in adult men and women: a cross-sectional national study. Nutrients 10:704. https://doi.org/10.3390/nu10060704
doi: 10.3390/nu10060704
pubmed: 29857537
pmcid: 6024814
Warburton DER, Nicol CW, Bredin SSD (2006) Health benefits of physical activity: the evidence. CMAJ 174:801–809. https://doi.org/10.1503/cmaj.051351
doi: 10.1503/cmaj.051351
pubmed: 16534088
pmcid: 1402378
Myers J, Kaykha A, George S et al (2004) Fitness versus physical activity patterns in predicting mortality in men. Am J Med 117:912–918. https://doi.org/10.1016/j.amjmed.2004.06.047
doi: 10.1016/j.amjmed.2004.06.047
pubmed: 15629729
Oliveira JM, Spositon T, Rugila DF et al (2023) Validity of the international physical activity questionnaire (short form) in adults with asthma. PLoS ONE 18:e0282137. https://doi.org/10.1371/journal.pone.0282137
doi: 10.1371/journal.pone.0282137
pubmed: 36827240
pmcid: 9956041
Kohlbrenner D, von Moos S, Schmid-Mohler G (2022) Criterion validity and test-retest reliability of a modified version of the international physical activity questionnaire-short form (IPAQ-SF) in kidney transplant recipients. Front Rehabil Sci 3:808476. https://doi.org/10.3389/fresc.2022.808476
doi: 10.3389/fresc.2022.808476
pubmed: 36189067
pmcid: 9397873
Chun MY (2012) Validity and reliability of Korean version of international physical activity questionnaire short form in the elderly. Korean J Fam Med 33:144–151. https://doi.org/10.4082/kjfm.2012.33.3.144
doi: 10.4082/kjfm.2012.33.3.144
pubmed: 22787536
pmcid: 3391639
Lee PH, Macfarlane DJ, Lam TH, Stewart SM (2011) Validity of the international physical activity questionnaire short form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act 8:115. https://doi.org/10.1186/1479-5868-8-115
doi: 10.1186/1479-5868-8-115
pubmed: 22018588
pmcid: 3214824
Couzi L, Moulin B, Morin M-P et al (2013) Factors predictive of medication nonadherence after renal transplantation: a French observational study. Transplantation 95:326–332. https://doi.org/10.1097/TP.0b013e318271d7c1
doi: 10.1097/TP.0b013e318271d7c1
pubmed: 23149477
De Geest S, Burkhalter H, Bogert L et al (2014) Describing the evolution of medication nonadherence from pretransplant until 3 years post-transplant and determining pretransplant medication nonadherence as risk factor for post-transplant nonadherence to immunosuppressives: the Swiss Transplant Cohort Study. Transpl Int 27:657–666. https://doi.org/10.1111/tri.12312
doi: 10.1111/tri.12312
pubmed: 24628915
Villeneuve C, Rousseau A, Rerolle J-P et al (2020) Adherence profiles in kidney transplant patients: Causes and consequences. Patient Educ Couns 103:189–198. https://doi.org/10.1016/j.pec.2019.08.002
doi: 10.1016/j.pec.2019.08.002
pubmed: 31447197
Suryadinata RV, Wirjatmadi B, Adriani M, Lorensia A (2020) Effect of age and weight on physical activity. J Public Health Res 9(2):1840. https://doi.org/10.4081/jphr.2020.1840
doi: 10.4081/jphr.2020.1840
pubmed: 32728579
pmcid: 7376490
Kotarska K, Wunsch E, Raszeja-Wyszomirska J et al (2015) Female sex but not original indication affects physical activity after liver transplant: a prospective. Single Center Study Exp Clin Transpl 13(3):243–246
Painter P, Krasnoff J, Paul SM, Ascher NL (2001) Physical activity and health-related quality of life in liver transplant recipients. Liver Transpl 7:213–219. https://doi.org/10.1053/jlts.2001.22184
doi: 10.1053/jlts.2001.22184
pubmed: 11244162
Cicognani E, Mazzoni D, Totti V et al (2015) Health-related quality of life after solid organ transplantation: the role of sport activity. Psychol Health Med 20:997–1004. https://doi.org/10.1080/13548506.2014.993404
doi: 10.1080/13548506.2014.993404
pubmed: 25531821
Neale J, Smith AC, Bishop NC (2017) Effects of exercise and sport in solid organ transplant recipients: a review. Am J Phys Med Rehabil 96:273–288. https://doi.org/10.1097/PHM.0000000000000599
doi: 10.1097/PHM.0000000000000599
pubmed: 27552351
Pérez-Amate È, Roqué-Figuls M, Fernández-González M, Giné-Garriga M (2023) Exercise interventions for adults after liver transplantation. Cochrane Datab Syst Rev 5:CD013204. https://doi.org/10.1002/14651858.CD013204.pub2
doi: 10.1002/14651858.CD013204.pub2
Mosconi G, Cuna V, Tonioli M et al (2014) Physical activity in solid organ transplant recipients: preliminary results of the Italian project. Kidney Blood Press Res 39(2–3):220–227. https://doi.org/10.1159/000355800
doi: 10.1159/000355800
pubmed: 25118112
de Labra C, Guimaraes-Pinheiro C, Maseda A et al (2015) Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials. BMC Geriatr 15:154. https://doi.org/10.1186/s12877-015-0155-4
doi: 10.1186/s12877-015-0155-4
pubmed: 26626157
pmcid: 4667405
Silva RB, Aldoradin-Cabeza H, Eslick GD et al (2017) The effect of physical exercise on frail older persons: a systematic review. J Frailty Aging 6:91–96. https://doi.org/10.14283/jfa.2017.7
Slapak M (2005) Sport and transplantation. Ann Transpl 10:60–67
Neuberger J, Armstrong MJ, Fisher J et al (2019) Sport and exercise in improving outcomes after solid organ transplantation: overview from a UK meeting. Transplantation 103:S1–S11. https://doi.org/10.1097/TP.0000000000002710
doi: 10.1097/TP.0000000000002710
pubmed: 31259878
Yang LS, Shan LL, Saxena A, Morris DL (2014) Liver transplantation: a systematic review of long-term quality of life. Liver Int 34:1298–1313. https://doi.org/10.1111/liv.12553
doi: 10.1111/liv.12553
pubmed: 24703371
Rosenberg DE, Norman GJ, Sallis JF et al (2007) Covariation of adolescent physical activity and dietary behaviors over 12 months. J Adolesc Health 41:472–478. https://doi.org/10.1016/j.jadohealth.2007.05.018
doi: 10.1016/j.jadohealth.2007.05.018
pubmed: 17950167
pmcid: 2121661
Hobbs M, Pearson N, Foster PJ, Biddle SJH (2015) Sedentary behaviour and diet across the lifespan: an updated systematic review. Br J Sports Med 49:1179–1188. https://doi.org/10.1136/bjsports-2014-093754
doi: 10.1136/bjsports-2014-093754
pubmed: 25351783
Compernolle S, De Cocker K, Teixeira PJ et al (2016) The associations between domain-specific sedentary behaviours and dietary habits in European adults: a cross-sectional analysis of the SPOTLIGHT survey. BMC Public Health 16:1057. https://doi.org/10.1186/s12889-016-3708-3
doi: 10.1186/s12889-016-3708-3
pubmed: 27716151
pmcid: 5052975
Mantzorou M, Mentzelou M, Vasios GK et al (2023) Mediterranean diet adherence is associated with favorable health-related quality of life, physical activity, and sleep quality in a community-dwelling greek older population. Antioxidants (Basel) 12:983. https://doi.org/10.3390/antiox12050983
doi: 10.3390/antiox12050983
pubmed: 37237849
U.S. Department of Health and Human Services. 2008 physical activity guidelines for Americans. The Department; 2008
Dunn MA, Rogal SS, Duarte-Rojo A, Lai JC (2020) Physical function, physical activity, and quality of life after liver transplantation. Liver Transpl 26:702–708. https://doi.org/10.1002/lt.25742
doi: 10.1002/lt.25742
pubmed: 32128971
pmcid: 8063858
Hickman IJ, Hannigan AK, Johnston HE et al (2021) Telehealth-delivered, cardioprotective diet and exercise program for liver transplant recipients: a randomized feasibility study. Transplant Direct 7:e667. https://doi.org/10.1097/TXD.0000000000001118
doi: 10.1097/TXD.0000000000001118
pubmed: 33564717
pmcid: 7861655