title: Progression of metabolic syndrome in renal transplant recipients.
abstract: BACKGROUND
  Metabolic syndrome, which is closely related to insulin resistance, is highly prevalent in renal transplant recipients.
  
  
  OBJECTIVE
  We aimed to investigate prevalence, risk factors, and progression of metabolic syndrome in renal transplant recipients.
  
  
  METHODS
  One hundred fifty-eight renal transplant recipients who had been on transplantation for more than 1 year and 79 age-sex matched healthy controls were included in the cross-sectional phase of the study. We measured baseline characteristics, blood pressure, fasting blood glucose, and lipid profiles and we defined metabolic syndrome using the National Cholesterol Education Program Adult Treatment Panel III criteria. One hundred twenty-four renal transplant recipients were eligible for the second evaluation after 22.9 ± 3.8 months. Metabolic syndrome prevalence and homeostasis model assessment insulin resistance levels were evaluated during the follow-up period.
  
  
  RESULTS
  Overall, metabolic syndrome was present in 34.2% of the patients and 12.7% of the controls at the cross-sectional phase of the study (P = .000). Only the hypertension component of metabolic syndrome was significantly increased in patients compared to controls (P = .000). Pretransplantation weight and body mass index were significantly higher in patients who had metabolic syndrome (P = .000). During the follow-up period, prevalence of metabolic syndrome did not change (P = .510); however, body mass index and blood pressure increased and the high density lipoprotein cholesterol component of metabolic syndrome decreased (P = .001). We did not find any significant difference in glomerular filtration rate change among patients with and without metabolic syndrome (-2.2 ± 11.36 vs -6.14 ± 13.19; P = .091). Glucose metabolism parameters including hemoglobin A1c, insulin, and homeostasis model assessment insulin resistance were disturbed in patients with metabolic syndrome (P = .000, P = .001, P = .002, respectively).
  
  
  CONCLUSIONS
  Metabolic syndrome is highly prevalent in renal transplant recipients and closely associated with insulin resistance. The prominent criterion of metabolic syndrome in patients seems to be hypertension, especially high systolic blood pressure. The identification of metabolic syndrome as a risk factor may yield new treatment modalities to prevent it.
authors.affiliation: Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Oruc
authors.forename: K
authors.initials: K
authors.lastname: Koseoglu
authors.forename: N
authors.initials: N
authors.lastname: Seyahi
authors.forename: S
authors.initials: S
authors.lastname: Alagoz
authors.forename: S
authors.initials: S
authors.lastname: Trabulus
authors.forename: M R
authors.initials: MR
authors.lastname: Altiparmak
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D016022:Case-Control Studies; D018450:Disease Progression; D006442:Glycated Hemoglobin / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D016030:Kidney Transplantation; D008055:Lipids / Q000097:blood; D024821:Metabolic Syndrome / Q000473:pathology*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids; C517652:hemoglobin A1c protein, human