Background: De novo metabolic syndrome (MS) is a frequent complication after liver transplantation (LT). The aim of this prospective study is to identify potential risk factors longitudinally associated to post-LT de novo MS. Patients without pre-LT MS who underwent LT between April 2013 and October 2017 were prospectively included. Metabolic variables were collected at LT and at 6, 12, and 24 months post-LT. Results: Sixty-three patients fulfilled the inclusion criteria (76% male, mean age 53.6±9.5 years). The prevalence of de novo MS was 46%, 43%, and 49% at 6, 12, and 24 months after LT, respectively. Among other MS components, the prevalence of type 2 diabetes, hypertension and hypertriglyceridemia significantly increased after LT. Considering the baseline characteristics at the adjusted analysis, alcoholic liver disease (OR 4.17, 95%CI 1.20-14.51; p =.03) and hypertension pre-LT (OR 11.3, 95% CI 1.49-85.46; p =.02) were confirmed as independent risk factors of post-LT de novo MS. In the time-varying analysis, only eGFR (OR.97, 95% CI.97-.98; p <.0001) was found associated with post-LT de novo MS. Conclusions: De novo MS frequently occurs shortly after LT, affecting nearly half of patients at 24 months post-LT. Lifestyle modifications should be recommended starting early post-LT, particularly for patients with established risk factors.
A prospective longitudinal assessment of de novo metabolic syndrome after liver transplantation
Becchetti C.;Ferrarese A.;Zeni N.;Russo F. P.;Senzolo M.;Gambato M.;Bassi D.;Cillo U.;Burra P.
;Germani G.
2022
Abstract
Background: De novo metabolic syndrome (MS) is a frequent complication after liver transplantation (LT). The aim of this prospective study is to identify potential risk factors longitudinally associated to post-LT de novo MS. Patients without pre-LT MS who underwent LT between April 2013 and October 2017 were prospectively included. Metabolic variables were collected at LT and at 6, 12, and 24 months post-LT. Results: Sixty-three patients fulfilled the inclusion criteria (76% male, mean age 53.6±9.5 years). The prevalence of de novo MS was 46%, 43%, and 49% at 6, 12, and 24 months after LT, respectively. Among other MS components, the prevalence of type 2 diabetes, hypertension and hypertriglyceridemia significantly increased after LT. Considering the baseline characteristics at the adjusted analysis, alcoholic liver disease (OR 4.17, 95%CI 1.20-14.51; p =.03) and hypertension pre-LT (OR 11.3, 95% CI 1.49-85.46; p =.02) were confirmed as independent risk factors of post-LT de novo MS. In the time-varying analysis, only eGFR (OR.97, 95% CI.97-.98; p <.0001) was found associated with post-LT de novo MS. Conclusions: De novo MS frequently occurs shortly after LT, affecting nearly half of patients at 24 months post-LT. Lifestyle modifications should be recommended starting early post-LT, particularly for patients with established risk factors.
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