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肝移植术后患者的心血管危险因素。

Cardiovascular Risk Factors in Patients Before and After Successful Liver Transplantation.

机构信息

Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland.

出版信息

Ann Transplant. 2022 Oct 18;27:e935656. doi: 10.12659/AOT.935656.

Abstract

BACKGROUND Liver transplantation (LTx) is useful in the treatment of end-stage liver disease. Outcomes of transplantation are dependent upon graft survival and can also be affected by superimposed cardiovascular morbidities. The present retrospective study was performed to assess the prevalence of cardiovascular risk factors before and after LTx. MATERIAL AND METHODS A retrospective review of 130 patients undergoing liver transplantation between October 2005 and April 2014 was completed. The mean age of the patients was 49.3±11.9 years. The prevalence of cardiovascular risk factors was assessed before and 2 years after transplantation. The prevalence of cardiovascular risk factors was assessed using a comparison based upon the etiologies of liver disease resulting in transplantation including alcohol, viral, and autoimmune processes using a chi-square analysis. RESULTS The prevalence of diabetes mellitus before and 2 years after liver transplantation (LTx) were 18% and 48% (P<0.001). Hypertension was documented in 24% of patients at baseline and 70% after 2 years of follow-up (P<0.001). The prevalence rates of diabetes mellitus before and 2 years after LTx were 18% and 48% (P<0.001). The prevalence of hypertriglyceridemia before and after LTx was 15% and 38%, respectively (P<0.001). Hypercholesterolemia was noted in 16% and 46%, respectively (P<0.001). Thirteen percent of patients before LTx and 18% after were obese (body mass index higher than 30 kg/m²). The annual incidence of diabetes mellitus, hypertension, hypertriglyceridemia, hypercholesterolemia, and obesity during the first 2 years after LTx was 15%, 23.5%, 15%, 18.5%, and 6%, respectively. Twenty-four percent of patients before and 10% after LTx admitted to tobacco use (P<0.001). The prevalence of diabetes (38% vs 67%, P=0.02), hypertriglyceridemia (19% vs 63%, P<0.001), hypercholesterolemia (28% vs 67%, P=0.002), and obesity (9% vs 33%, P=0.02) was lower in patients with an autoimmune cause of liver cirrhosis in comparison to patients with alcoholic disease. CONCLUSIONS The prevalence of hypertension and glucose and lipid metabolism abnormalities may increase in patients after liver transplantation. The prevalence of cardiovascular risk factors in patients after LTx may be related to the cause of liver injury before LTx.

摘要

背景

肝移植(LTx)在治疗终末期肝病方面非常有用。移植的结果取决于移植物的存活,也可能受到叠加的心血管疾病的影响。本回顾性研究旨在评估 LTx 前后心血管危险因素的患病率。

材料和方法

对 2005 年 10 月至 2014 年 4 月期间进行的 130 例肝移植患者进行回顾性分析。患者的平均年龄为 49.3±11.9 岁。评估了 LTx 前后的心血管危险因素患病率。使用卡方分析,根据导致肝移植的肝病病因(酒精、病毒和自身免疫过程)来评估心血管危险因素的患病率。

结果

LTx 前后糖尿病的患病率分别为 18%和 48%(P<0.001)。基线时有 24%的患者存在高血压,2 年后有 70%(P<0.001)。LTx 前后糖尿病的患病率分别为 18%和 48%(P<0.001)。LTx 前后高甘油三酯血症的患病率分别为 15%和 38%(P<0.001)。高胆固醇血症分别为 16%和 46%(P<0.001)。13%的患者在 LTx 前肥胖(体重指数高于 30 kg/m²),而 18%的患者在 LTx 后肥胖。LTx 后第一年的糖尿病、高血压、高甘油三酯血症、高胆固醇血症和肥胖的年发病率分别为 15%、23.5%、15%、18.5%和 6%。LTx 前有 24%的患者和 LTx 后有 10%的患者承认吸烟(P<0.001)。与酒精性肝病患者相比,自身免疫性肝硬化患者的糖尿病(38%比 67%,P=0.02)、高甘油三酯血症(19%比 63%,P<0.001)、高胆固醇血症(28%比 67%,P=0.002)和肥胖(9%比 33%,P=0.02)的患病率较低。

结论

肝移植后,高血压和糖脂代谢异常的患病率可能会增加。LTx 后患者的心血管危险因素的患病率可能与 LTx 前肝损伤的原因有关。

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