Couto Claudia A, Gelape Claudio L, Doycheva Iliana B, Kish Jonathan K, Martin Paul, Levy Cynthia
Department of Internal Medicine, School of Medicine and Alfa Gastroenterology Institute, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Department of Surgery, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Hepatol Int. 2013 Jun;7(2):741-8. doi: 10.1007/s12072-012-9416-x. Epub 2012 Dec 27.
Post-transplant metabolic syndrome (PTMS) is associated with important causes of morbidity and mortality in solid organ transplant recipients. Our aim was to investigate predictors of PTMS in liver transplant (LT) recipients.
We randomly selected 343 adults (>18 years of age) from a large cohort of 1,262 ethnically diverse patients who received LTs during 2000-2010.
Of 343 patients included, 68.2 % were male, with a mean age of 54 ± 10 years, 87 % White, and 31 % Hispanic. Prior to LTs, 6.2 % were on lipid-lowering agents and 24.5 % had BMI ≥ 30 (mean 26.9 ± 5 kg/m(2)). More Hispanics had diabetes before LTs compared to non-Hispanics (p = 0.037). Among those with follow-up of >6 months (n = 304) after LTs, the proportion of patients with diabetes and hypertension increased from 21.9 to 27 % (p < 0.0001), and from 11.5 to 51.6 % (p < 0.0001), respectively. Cholesterol levels increased from 150 ± 115 to 167 ± 70 (p < 0.0001). BMI remained unchanged. PTMS developed in 41 (13.5 %) and cardiovascular events in 31 (10.2 %) patients. Hispanics had higher risk of developing PTMS compared to non-Hispanics (OR 2.30, 95 % CI 1.18-4.49). Survival was not affected by PTMS (p = 0.3), ethnicity (p = 0.52), or nonalcoholic steatohepatitis as the etiology of liver disease (p = 0.50).
More Hispanics had diabetes before LTs (29 to 18 %, p < 0.05) and were more prone to developing PTMS after LTs compared to non-Hispanics.
移植后代谢综合征（PTMS）与实体器官移植受者发病和死亡的重要原因相关。我们的目的是研究肝移植（LT）受者中PTMS的预测因素。
我们从2000年至2010年期间接受肝移植的1262名种族多样的患者的大型队列中随机选取了343名成年人（年龄>18岁）。
纳入的343名患者中，68.2%为男性，平均年龄54±10岁，87%为白人，31%为西班牙裔。肝移植前，6.2%的患者服用降脂药物，24.5%的患者BMI≥30（平均26.9±5kg/m²）。与非西班牙裔相比，更多西班牙裔在肝移植前患有糖尿病（p = 0.037）。在肝移植后随访>6个月的患者（n = 304）中，糖尿病患者和高血压患者的比例分别从21.9%增至27%（p < 0.0001），以及从11.5%增至51.6%（p < 0.0001）。胆固醇水平从150±115增至167±70（p < 0.0001）。BMI保持不变。41名（13.5%）患者发生了PTMS，31名（10.2%）患者发生了心血管事件。与非西班牙裔相比，西班牙裔发生PTMS的风险更高（OR 2.30，95%CI 1.18 - 4.49）。PTMS（p = 0.3）、种族（p = （此处原文有误，按照逻辑应为0.52））或非酒精性脂肪性肝炎作为肝病病因（p = 0.50）均不影响生存率。
与非西班牙裔相比，更多西班牙裔在肝移植前患有糖尿病（29%对18%，p < 0.05），且肝移植后更易发生PTMS。
