Ruangkanchanasetr Prajej, Bunnag Sakarn, Vongwiwatana Attapong, Premasathian Nalinee, Avihingsanon Yingyos, Gojaseni Pongsathorn, Supaporn Thanom, Satirapoj Bancha
Division of Nephrology, Phramongkutklao Hospital, Bangkok, Thailand.
Division of Nephrology, Rajavithi Hospital, Bangkok, Thailand.
Ann Transplant. 2015 Aug 27;20:500-5. doi: 10.12659/AOT.893664.
BACKGROUND Many renal transplant recipients develop complications such as obesity, posttransplantation diabetes mellitus, and dyslipidemia. There have been few studies of metabolic syndrome (MS) in Asian renal transplant recipients. MATERIAL AND METHODS This cross-sectional study was performed in 303 patients in 5 transplant centers in Bangkok, Thailand. The diagnosis of MS was based on the criteria of the modified NCEP-ATPIII, and chronic allograft dysfunction was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m^2. RESULTS Of 303 recipients, MS was diagnosed in 94 cases (31.0%) and the prevalence of MS in the first 3 years and after 3 years posttransplantation were 21.4% and 34.7% (P=0.042), respectively. There was an association between advanced age and chronic allograft dysfunction and higher prevalence of MS. Regarding non-anti-hypertensive and non-hypoglycemic medications, m-TOR inhibitor (odds ratio [OR], 2.14; 95% CI, 1.02-4.5) was associated with the prevalence of MS. Multivariate analysis revealed MS was associated with the use of beta-blockers (OR, 3.17; 95% CI, 1.88-5.32). Patients with no MS components had 26.9% prevalence of chronic allograft dysfunction and patients with higher numbers of MS components had 87.5% prevalence of chronic allograft dysfunction, which was significantly different (P=0.022). CONCLUSIONS Our study revealed that the prevalence of MS was higher in patients with higher numbers of MS components, especially after 3 years posttransplantation. Presence of more components of MS was associated with worse renal function in renal transplant recipients.
许多肾移植受者会出现肥胖、移植后糖尿病和血脂异常等并发症。针对亚洲肾移植受者的代谢综合征(MS)研究较少。
这项横断面研究在泰国曼谷5个移植中心的303例患者中进行。MS的诊断基于改良的NCEP-ATPIII标准,慢性移植肾失功定义为估算肾小球滤过率(eGFR)<60 mL/min/1.73 m²。
303例受者中,94例(31.0%)被诊断为MS,移植后前3年和3年后MS的患病率分别为21.4%和34.7%(P=0.042)。高龄与慢性移植肾失功以及MS较高的患病率之间存在关联。关于非抗高血压和非降糖药物,m-TOR抑制剂(比值比[OR],2.14;95%可信区间,1.02 - 4.5)与MS的患病率相关。多因素分析显示MS与β受体阻滞剂的使用相关(OR,3.17;95%可信区间,1.88 - 5.32)。无MS组分的患者慢性移植肾失功患病率为26.9%,MS组分较多的患者慢性移植肾失功患病率为87.5%,差异有统计学意义(P=0.022)。
我们的研究表明,MS组分较多的患者中MS患病率较高,尤其是移植后3年。肾移植受者中MS组分越多,肾功能越差。