Prospective evaluation of metabolic syndrome and its components among long-term liver recipients

Background & Aims Survival after liver transplantation (LTx) has increased. Metabolic syndrome (MS) is widely reported in patients in the early years after LTx; few studies have researched this condition in relatively long‐term liver recipients. To describe, prospectively, the prevalence of MS, its components and its associated factors in relatively long‐term liver recipients. Methods A total of 117 patients were evaluated in 2008 (median of 3 years after LTx, range 0–13 years) and in 2012 (median of 7 years after LTx, range 3–17 years) for the presence of MS [using modified NCEP Adult Treatment Panel III and International Diabetes Federation (IDF) criteria]; its components; and its associated factors, including demographic, socioeconomic, lifestyle, clinical, body composition (measured using bioelectric impedance) and dietetic factors. Results MS increased over the years (IDF, 43.1–53.3%, P = 0.12; and NCEP, 34.3–44.8%, P = 0.03). Blood glucose increased over the years (98.8 ± 24.7 to 109.2 ± 33.3 mg/dl, P < 0.01), which resulted in an increased prevalence of glucose intolerance (34.2–48.6%, P < 0.01). Waist circumference (93.3 ± 14.3 to 99.4 ± 14.9 cm, P < 0.01) and body fat (30.3 ± 8.9 to 31.8 ± 10.3%, P = 0.03) also increased. The MS associated factors (P < 0.05) were age [Odds ratio (OR) 1.05, confidence interval (CI) 1.02–1.11], family history of diabetes (OR 3.38, CI 1.19–9.61), body mass index (BMI) prior to liver disease (OR 1.39, CI 1.19–1.63) and body fat (OR 1.09, CI 1.03–1.14). The MS components were associated (P < 0.05) with greater age, family history of diabetes, current and previous BMI, body fat, current corticosteroid use, lack of exercise and greater carbohydrate and fat intakes. Conclusion MS prevalence increased over the years after LTx because of the increases in waist circumference and blood glucose. MS and its components are associated with modifiable factors, such as greater BMI, body fat and carbohydrate and fat intake.