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Metabolic syndrome found in more than half of patients after liver transplantation
Iaish I. Liver Transpl. 2010;doi:10.1002/lt.22198.
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Post-transplantation metabolic syndrome occurs in more than half of liver transplant recipients, placing them at higher risk for cardiovascular disease, according to researchers.
For a retrospective prevalence study, researchers at the Liver Transplant Unit at Rabin Medical Center in Israel reviewed data for 252 patients (mean age 54.5 years) who had liver transplants between 1985 and 2007. Incidence of post-transplant metabolic syndrome (PTMS) was determined by the presence of at least three of the following: BMI of 30 or greater or waist circumference greater than 102 cm for men, 88 cm for women; fasting plasma glucose of 130/85 mm Hg or greater; triglycerides of 150 mg/mL or greater (1.7 mmol/L); and HDL levels less than 40 mg/dL (1 mmol/L) in men and less than 50 mg/dL (1.3 mmol/L) in women. Coronary events were identified by coronary angiography or vascularization.
Significant independent predictors of metabolic derangement after transplantation were age (OR=1.04), the existence of pre-transplant, non-alcoholic fatty liver disease (OR=3.4), BMI (OR=1.13), diabetes (OR=5.95) and triglycerides (OR=1.01).
Metabolic derangements were found in 5.4% patients before transplantation and 51.9% after transplantation (P<.0001). Patients with PTMS were older and heavier than patients without PTMS and had a higher rate of hepatitis C virus infection before transplant (P<.03). Patients with PTMS were nearly four times more likely to experience major vascular and CV events after transplantation than patients without the syndrome (20 events in 15.2% vs. 6 events in 4.9%; P<.007).
“The prevalence of metabolic syndrome is significantly higher in patients after liver transplantation than the estimated value in the general population. Metabolic syndrome is associated with CV morbidity but not mortality. Pre-transplantation conditions may predict PTMS. Prospective studies are required to identity the significance of metabolic syndrome in liver transplant recipients, and to establish optimal management,” the researchers wrote.
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