title: Metabolic syndrome and its association with fatty liver disease after orthotopic liver transplantation.
abstract: The metabolic syndrome (MetS) might contribute to morbidity after orthotopic liver transplantation (OLT). For this reason, we searched for MetS-associated risk factors and analyzed the link with nonalcoholic fatty liver disease (NAFLD) in OLT recipients. De novo MetS affected 32.9% of our cohort (n = 170) within 2 years after OLT. Multivariate analysis identified glycosylated hemoglobin (HbA1c) levels ≥5% [odds ratio (OR) = 3.5; 95% confidence interval (CI) = 1.56-8.13, P = 0.003], diabetes mellitus (OR = 4.31, CI = 1.69-10.99, P = 0.002), and arterial hypertension (OR = 4.59, CI = 1.46-14.49, P = 0.009) as independent risk factors for de novo MetS. MetS incidence correlated with steroid dosage after OLT (5.2 ± 2.4 mg/day vs. 7.1 ± 4.7 mg/day, P = 0.014), and was linked to NAFLD (P = 0.001) via obesity (OR = 4.67, CI = 1.55-14.1, P = 0.006) and dyslipidemia (OR = 4.23, CI = 1.35-13.3, P = 0.013) post-OLT. In conclusion, we were able to identify low threshold HbA1c as a novel risk factor for MetS after OLT and described a link of MetS with NAFLD in transplant organs. This study also indicated that steroid treatment is associated with MetS rates after OLT.
authors.affiliation: I. Department of Internal Medicine, Johannes Gutenberg-University, Mainz, Germany.
authors.forename: Martin F
authors.initials: MF
authors.lastname: Sprinzl
authors.forename: Arndt
authors.initials: A
authors.lastname: Weinmann
authors.forename: Nikola
authors.initials: N
authors.lastname: Lohse
authors.forename: Hanna
authors.initials: H
authors.lastname: Tönissen
authors.forename: Sandra
authors.initials: S
authors.lastname: Koch
authors.forename: Jörn
authors.initials: J
authors.lastname: Schattenberg
authors.forename: Maria
authors.initials: M
authors.lastname: Hoppe-Lotichius
authors.forename: Tim
authors.initials: T
authors.lastname: Zimmermann
authors.forename: Peter R
authors.initials: PR
authors.lastname: Galle
authors.forename: Torsten
authors.initials: T
authors.lastname: Hansen
authors.forename: Gerd
authors.initials: G
authors.lastname: Otto
authors.forename: Marcus
authors.initials: M
authors.lastname: Schuchmann
mesh_terms: D000328:Adult; D000368:Aged; D005234:Fatty Liver / Q000209:etiology* / Q000473:pathology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D024821:Metabolic Syndrome / Q000209:etiology*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human