NASH is often seen together with the components of metabolic syndrome including type II diabetes

(DM). The causal relationship between NASH and DM is currently believed to be bidirectional. The aim of this study was to assess the risk of post-transplant DM in subjects who underwent liver transplantation for NASH. METHODS: All adult (18+) subjects who underwent liver transplantation for NASH or cryp-togenic cirrhosis (the NASH cohort) from the Scientific Registry of Transplant Recipients with annually recorded post-transplant DM selleck chemicals llc were included (2002-2012). Patients with alcoholic cirrhosis (ALD) were used as controls. RESULTS: A total 5,890 NASH subjects and 6,114 ALD controls were included. Patients with NASH were older (57.9±9.5 vs. 54.3±8.7 years), less likely male (56.1% vs. 77.9%), more likely obese (BMI ≥30: 50.5% vs. 31.2%) and had higher rate of pre-transplant diabetes (35.3% vs. 13.7%) (all p<0.0001). They also had slightly lower MELD score: 22.4±8.5 vs. 23.6±8.8 (p<0.0001). Post-transplant, 36.6% of NASH and 29.1% of ALD patients developed DM (p<0.0001). In fact, higher rates of post-transplant diabetes were observed

starting 6 months post-transplant: 25.0% in NASH and 19.0% in ALD (p<0.0001). The risk of developing post-transplant DM in the NASH cohort was also significantly higher in later follow up. In particular, by 3 years post-transplant, the relative risk of having DM in NASH patients as compared to ALD was RR (95% CI) = 1.27 (1.211.35), p<0.0001. By follow-up year 5, RR Target Selective Inhibitor Library cost = 1.26 (1.19-1.33), p<0.0001, and the hazard ratio for the time to development of DM was 1.35 (1.27-1.44), Etomidate p<0.0001. Even after exclusion of those who developed DM potentially due to intense early post-transplant immunosuppression (DM that resolved after the first year), long-term DM remained higher in the NASH cohort: 12.1% vs. 8.2%, RR = 1.47 (1.30-1.66), p<0.0001. In multi- variate analysis, after adjustment for confounders including the use of immunosuppressants, having NASH was independently associated with development of post-transplant

DM: aHR = 1.17 (1.07-1.27), p=0.0003. CONCLUSIONS: Subjects receiving liver transplantation due to NASH are at higher risk of developing post-transplant DM. This suggest the presence of an underlying metabolic disorder beyond fatty liver that may be causative for developing of both NASH and DM. Disclosures: Sammy Saab – Advisory Committees or Review Panels: BMS, Gilead, Merck, Genentech; Grant/Research Support: Merck, Gilead; Speaking and Teaching: BMS, Gilead, Merck, Genentech, Salix, Onyx, Bayer, Janssen; Stock Shareholder: Salix, Johnson and Johnson, BMS, Gilead The following people have nothing to disclose: Zobair Younossi, Maria Ste-panova, Kelly E. Hoyle, Rebecca Cable, Alita Mishra, Stephen C. Clement, Sharon L.