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Title: Prevalence of Metabolic Syndrome in Renal Transplant Patients: Comparison of Two Diagnostic Criteria
Citation: AMERICAN JOURNAL OF TRANSPLANTATION, v.13, suppl.5, Special Issue, p.469-469, 2013
Abstract: Metabolic syndrome (MS) is now recognized as a risk factor for cardiovascular disease (CV), the leading cause of death with a functioning graft in renal transplantation. We invited 243 patients to conduct a cross-sectional study to compare the assessment of all risk factors for MS according to the National Cholesterol Education Program (NCEP ATP-III) and International Diabetes Federation (IDF) criteria. Sixty patients were excluded due to lack of agreement, BMI 40kg/m2 or GFR 20ml/min. Our study population consisted of 183 patients, predominantly male (54%), whites (63%) with a mean age of 11 years and 49 to 57 transplanted 32 months. The mean creatinine was 1.36 ± 0.59 mg / dL, and only 22 (12%) patients had SCr 2mg/dL. All patients were on steroids and 169 in use of calcineurin inhibitors (CNI). Fifty-eight patients (32%) were diabetic. All risk factors for the MS, hypertension was observed in 169 (92%), hypertriglyceridemia in 86 (47%), low HDL in 51 (28%), hyperglycemia, in 58 (32%) patients. Waist circumference great in 88 (48%) to the NCEP-ATP III criteria, and 132 (72%) to IDF criteria (p <0.05). Metabolic Syndrome (3 risk factors) was observed in 81 (44%) patients to NCEP-ATP III criteria and 71 (39%) for IDF (p= NS). Most patients 39/81 (48%) had three risk factors for NCEP ATP III. At IDF, 36/77 (47%) had three risk factors. There was a predominance of young patients (age <50 years) with good renal function (creatinine <2.0mg/dL) among patients with MS, regardless of the criteria used diagnoses, compared to patients without the disease to age (<50 years: MS 62% vs no MS 38% p <0.0001, creatinine <2.0mg/dL: MS 47% vs. no MS 53%, p = 0.03). Analyzing all 183 patients, there was a significant correlation between large waist circumference (WC) and metabolic changes: WC (uric acid vs: p = 0.003, r = 0.22, r2 = 0.046), WC vs SCR: p = 0.001, r-0, 49, WC vs glucose (p <0.0001, r = 0.31), WC vs triglycerides (p <0.0001, r = 0.33), WC vs. age (p <0.0001, r = 0.35), HOMA-R vs WC (p <0.0001, r = 0 51). In our renal transplant population, MS occurs predominantly in young patients. Among all risk factors for characterizing the metabolic syndrome, waist circumference, appears as an important variable associated with other metabolic disorders and should be a target in the post-transplant management, and the criteria used by IDF considers most suitable for the waist measurement factor for classification of metabolic syndrome.
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Comunicações em Eventos - FM/MCG
Departamento de Cirurgia - FM/MCG

Comunicações em Eventos - HC/ICHC
Instituto Central - HC/ICHC

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