Metabolic Syndrome and Coronary Artery Calcification in Renal Transplant Recipients

Adeseun, Gbemisola A.; Rivera, Maria E.; Thota, Subhashini; Joffe, Marshall M.; Rosas, Sylvia E.

doi:10.1097/tp.0b013e3181826d12

Cited by 26 publications

(11 citation statements)

References 34 publications

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“…In kidney transplant patient populations, the reported prevalence of metabolic syndrome varies widely from as low as 14.9% to as high as 65%, likely reflecting the difference in populations studied (2, 18–20). The presence of MS is associated with the risk of developing NODAT.…”

Section: Discussionmentioning

confidence: 99%

“…Both MS and NODAT are associated with chronic allograft dysfunction, poor graft, and patient survival (2, 6, 19). One recent study found that kidney transplant recipients with MS had significantly higher coronary artery calcification, a risk for coronary artery disease (18). Another group of investigators showed that the presence of MS was associated with an increased risk of cardiovascular events (21).…”

Section: Discussionmentioning

confidence: 99%

“…Metabolic syndrome is present in over 20% of US adults over the age of twenty and predicts the future risk for adverse cardiovascular outcomes (15)(16)(17). In kidney transplant patient populations, the reported prevalence of metabolic syndrome varies widely from as low as 14.9% to as high as 65%, likely reflecting the difference in populations studied (2,(18)(19)(20). The presence of MS is associated with the risk of developing NODAT.…”

Section: Discussionmentioning

confidence: 99%

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Metabolic syndrome and new onset diabetes after transplantation in kidney transplant recipients

Luan

Langewisch

2010

Clinical Transplantation

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Background Metabolic syndrome (MS) and new onset diabetes after transplant (NODAT) are common in kidney transplant patients. We studied the relationship between the two conditions and their impact on metabolic and cardiovascular risk profiles. Methods All non-diabetic patients transplanted between 1999 and 2005 who were followed up to 2006 were included. MS and NODAT were determined. Kaplan–Meier survival and various regression analyses were performed to determine the clinical correlates for both conditions and their association with various cardiovascular risk factors. Results Among 591 patients, 314 (53.1%) had MS and 90 (15.2%) developed NODAT. The two conditions were highly associated with each other as 84 patients with NODAT also had MS (14.2%). Elevated body mass index and fasting glucose levels at transplant were risk factors for both conditions, whereas weight gain after transplant was associated only with MS. African American, old age, and hypertension-related ESRD were risk factors for NODAT. Finally, the presence of MS was associated with reduced kidney function and elevated uric acid levels, whereas the presence of NODAT with elevated pulse pressure. Conclusions MS and NODAT are highly prevalent and significantly associated with impaired metabolic and cardiovascular risk profiles. Early identification of such conditions may facilitate targeted therapeutic intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Metabolic syndrome and new onset diabetes after transplantation in kidney transplant recipients

Luan

Langewisch

2010

Clinical Transplantation

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“…In line, Culver et al [4] showed that a similar percentage (33%) of their lung transplant recipients were overweight or obese. Obesity-related diseases such as type II diabetes, hypertension, and cardiovascular disorders affect post-lung transplantation survival [5,6,7,8,9]. Five years after lung transplantation almost 17% of deaths are accounted for by malignancies and cardiovascular causes [10].…”

Section: Introductionmentioning

confidence: 99%

Determinants of Overweight and Obesity in Lung Transplant Recipients

Bossenbroek¹,

Ouden

Greef

et al. 2011

Respiration

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Background: Obesity-related diseases have been shown to affect post-lung transplantation survival. An estimated 30% of lung transplant recipients develop overweight. Objective: The aim of this study was to examine the possible determinants of large increases in weight after lung transplantation. The contribution of physical activity, food intake, and resting energy expenditure was examined in lung transplant recipients. Methods: In this cross-sectional study 21 overweight lung transplant recipients (11 men, mean age 57 ± 7 years; BMI 30 ± 3) and 21 normal-weight lung transplant recipients (11 men, mean age 56 ± 5 years; BMI 22 ± 3) were matched for disease, gender, age, prescribed medication, and time since lung transplantation. Physical activity was measured by a pedometer and a questionnaire; resting energy expenditure was measured by the ventilated-hood technique, and daily food intake by a dietician. Additionally, fat-free mass, lower-body strength, and fatigue were measured. Results: The overweight lung transplant recipients had a significantly lower number of steps per day (4,686 ± 3,266 vs. 7,524 ± 3,448 steps/day, p = 0.01) and a lower fat-free mass (64 ± 9 vs. 75 ± 6%, p < 0.05) compared to normal-weight recipients. Obese subjects had a lower percentage of predicted resting energy expenditure level compared to normal-weight recipients (90 ± 14 vs. 100 ± 14% predicted, p = 0.04). Conclusion: Our data suggest that overweight in lung transplant recipients is associated with a lower fat-free mass and lower levels of physical activity and resting energy expenditure compared to normal-weight recipients.

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“…The prevalence of MS after kidney transplantation has varied between 20% and 65%, probably reflecting differences in study populations and perhaps in diagnostic criteria . Even though the individual elements of MS, mainly hypertension and obesity, also have a negative effect on kidney transplant outcomes , it is not clear whether the MS is a better predictor of outcomes then its individual components .…”

Section: Introductionmentioning

confidence: 99%

Effects of metabolic syndrome on kidney transplantation outcomes: a systematic review and meta-analysis

et al. 2016

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Metabolic syndrome (MS) has been associated with proteinuria and reduced glomerular filtration rate. Immunosuppressive agents increase the incidence of traditional risk factors for cardiovascular disease (CVD) and have known effects on MS components after kidney transplantation. The purpose of this meta-analysis was to evaluate the impact of MS on relevant outcomes after kidney transplantation. MEDLINE, EMBASE, and Cochrane Library were searched up to November 7, 2015. Papers that compared patients with and without MS and assessed one of the following outcomes, graft loss, death by cardiovascular disease, and all-cause mortality, were included. Of 585 studies identified, five studies including 1269 patients were evaluated. MS was identified as a risk factor for graft loss [relative risk, 3.06; 95% confidence interval (CI), 2.17, 4.32; I² = 0%; P heterogeneity = 0.72] and death by CVD (relative risk, 3.53; 95% CI, 1.27, 9.85; I² = 0%; P heterogeneity = 0.40). Results on the association between MS and all-cause mortality were inconclusive (relative risk, 2.61; 95% CI, 0.70, 9.81; I² = 58%; P heterogeneity = 0.09). Graft loss and death by CVD were associated with the presence of MS after transplantation. Randomized clinical trials should be conducted to define whether interventions on each MS component would result in better outcomes after transplantation.

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Metabolic Syndrome and Coronary Artery Calcification in Renal Transplant Recipients

Cited by 26 publications

References 34 publications

Metabolic syndrome and new onset diabetes after transplantation in kidney transplant recipients

Metabolic syndrome and new onset diabetes after transplantation in kidney transplant recipients

Determinants of Overweight and Obesity in Lung Transplant Recipients

Effects of metabolic syndrome on kidney transplantation outcomes: a systematic review and meta-analysis

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