Ethnicity predicts metabolic syndrome after liver transplant

Abstract

Purpose: Post-transplant metabolic syndrome (PTMS) is associated with important causes of morbidity and mortality in solid organ transplant recipients. Our aim was to investigate predictors of PTMS in liver transplant (LT) recipients.

Methods: We randomly selected 343 adults (>18 years of age) from a large cohort of 1,262 ethnically diverse patients who received LTs during 2000-2010.

Results: Of 343 patients included, 68.2 % were male, with a mean age of 54 ± 10 years, 87 % White, and 31 % Hispanic. Prior to LTs, 6.2 % were on lipid-lowering agents and 24.5 % had BMI ≥ 30 (mean 26.9 ± 5 kg/m(2)). More Hispanics had diabetes before LTs compared to non-Hispanics (p = 0.037). Among those with follow-up of >6 months (n = 304) after LTs, the proportion of patients with diabetes and hypertension increased from 21.9 to 27 % (p < 0.0001), and from 11.5 to 51.6 % (p < 0.0001), respectively. Cholesterol levels increased from 150 ± 115 to 167 ± 70 (p < 0.0001). BMI remained unchanged. PTMS developed in 41 (13.5 %) and cardiovascular events in 31 (10.2 %) patients. Hispanics had higher risk of developing PTMS compared to non-Hispanics (OR 2.30, 95 % CI 1.18-4.49). Survival was not affected by PTMS (p = 0.3), ethnicity (p = 0.52), or nonalcoholic steatohepatitis as the etiology of liver disease (p = 0.50).

Conclusions: More Hispanics had diabetes before LTs (29 to 18 %, p < 0.05) and were more prone to developing PTMS after LTs compared to non-Hispanics.

Keywords: Ethnicity; Liver transplant; Metabolic syndrome.