Metabolic syndrome and new onset diabetes after transplantation in kidney transplant recipients

Abstract

Background: Metabolic syndrome (MS) and new onset diabetes after transplant (NODAT) are common in kidney transplant patients. We studied the relationship between the two conditions and their impact on metabolic and cardiovascular risk profiles.

Methods: All non-diabetic patients transplanted between 1999 and 2005 who were followed up to 2006 were included. MS and NODAT were determined. Kaplan-Meier survival and various regression analyses were performed to determine the clinical correlates for both conditions and their association with various cardiovascular risk factors.

Results: Among 591 patients, 314 (53.1%) had MS and 90 (15.2%) developed NODAT. The two conditions were highly associated with each other as 84 patients with NODAT also had MS (14.2%). Elevated body mass index and fasting glucose levels at transplant were risk factors for both conditions, whereas weight gain after transplant was associated only with MS. African American, old age, and hypertension-related ESRD were risk factors for NODAT. Finally, the presence of MS was associated with reduced kidney function and elevated uric acid levels, whereas the presence of NODAT with elevated pulse pressure.

Conclusions: MS and NODAT are highly prevalent and significantly associated with impaired metabolic and cardiovascular risk profiles. Early identification of such conditions may facilitate targeted therapeutic intervention.

© 2009 John Wiley & Sons A/S.

Figures

Fig. 1

Kaplan–Meier new onset diabetes after transplant (NODAT)-free survival between patients with and without metabolic syndrome (MS) (A) and association between MS and NODAT (B).

Fig. 2

Distribution of metabolic syndrome (MS) components between patients with and without new onset diabetes after transplant (NODAT).