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肝移植受者的体力活动与代谢综合征。

Physical activity and metabolic syndrome in liver transplant recipients.

机构信息

Division of Hepatology, Loyola University Medical Center, Maywood, IL.

出版信息

Liver Transpl. 2013 Oct;19(10):1125-31. doi: 10.1002/lt.23710. Epub 2013 Aug 15.

Abstract

There is a high prevalence of metabolic syndrome in liver transplant recipients, a population that tends to be physically inactive. The aim of this study was to characterize physical activity and evaluate the relationship between physical activity and metabolic syndrome after liver transplantation. A cross-sectional analysis was performed in patients more than 3 months after transplantation. Metabolic syndrome was classified according to National Cholesterol Education Panel Adult Treatment Panel III guidelines. Physical activity, including duration, frequency, and metabolic equivalents of task (METs), was assessed. The study population consisted of 204 subjects, with 156 more than 1 year after transplantation. The median time after transplantation was 53.5 months (range = 3-299 months). The mean duration of exercise was 90 ± 142 minutes, and the mean MET score was 3.6 ± 1.5. Metabolic syndrome was observed in 58.8% of all subjects and in 63.5% of the subjects more than 1 year after transplantation. In a multivariate analysis involving all subjects, metabolic syndrome was associated with a time after transplantation greater than 1 year [odds ratio (OR) = 2.909, 95% confidence interval (CI) = 1.389-6.092] and older age (OR = 1.036, 95% CI = 1.001-1.072). A second analysis was performed for only patients more than 1 year after transplantation. In a multivariate analysis, metabolic syndrome was associated with lower exercise intensity (OR = 0.690, 95% CI = 0.536-0.887), older age (OR = 1.056, 95% CI = 1.014-1.101), and pretransplant diabetes (OR = 4.246, 95% CI = 1.300-13.864). In conclusion, metabolic syndrome is common after liver transplantation, and the rate is significantly higher in patients more than 1 year after transplantation. The observation that exercise intensity is inversely related to metabolic syndrome after transplantation is novel and suggests that physical activity might provide a means for reducing metabolic syndrome complications in liver transplant recipients.

摘要

肝移植受者代谢综合征的患病率很高,而这类人群往往身体活动不足。本研究的目的是描述肝移植受者的身体活动情况,并评估其与代谢综合征之间的关系。对移植后 3 个月以上的患者进行了横断面分析。根据国家胆固醇教育计划成人治疗小组 III 指南对代谢综合征进行分类。评估身体活动,包括持续时间、频率和代谢当量(MET)。研究人群包括 204 名患者,其中 156 名患者在移植后 1 年以上。移植后中位时间为 53.5 个月(范围=3-299 个月)。运动的平均持续时间为 90±142 分钟,平均 MET 评分为 3.6±1.5。所有患者中代谢综合征的发生率为 58.8%,在移植后 1 年以上的患者中为 63.5%。在对所有患者进行的多变量分析中,代谢综合征与移植后 1 年以上的时间有关(比值比[OR] = 2.909,95%置信区间[CI] = 1.389-6.092)和年龄较大(OR = 1.036,95%CI = 1.001-1.072)。对仅在移植后 1 年以上的患者进行了第二次分析。在多变量分析中,代谢综合征与较低的运动强度(OR=0.690,95%CI=0.536-0.887)、年龄较大(OR=1.056,95%CI=1.014-1.101)和移植前糖尿病(OR=4.246,95%CI=1.300-13.864)有关。总之,肝移植后代谢综合征很常见,在移植后 1 年以上的患者中发生率显著更高。运动强度与移植后代谢综合征呈负相关的观察结果是新颖的,这表明身体活动可能为降低肝移植受者代谢综合征并发症提供一种手段。

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