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Overweight,central obesity,and cardiometabolic risk factors in pediatric liver transplantation
Authors:Marc Dagher  Vicky L. Ng  Andrea Carpenter  Stephanie Rankin  Maria De Angelis  Yaron Avitzur  Marialena Mouzaki
Affiliation:1. University of Toronto, Toronto, ON, Canada;2. Department of Pediatrics, SickKids Transplant Centre, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada;3. Clinical Dietetics, Hospital for Sick Children, Toronto, ON, Canada
Abstract:PTMS describes the presence of ≥3 cardiometabolic risk factors that include obesity, hypertension, dyslipidemia, and IR. The prevalence of the clustering of ≥3 cardiometabolic risk factors or central obesity has not been studied in pediatric LT recipients. Single‐center, cross‐sectional study. Inclusion criteria: LT recipients 2–18 yr‐old, at least one yr post‐LT. Exclusion criteria: recipients of liver retransplants or multivisceral transplants. Eighty‐seven patients were identified. Median age was 9.8 yr (range 2–18), median time since LT was 6.9 yr (range 1–17). The most common indication for LT was biliary atresia (56%), and the most frequently used immunosuppressant was tacrolimus (80%). The prevalence of overweight and obesity was 21% and 5%, respectively. Central obesity affected 14%, hypertension 44%, IR 27%, low HDL 20%, and hypertriglyceridemia 39% of patients. The prevalence of ≥3 cardiometabolic risk factors was 19%. Fifty percent of the overweight/obese patients had ≥3 risk factors. Time since transplant, immunosuppression and renal function were not different between those with <3 or ≥3 risk factors. Clustering of cardiometabolic risk factors is prevalent in pediatric LT recipients, suggesting an increased risk of future CV events.
Keywords:metabolic syndrome  waist circumference  liver transplant  children  outcome
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