Endocrine Abstracts

Background: Metabolic syndrome (MS) is a common condition among liver transplanted patients and it contributes to late morbidity and mortality by favoring the development of cardiovascular disease (CVD).

The aim of this study was to assess the prevalence of MS in the first 6 months after orthotopic liver transplantation (OLT) and the associated pre-operative and post-operative risk factors.

Methods: Seventy-one cirrhotic patients were evaluated at baseline and after OLT. The presence of MS was assessed accordingly to 2004 revised ATP III criteria. Nutritional habits were assessed using 3-day-food records.

Results: The prevalence of MS was 8/71 (11.3%) before OLT, and 23/71 (32.4%) and 21/71 (29.6%) 3 and 6 months after OLT respectively (P=0.006). The factors independently associated with MS were older age (P=0.042), family history of diabetes (P=0.005) and excess body weight at baseline (P=0.025). The analysis of daily food intake after transplantation showed an increase in caloric intake, with redistributions of macronutrients. As compared to subjects without MS, MS patients showed an higher intake of total energy (3 months: 2607±873 vs 2155±595 kcal/die, P=0.03; 6 months: 2132±500 vs 1864±417 kcal/die, P=0.074), saturated fatty acids (3 months: 11±3.6 vs 8.0±2.6%, P=0.007; 6 months: 11.5±3.5 vs 8.8±2.8%, P=0.065) and cholesterol (3 months: 367±170 vs 275±174 mg, P=0.02; 6 months: 276±122 vs 208±83 mg, P=0.04). MS patients showed higher prevalence of graft rejection (45.4 vs 31.7% respectively), infections (41 vs 26.8% respectively) and major cardiovascular events (11.6 vs 6.7% respectively), as compared with non-MS patients, although these differences did not reach statistical significance.

Conclusion: Transplanted patients are at high risk of developing MS. Both pre- and post-operative factors predispose patients to the onset of MS. Control of modifiable risk factors, such as body weight and dietary intake, may reduce the prevalence of MS after liver transplantation.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.