Metabolic Syndrome Common After Renal Transplantation

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PHILADELPHIA—Metabolic syndrome (MS) is present in 35%-40% of renal transplant recipients in the first five years post-transplant, new findings suggest.

Their analysis of data on 2,253 patients from the Patient Outcomes in Renal Transplantation international data collaboration showed that the prevalence varied little over time. It was 39.1% at 6-12 months post-transplant, 39.8% at 12-24 months, 35.7% at 24-36 months, 35.4% at 38-48 months, and 36.7% at 48-60 months, according to a poster presentation at the 2011 American Transplant Congress.

The most common MS-defining risk factors were hypertension and elevated triglycerides and glucose levels, researchers Bertram L. Kasiske, MD, and colleagues at the Chronic Disease Research Group in Minneapolis reported. Low HDL was the least common risk factor.

Independent baseline predictors for MS at 6-12 months were recipient age, baseline body mass index (BMI), pretransplant time on dialysis, and history of revascularization.

Additionally, the study demonstrated that the overall incidence of new-onset diabetes after transplantation (NODAT) from 12-60 months post-transplant was 13%. MS in the 6-12 month interval was significantly associated with an increased risk of NODAT. The incidence was 23% among recipients with MS in the 6-12 month interval versus 7% in those without MS in that interval.

Dr. Kasiske's group considered patients to have MS if they had at least three of the following factors: body mass index greater than 30 kg/m2, triglyceride levels of 150 mg/dL or higher, high-density lipoprotein levels below 40 mg/dL (for men) or below 50 mg/dL (for women), blood pressure of 130/85 or higher or treatment for antihypertension, and fasting glucose above 100 mg/dL or treatment for diabetes.

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