Naganuma Toshihide, Iwai Tomoaki, Kabata Daijiro, Machida Yuichi, Takemoto Yoshiaki, Uchida Junji
Department of Urology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8586, Japan.
Center for Mathematical and Data Sciences, Kobe University, Kobe 657-8501, Japan.
J Clin Med. 2025 Jul 27;14(15):5303. doi: 10.3390/jcm14155303.
Several epidemiological studies have indicated that metabolic syndrome (MetS) after renal transplantation is caused by an accumulation of non-immunological risks of renal transplantation, and affects the prognosis of the kidney and the patient by increasing the risk of arteriosclerosis and cardiovascular complications. The incidence of MetS in Japanese renal transplant recipients is 14.9 to 23.8%, but its effects on cardiovascular events and kidney prognosis are not clear. Here, we report the results of a longitudinal study on MetS in renal transplant recipients. A retrospective cohort study was conducted in 104 stable renal transplant recipients who attended our outpatient department from January 2006 to June 2007 and were diagnosed with MetS at least 6 months after renal transplantation until 31 December 2020, or did not have MetS. The impact of MetS on composite vascular events was examined using multivariate Cox proportional hazards analysis. The hazard ratios for the impact of MetS on composite vascular events diagnosed by NCEP Japan, NCEP Original, NCEP Asia, and IDF criteria on composite vascular events were 2.78 (95% CI: 1.15 to 6.75, = 0.024), 2.65 (95% CI: 1.04 to 6.80, = 0.042), 2.37 (95% CI: 0.93 to 6.01, = 0.070), and 1.91 (95% CI: 0.77 to 4.75, = 0.164), respectively. P for interaction was used to test the influence of each indicator, but was not statistically significant. MetS is a robust risk factor for graft loss and development of cardiovascular events in Japanese renal transplant recipients, even during long-term follow-up. This finding emphasizes the importance of monitoring and managing MetS in this population to improve long-term outcomes.
多项流行病学研究表明,肾移植后的代谢综合征(MetS)是由肾移植非免疫风险的累积所致,并通过增加动脉硬化和心血管并发症的风险影响肾脏及患者的预后。日本肾移植受者中MetS的发生率为14.9%至23.8%,但其对心血管事件和肾脏预后的影响尚不清楚。在此,我们报告一项关于肾移植受者MetS的纵向研究结果。对2006年1月至2007年6月在我院门诊就诊、肾移植后至少6个月被诊断为MetS直至2020年12月31日的104例稳定肾移植受者,或未患MetS的受者进行了一项回顾性队列研究。使用多变量Cox比例风险分析来检验MetS对复合血管事件的影响。MetS对根据日本国家胆固醇教育计划(NCEP)日本版、NCEP原版、NCEP亚洲版和国际糖尿病联盟(IDF)标准诊断的复合血管事件的影响的风险比分别为2.78(95%置信区间:1.15至6.75,P = 0.024)、2.65(95%置信区间:1.04至6.80,P = 0.042)、2.37(95%置信区间:0.93至6.01,P = 0.070)和1.91(95%置信区间:0.77至4.75,P = 0.164)。交互作用的P值用于检验各指标的影响,但无统计学意义。即使在长期随访中,MetS仍是日本肾移植受者移植物丢失和发生心血管事件的有力危险因素。这一发现强调了在该人群中监测和管理MetS以改善长期预后的重要性。
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