Metabolic Syndrome In Liver Transplant Recipients:prevalence And Risk Factors

Objective: To evaluate the prevalence and risk factors analysis of posttransplantation metabolic syndrome(PTMS)in liver transplant recipients,in order to proved theoretical evidence for clinical prevention and treatment at early stage,and improve the quality of survival in liver transplant recipients and alleviate metabolic complications.Methods: According to joint committee for developing Chinese guidelines on prevention and treatment of dyslipidemia in adults(2007 edition)guidelines suggest that MS diagnostic criteria,retrospective analysis for the clinical follow-up data in 65 transplantation recipients which have lived ?12 months after liver transplant in the affiliated hospital of Qingdao university in February 2014 to May 2015,assess for the presence of PTMS and related symptoms,and it can be divided into MS and non-MS group after transplantation.Single factor analysis was conducted in affecting factors,such as age,gender,history of smoking,history of drinking,waist circumference,body mass index,primary disease,diabetes mellitus,hypertension,hypertriglyceridemia,low level of high density lipoprotein cholestrol,obesity,model for end-stage liver disease scaling,hepatic function Child-Pugh grading,perioperative infection(lung,bacteremia,end of the catheter and biliary tract and so on),and multivariate logistic regression was conducted for the single factors with statistical significance,screening for the independent risk factor for PTMS.Results: Among 65 patients assessed,male and female were 54 and 11 cases respectively,male and female than for(4.9:1).The preoperative and postoperative patients with PTMS in liver transplant were 17 and 27 cases respectively,incidence of PTMS were 26.2% and41.5% respectively,and the difference was statistical significant(P < 0.05).PTMS symptoms before liver transplantation such as diabetes mellitus,hypertension,hypertriglyceridemia,low level of high density lipoprotein cholestrol and obesity,their postoperative patients were 14,14,6,21 and 12 cases respectively,and preoperative incident rates were 21.5%,21.5%,9.2%,32.3% and 18.5% respectively.PTMS symptoms after liver transplantation such as diabetes mellitus,hypertension,hypertriglyceridemia,low level of high density lipoprotein cholestrol and obesity,their postoperative patients were 21,23,16,24 and 18 cases respectively,and postoperative incident rates were32.3%,35.4%,24.6%,36.9% and 27.7% respectively,higher thanpreoperative and had statistical significance(P < 0.05).MS and non-MS group after liver transplantation in single factor analysis: history of smoking,preoperative diabetes and preoperative obesity were more common in MS group,and had statistical significance(P< 0.05).No statistical significance was noticed in history of drinking,preoperative hypertriglyceridemia,preoperative low level of high density lipoprotein,model for end-stage liver disease scaling,hepatic function Child-Pugh grading and primary disease or other affecting factors(P > 0.05).MS and non-MS group after liver transplantation in multivariate logistic regression analysis: preoperative diabetes(P = 0.017,OR = 5.786)and preoperative obesity(P = 0.018,OR = 7.916)and had statistical significance.No statistical significance was noticed in age,history of drinking,preoperative hypertriglyceridemia,preoperative low level of high density lipoprotein,preoperative hypertension,model for end-stage liver disease scaling,hepatic function Child-Pugh grading,perioperative infection(lung,bacteremia,end of the catheter and biliary tract and so on),primary disease or other affecting factors(P > 0.05).Conclusion: PTMS is highly prevalent among liver transplant recipients,significantly higher than the general population in our country.Preoperative diabetes mellitus and preoperative obesity are independent risk factors for PTMS in liver transplant,and the two are factors that can interveve.Age,history of smoking,preoperative hypertriglyceridemia,preoperative low level of high density lipoprotein and preoperative hypertension or other are not independent risk factors for PTMS in liver transplant.