Clinical diagnosis of metabolic syndrome: predicting new-onset diabetes, coronary heart disease, and allograft failure late after kidney transplant
Summary Metabolic syndrome is associated with coronary heart disease (CHD) and new‐onset diabetes after kidney transplant (NODAT). Using data collected from transplant centers worldwide for the Patient Outcomes in Renal Transplantation study, we examined associations of metabolic syndrome (n = 2253...
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| Veröffentlicht in: | Transplant international 2012-07, Vol.25 (7), p.748-757 |
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| creator | Israni, Ajay K. Snyder, Jon J. Skeans, Melissa A. Kasiske, Bertram L. |
| description | Summary
Metabolic syndrome is associated with coronary heart disease (CHD) and new‐onset diabetes after kidney transplant (NODAT). Using data collected from transplant centers worldwide for the Patient Outcomes in Renal Transplantation study, we examined associations of metabolic syndrome (n = 2253 excluding recipients with diabetes pretransplant), CHD (n = 2253), and NODAT (n = 1840 further excluding recipients with diabetes in the first year post‐transplant), with the primary outcome of allograft failure. We assessed risk factors associated with secondary outcomes of metabolic syndrome, NODAT, and CHD after adjusting for type of baseline immunosuppression and transplant center effects. Metabolic syndrome prevalence was 39.8% at 12–24 months post‐transplant and 35.4% at 36–48 months. Metabolic syndrome was independently associated with NODAT (hazard ratio 3.46, 95% confidence interval 2.40–4.98, P |
| doi_str_mv | 10.1111/j.1432-2277.2012.01488.x |
| format | Article |
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Metabolic syndrome is associated with coronary heart disease (CHD) and new‐onset diabetes after kidney transplant (NODAT). Using data collected from transplant centers worldwide for the Patient Outcomes in Renal Transplantation study, we examined associations of metabolic syndrome (n = 2253 excluding recipients with diabetes pretransplant), CHD (n = 2253), and NODAT (n = 1840 further excluding recipients with diabetes in the first year post‐transplant), with the primary outcome of allograft failure. We assessed risk factors associated with secondary outcomes of metabolic syndrome, NODAT, and CHD after adjusting for type of baseline immunosuppression and transplant center effects. Metabolic syndrome prevalence was 39.8% at 12–24 months post‐transplant and 35.4% at 36–48 months. Metabolic syndrome was independently associated with NODAT (hazard ratio 3.46, 95% confidence interval 2.40–4.98, P < 0.0001), CHD (2.03, 1.16–3.52, P = 0.013), and allograft failure (1.36, 1.03–1.79, P = 0.028). Allograft failure occurred in 218 patients (14.6%). After adjustment for metabolic syndrome, NODAT (1.63, 1.18–2.24, P = 0.003) and CHD (5.48, 3.27–9.20, P < 0.0001) remained strongly associated with increased risk of allograft failure. Metabolic syndrome, NODAT, and CHD are risk factors for allograft failure. NODAT and CHD are risk factors for allograft failure, independent of metabolic syndrome.</description><identifier>ISSN: 0934-0874</identifier><identifier>EISSN: 1432-2277</identifier><identifier>DOI: 10.1111/j.1432-2277.2012.01488.x</identifier><identifier>PMID: 22548293</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Allograft failure ; Cardiovascular disease ; Cholesterol ; Coronary Disease - diagnosis ; coronary heart disease ; Diabetes Mellitus - diagnosis ; Female ; Humans ; Immunosuppressive Agents - therapeutic use ; Insulin ; Kidney Transplantation - adverse effects ; Male ; Metabolic syndrome ; Metabolic Syndrome - diagnosis ; Metabolic Syndrome - etiology ; Middle Aged ; new-onset diabetes after kidney transplant ; Prevalence ; Proportional Hazards Models ; Renal Insufficiency - complications ; Risk ; Risk Factors ; Time Factors ; Transplantation, Homologous ; Transplants & implants</subject><ispartof>Transplant international, 2012-07, Vol.25 (7), p.748-757</ispartof><rights>2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation</rights><rights>2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3868-89411e77f72f8951474c0d5753839c45f6a15191e02944ebace61c8ca28857993</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1432-2277.2012.01488.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1432-2277.2012.01488.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22548293$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Israni, Ajay K.</creatorcontrib><creatorcontrib>Snyder, Jon J.</creatorcontrib><creatorcontrib>Skeans, Melissa A.</creatorcontrib><creatorcontrib>Kasiske, Bertram L.</creatorcontrib><creatorcontrib>PORT Investigators</creatorcontrib><title>Clinical diagnosis of metabolic syndrome: predicting new-onset diabetes, coronary heart disease, and allograft failure late after kidney transplant</title><title>Transplant international</title><addtitle>Transpl Int</addtitle><description>Summary
Metabolic syndrome is associated with coronary heart disease (CHD) and new‐onset diabetes after kidney transplant (NODAT). Using data collected from transplant centers worldwide for the Patient Outcomes in Renal Transplantation study, we examined associations of metabolic syndrome (n = 2253 excluding recipients with diabetes pretransplant), CHD (n = 2253), and NODAT (n = 1840 further excluding recipients with diabetes in the first year post‐transplant), with the primary outcome of allograft failure. We assessed risk factors associated with secondary outcomes of metabolic syndrome, NODAT, and CHD after adjusting for type of baseline immunosuppression and transplant center effects. Metabolic syndrome prevalence was 39.8% at 12–24 months post‐transplant and 35.4% at 36–48 months. Metabolic syndrome was independently associated with NODAT (hazard ratio 3.46, 95% confidence interval 2.40–4.98, P < 0.0001), CHD (2.03, 1.16–3.52, P = 0.013), and allograft failure (1.36, 1.03–1.79, P = 0.028). Allograft failure occurred in 218 patients (14.6%). After adjustment for metabolic syndrome, NODAT (1.63, 1.18–2.24, P = 0.003) and CHD (5.48, 3.27–9.20, P < 0.0001) remained strongly associated with increased risk of allograft failure. Metabolic syndrome, NODAT, and CHD are risk factors for allograft failure. NODAT and CHD are risk factors for allograft failure, independent of metabolic syndrome.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Allograft failure</subject><subject>Cardiovascular disease</subject><subject>Cholesterol</subject><subject>Coronary Disease - diagnosis</subject><subject>coronary heart disease</subject><subject>Diabetes Mellitus - diagnosis</subject><subject>Female</subject><subject>Humans</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Insulin</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Male</subject><subject>Metabolic syndrome</subject><subject>Metabolic Syndrome - diagnosis</subject><subject>Metabolic Syndrome - etiology</subject><subject>Middle Aged</subject><subject>new-onset diabetes after kidney transplant</subject><subject>Prevalence</subject><subject>Proportional Hazards Models</subject><subject>Renal Insufficiency - complications</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Transplantation, Homologous</subject><subject>Transplants & implants</subject><issn>0934-0874</issn><issn>1432-2277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc1uEzEUhUcIREPhFZAlNiw6g3_HHiQWVaA_UlUQCqrExnI8d4JTxw72jJo8R1-YGVKywBtbPt-5ujqnKBDBFRnPh3VFOKMlpVJWFBNaYcKVqnbPitlReF7McMN4iZXkJ8WrnNcYY6oEflmcUCq4og2bFY9z74KzxqPWmVWI2WUUO7SB3iyjdxblfWhT3MBHtE3QOtu7sEIBHsoYMvSTawk95DNkY4rBpD36BSZNQgaT4QyZ0CLjfVwl0_WoM84PCZA3PaDxAxK6d22APeqTCXnrTehfFy864zO8ebpPix8XXxbzq_Lm6-X1_PymtEzVqlQNJwSk7CTtVCMIl9ziVkjBFGssF11tiCANAUwbzmFpLNTEKmuoUkI2DTst3h_mblP8PUDu9cZlC37cAeKQNcEMCzxGNaHv_kPXcUhh3E4TWdcNZgqLkXr7RA3LDbR6m9xmTET_i3sEPh2AB-dhf9QJ1lOteq2n9vTUnp5q1X9r1Tu9-H49vUZ_efC73MPu6DfpXteSSaHvbi_17d3Vt8Wi_qk_sz8efKXm</recordid><startdate>201207</startdate><enddate>201207</enddate><creator>Israni, Ajay K.</creator><creator>Snyder, Jon J.</creator><creator>Skeans, Melissa A.</creator><creator>Kasiske, Bertram L.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QO</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201207</creationdate><title>Clinical diagnosis of metabolic syndrome: predicting new-onset diabetes, coronary heart disease, and allograft failure late after kidney transplant</title><author>Israni, Ajay K. ; Snyder, Jon J. ; Skeans, Melissa A. ; Kasiske, Bertram L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3868-89411e77f72f8951474c0d5753839c45f6a15191e02944ebace61c8ca28857993</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Allograft failure</topic><topic>Cardiovascular disease</topic><topic>Cholesterol</topic><topic>Coronary Disease - diagnosis</topic><topic>coronary heart disease</topic><topic>Diabetes Mellitus - diagnosis</topic><topic>Female</topic><topic>Humans</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Insulin</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Male</topic><topic>Metabolic syndrome</topic><topic>Metabolic Syndrome - diagnosis</topic><topic>Metabolic Syndrome - etiology</topic><topic>Middle Aged</topic><topic>new-onset diabetes after kidney transplant</topic><topic>Prevalence</topic><topic>Proportional Hazards Models</topic><topic>Renal Insufficiency - complications</topic><topic>Risk</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Transplantation, Homologous</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Israni, Ajay K.</creatorcontrib><creatorcontrib>Snyder, Jon J.</creatorcontrib><creatorcontrib>Skeans, Melissa A.</creatorcontrib><creatorcontrib>Kasiske, Bertram L.</creatorcontrib><creatorcontrib>PORT Investigators</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplant international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Israni, Ajay K.</au><au>Snyder, Jon J.</au><au>Skeans, Melissa A.</au><au>Kasiske, Bertram L.</au><aucorp>PORT Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical diagnosis of metabolic syndrome: predicting new-onset diabetes, coronary heart disease, and allograft failure late after kidney transplant</atitle><jtitle>Transplant international</jtitle><addtitle>Transpl Int</addtitle><date>2012-07</date><risdate>2012</risdate><volume>25</volume><issue>7</issue><spage>748</spage><epage>757</epage><pages>748-757</pages><issn>0934-0874</issn><eissn>1432-2277</eissn><abstract>Summary
Metabolic syndrome is associated with coronary heart disease (CHD) and new‐onset diabetes after kidney transplant (NODAT). Using data collected from transplant centers worldwide for the Patient Outcomes in Renal Transplantation study, we examined associations of metabolic syndrome (n = 2253 excluding recipients with diabetes pretransplant), CHD (n = 2253), and NODAT (n = 1840 further excluding recipients with diabetes in the first year post‐transplant), with the primary outcome of allograft failure. We assessed risk factors associated with secondary outcomes of metabolic syndrome, NODAT, and CHD after adjusting for type of baseline immunosuppression and transplant center effects. Metabolic syndrome prevalence was 39.8% at 12–24 months post‐transplant and 35.4% at 36–48 months. Metabolic syndrome was independently associated with NODAT (hazard ratio 3.46, 95% confidence interval 2.40–4.98, P < 0.0001), CHD (2.03, 1.16–3.52, P = 0.013), and allograft failure (1.36, 1.03–1.79, P = 0.028). Allograft failure occurred in 218 patients (14.6%). After adjustment for metabolic syndrome, NODAT (1.63, 1.18–2.24, P = 0.003) and CHD (5.48, 3.27–9.20, P < 0.0001) remained strongly associated with increased risk of allograft failure. Metabolic syndrome, NODAT, and CHD are risk factors for allograft failure. NODAT and CHD are risk factors for allograft failure, independent of metabolic syndrome.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>22548293</pmid><doi>10.1111/j.1432-2277.2012.01488.x</doi><tpages>10</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adolescent Adult Aged Allograft failure Cardiovascular disease Cholesterol Coronary Disease - diagnosis coronary heart disease Diabetes Mellitus - diagnosis Female Humans Immunosuppressive Agents - therapeutic use Insulin Kidney Transplantation - adverse effects Male Metabolic syndrome Metabolic Syndrome - diagnosis Metabolic Syndrome - etiology Middle Aged new-onset diabetes after kidney transplant Prevalence Proportional Hazards Models Renal Insufficiency - complications Risk Risk Factors Time Factors Transplantation, Homologous Transplants & implants |
| title | Clinical diagnosis of metabolic syndrome: predicting new-onset diabetes, coronary heart disease, and allograft failure late after kidney transplant |
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