Post liver transplant metabolic syndrome: Frequency, predictors and outcome

Objective: To determine frequency of post-transplant metabolic syndrome (PTMS) after liver transplantation (LT), its pre-transplant predictors and its association with cardiovascular events. Methods: In this observational, analytical cross-sectional study done at Gastroenterology Department, Shaikh Zayed Post Graduate Medical Institute Lahore from January 2021 to March 2023, pre-transplant data of patients having LT for > 1 year including etiology of liver disease, presence of metabolic syndrome (MS), diabetes mellitus (DM), hypertension (HTN) and obesity were noted. Post-transplant evaluation was done to document DM, HTN, Dyslipidemia, obesity, PTMS and cardiovascular events after LT. Student's t test and chi square were used for correlation and linear regression for multivariate analysis. Results: Total of 111 post LT patients with mean age 45.2 (+/- 10.45) and male to female ratio 6.4/1 (96/15) were included. Before LT, 15(13.5%) patients had DM, 11 (9.9%) had HTN, 48(43.2%) were obese and MS was present in 13 (11.7%) patients. Median duration since LT was three years. Post LT, PTMS developed in 60(54.1%) patients, 64(57.7%) had DM, 27(24.3%) had HTN, dyslipidemia was noted in 60(54.1%) patients and 69(62.2%) were obese. Presence of DM (OR 15.21; p< 0.001), HTN (OR 10.00; p=0.01) and MS (OR 12.50; p=0.003) before transplant was significantly associated with development of PTMS. No significant difference in development of cardiovascular events was noted in patients with and without PTMS. Conclusion: Post transplant metabolic syndrome develops in majority of LT patients, risk is higher in those with diabetes mellitus, hypertension and metabolic syndrome before liver transplantation.