Incidence and Risk Factors for Diabetes, Hypertension and Hyperlipidemia after Liver Transplantation

Abstract

Introduction and aim: Post-liver transplant recipients present a vast array of metabolic disturbances in the post-transplant period which impact on their morbidity and mortality. Post-transplant diabetes and hypertension were associated with increased risks of graft failure, infection, cardiovascular disease, and death. Therefore, predicting and preventing post-transplant metabolic complications would be a compelling objective for improving care of post-transplant recipients. The aim of this study was to identify the incidence and risk factors of metabolic complications after liver transplantation. Methods: Incidence and risk factors for new onset arterial hypertension, diabetes mellitus and hyperlipidemia were assessed progressively in 100 post- liver transplant recipients at least one year after transplantation (91% male; mean age 52 ± 7.7 y). Risk factors were assessed using logistic regression analysis according to demographic, clinical and laboratory variables. Results: The incidence of hypertension was 38.6%; diabetes, 39.7% and hyperlipidemia, 19% at one year post-liver transplantation (LTX). Independent risk factors for new onset of hypertension were family history of hypertension (OR: 4.85; 95% CI: 3.04-7.74), and cyclosporine use (OR: 6.33; 95%CI: 2.36-16.96). Risk factor for new onset of diabetes were HCV infection (OR: 2.54; 95%CI: 0.84-7.72) and cyclosporine use (12.63; 95%CI: 3.06-52.09). The incidence of hyperlipidemia after LTX was related to the use of cyclosporine (OR: 1.56; 95%CI: 1.04-1.98), or tacrolimus (OR: 1.34; 95%CI: 1.02-1.67). Conclusion: LTX was associated with significantly increased rates of hypertension, diabetes and hyperlipidemia. Furthermore, the incidences of these disorders were related to immunosuppressive therapy.