title: Metabolic syndrome after a liver transplantation in an Asian population.
abstract: BACKGROUND
  With improvements in patient survival after a liver transplantation (LT), long-term sequelae such as metabolic syndrome (MS) have become increasingly common. This study aims to characterize the prevalence, associations and long-term outcomes of post-LTMS and its components in an Asian population.
  
  
  METHODS
  A retrospective review of all adult patients who underwent LT at the National University Health System Singapore between December 1996 and May 2012 was performed. MS was defined using the Adult Treatment Panel (ATP) III criteria modified for an Asian population.
  
  
  RESULTS
  The median age of this cohort of 90 patients was 50.0 (16.0-67.0) years, with a median follow-up duration of 60.0 (7.0-192.0) months. The prevalence of post-LTMS was 35.6%, diabetes mellitus (DM) 51.1%, hypertension 60.0%, obesity 26.7% and dyslipidaemia 46.7%. On univariate analysis, factors significantly associated with post-LT MS include female gender (P = 0.066), pre-LT respiratory comorbidities (P = 0.038), pre-LT obesity (P = 0.014), pre-LTDM (P < 0.001), pre-LT hypertension (P = 0.039), pre-LTMS (P < 0.001), prednisolone use ≥24 months (P = 0.005) and mycophenolate mofetil use ≥24 months (P = 0.035). On multivariate analysis, independent associations of post-LT MS were pre-LTDM (P = 0.011) and pre-LTMS (P = 0.024). There was no difference in long-term survival of patients with and without post-LTMS (P = 0.425).
  
  
  CONCLUSIONS
  In conclusion, pre-LT components of the MS and the use of certain immunosuppressants are related to developing post-LTMS.
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, University Surgical Cluster, National University Health System Singapore, Singapore, Singapore.
authors.forename: Hwee Leong
authors.initials: HL
authors.lastname: Tan
authors.affiliation: Department of Gastroenterology and Hepatology, National University Health System Singapore, Singapore.
authors.forename: Kieron B L
authors.initials: KB
authors.lastname: Lim
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, University Surgical Cluster, National University Health System Singapore, Singapore, Singapore.
authors.forename: Shridhar Ganpathi
authors.initials: SG
authors.lastname: Iyer
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, University Surgical Cluster, National University Health System Singapore, Singapore, Singapore.
authors.forename: Stephen K Y
authors.initials: SK
authors.lastname: Chang
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, University Surgical Cluster, National University Health System Singapore, Singapore, Singapore.
authors.forename: Krishnakumar
authors.initials: K
authors.lastname: Madhavan
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, University Surgical Cluster, National University Health System Singapore, Singapore, Singapore.
authors.forename: Alfred W C
authors.initials: AW
authors.lastname: Kow
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data*; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D055105:Waist Circumference
chemical_list: D007166:Immunosuppressive Agents