CHANGES IN ADIPOSE-TISSUE COMPOSITION IN MALNOURISHED PATIENTS BEFOREAND AFTER LIVER-TRANSPLANTATION - A C-13 MAGNETIC-RESONANCE SPECTROSCOPY AND GAS-LIQUID-CHROMATOGRAPHY STUDY

We investigated adipose tissue fatty acid composition in 22 moderately to severely malnourished patients with cirrhosis and in 22 healthy vo lunteers by in vivo carbon-13 magnetic resonance spectroscopy (MRS). G as-liquid chromatography (GLC) of adipose tissue samples was also perf ormed in 11 of the patients and in 4 volunteers. In vivo C-13 magnetic resonance spectra were obtained from the subcutaneous adipose tissue before and after eight weeks following orthotopic liver transplantatio n (OLT). Adipose tissue biopsy samples were obtained for GLC analysis at the time of transplantation in the patients and at inguinal hernia repair in the 4 volunteers. No significant differences were found in t he subcutaneous adipose tissue total-saturated, -polyunsaturated or -m onounsaturated fatty acid composition between patients and healthy vol unteers by in vivo C-13 MRS. GLC analysis of adipose tissue samples co nfirmed that total levels of saturated, poly-, and monounsaturated fat ty acids remained the same but revealed significant differences in lev els of individual fatty acids, particularly n-3 fatty acids (total n-3 , cirrhotics:.84% +/- .07% vs. controls: 1.36% +/- .13%, P <.01). Eigh t weeks following transplantation, recipients showed a considerable in crease in body mass (pretransplantation: 59.3 +/- 3.2 vs, posttranspla ntation: 63.2 +/- 3 kg, P <.01). C-13 MRS revealed a significant incre ase in saturated fatty acids (pretransplantation: 21.6 +/- 2.8 vs, pos ttransplantation: 25.5% +/- 1.2%, P <.05) and a significant decrease i n unsaturated fatty acids. The application of noninvasive MRS techniqu es may be important to identify the differential uptake of fats, exami ning both specific fatty acids and different body fat compartments, In the future, this may be useful in optimizing the dietary management o f severely malnourished patients with chronic liver disease before liv er transplantation.