title: High prevalence of the metabolic syndrome and associated left ventricular hypertrophy in pediatric renal transplant recipients.
abstract: The goal of this study was to estimate prevalence of the metabolic syndrome and its association with cardiac abnormalities in children with kidney transplant. A multi-center retrospective review of demographic, clinical, laboratory, and echocardiographic parameters at time of and at one-yr post-transplant was conducted in 234 pediatric recipients between 2000 and 2006. Eighty-eight patients (37.6%) met criteria for metabolic syndrome. Among 55 overweight patients, 40% had metabolic syndrome. Among 51 obese patients, 74.5% had metabolic syndrome. A total of 181 (71.0%) patients had complete data at both time points: prevalence of metabolic syndrome at time of transplant was 18.8%, compared with 37.0% at one-yr post-transplant (p < 0.0001). Among 147 patients without metabolic syndrome at time of transplant, 41 (27.9%) had developed metabolic syndrome by one-yr post-transplant. A total of patients from four centers had routine echocardiogram at one-yr post-transplant. LVH was significantly more common in those with metabolic syndrome (55%) than in those without (32%) (OR 2.6, 95% CI 1.2-5.9).
  
  
  CONCLUSIONS
  metabolic syndrome is common at time of pediatric kidney transplant, and prevalence rises sharply at one-yr post-transplant. The presence of metabolic syndrome is strongly associated with LVH in these patients.
authors.affiliation: Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229-3039, USA.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Wilson
authors.forename: Larry A
authors.initials: LA
authors.lastname: Greenbaum
authors.forename: Gina M
authors.initials: GM
authors.lastname: Barletta
authors.forename: Deepa
authors.initials: D
authors.lastname: Chand
authors.forename: Jen-Jar
authors.initials: JJ
authors.lastname: Lin
authors.forename: Hiren P
authors.initials: HP
authors.lastname: Patel
authors.forename: Mark
authors.initials: M
authors.lastname: Mitsnefes
mesh_terms: D015992:Body Mass Index; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology