title: Metabolic syndrome after pediatric liver transplantation.
abstract: Half of adult liver transplantation (LT) recipients develop metabolic syndrome, but the prevalence after childhood LT remains unknown. We conducted a national cross-sectional study of all living patients who had undergone LT between 1987 and 2007 at an age less than 18 years. We gathered information on blood pressure, body composition, serum lipids, glucose metabolism, and histological liver fat content. The diagnostic criteria for metabolic syndrome of the American Heart Association and the International Diabetes Federation were used. After a median post-LT follow-up time of 12 years, half of all patients had no components of metabolic syndrome. The prevalence of overweight/obesity was 20%, and the prevalence of hypertension was 24%. Serum triglycerides were high in 9%, and high-density lipoprotein levels were low in 23%. Fasting glucose levels were impaired in 14%, but none had diabetes. Altogether, 9 patients (14%) had metabolic syndrome. Moderate liver steatosis found in protocol liver biopsy samples was associated with the accumulation of metabolic syndrome features (P = 0.01). No significant associations were found between immunosuppressive medications and metabolic syndrome. In conclusion, the prevalence of metabolic syndrome after childhood LT is similar to the prevalence in the general population of the same age. Guidelines for the general population, therefore, seem valid for the prevention and treatment of metabolic syndrome after pediatric LT as well.
authors.affiliation: Pediatric Surgery and Pediatric Transplantation Surgery, Pediatric Liver and Gut Research Group, Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Finland.
authors.forename: Silja
authors.initials: S
authors.lastname: Kosola
authors.forename: Hanna
authors.initials: H
authors.lastname: Lampela
authors.forename: Heikki
authors.initials: H
authors.lastname: Makisalo
authors.forename: Jouko
authors.initials: J
authors.lastname: Lohi
authors.forename: Johanna
authors.initials: J
authors.lastname: Arola
authors.forename: Hannu
authors.initials: H
authors.lastname: Jalanko
authors.forename: Mikko
authors.initials: M
authors.lastname: Pakarinen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000150:complications*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult