title: Effects of prednisone withdrawal on the new metabolic triad in cyclosporine-treated kidney transplant patients.
abstract: BACKGROUND
  Cardiovascular disease is a major cause of morbidity and mortality after renal transplantation. Prednisone (Pred) maintenance therapy is associated with risk factors for atherosclerosis. Therefore, we were interested in quantifying the effects of Pred withdrawal on body weight and waist circumference as well as on metabolic markers of coronary heart disease risk.
  
  
  METHODS
  Twenty-six cyclosporine-treated renal transplant patients (13 men and 13 women) were evaluated before and after at least 11 months (16 +/- 2.9 months) of Pred withdrawal. A complete fasting lipoprotein-lipid profile as well as anthropometric measurements were obtained from each patient.
  
  
  RESULTS
  Pred withdrawal was associated with a 6.0% reduction of body weight (-4.34 +/- 5.40 kg; P < 0.05) and with a 7.7% decrease in waist girth (-7.13 +/- 5.75 cm; P < 0.005) in women, whereas no change in these variables were observed in men. In both genders, plasma low-density lipoprotein (LDL) cholesterol and triglyceride concentrations were unaffected by Pred withdrawal, whereas plasma high-density lipoprotein (HDL) cholesterol levels decreased by 14.0% in women (-0.22 +/- 0.22 mmol/L; P < 0.005) and 22.0% in men (-0.36 +/- 0.28 mmol/L; P < 0.005). Pred withdrawal was associated with a significant reduction in plasma apolipoprotein B concentrations in both women (-0.28 +/- 0.15 g/L; -24.6%; P < 0.0001) and men (-0.22 +/- 0.19 g/L; -20.5%; P < 0.005). A significant reduction in fasting insulin was observed in both women (-27.8 +/- 27.9 pmol/L; -25.3%; P < 0.005) and men (-25.0 +/- 32.8 pmol/L; -21.4%; P < 0.05), whereas the LDL peak particle size was unaffected by Pred withdrawal.
  
  
  CONCLUSIONS
  Pred withdrawal modifies several anthropometric and metabolic cardiovascular risk factors in renal transplant patients. Furthermore, female patients may derive further benefits of Pred withdrawal resulting from the concomitant loss of body weight and abdominal fat.
authors.affiliation: Lipid Reseach Center, CHUL Research Center, Ste-Foy, Québec, Canada.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Lemieux
authors.forename: Isabelle
authors.initials: I
authors.lastname: Houde
authors.forename: Agnès
authors.initials: A
authors.lastname: Pascot
authors.forename: Jean-Guy
authors.initials: JG
authors.lastname: Lachance
authors.forename: Réal
authors.initials: R
authors.lastname: Noël
authors.forename: Thierry
authors.initials: T
authors.lastname: Radeau
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Després
authors.forename: Jean
authors.initials: J
authors.lastname: Bergeron
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001055:Apolipoproteins B / Q000097:blood; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000601:surgery; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D016572:Cyclosporine / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D011241:Prednisone / Q000008:administration & dosage*; D012307:Risk Factors
chemical_list: D000893:Anti-Inflammatory Agents; D001055:Apolipoproteins B; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007166:Immunosuppressive Agents; D007328:Insulin; D016572:Cyclosporine; D011241:Prednisone