Different classifications yield variance in metabolic syndrome prevalence and dynamics in renal transplant recipients

The metabolic syndrome (MS) is a combination of factors that are associated with increased cardiovascular diseases. High MS prevalence was reported in renal transplant recipients. However, little is known about the longitudinal prevalence and its dynamic properties in this population. We studied the longitudinal prevalence of MS at 3 and 12 months post-transplantation using 3 classifications.

We studied a cohort of 322 patients who underwent transplantation between 1996 and 2003 who had isotopic measurement of transplant glomerular filtration rate and MS assessment at 3 and 12 months after transplantation. Prevalence and change of MS status in terms of acquisition or regression were analyzed based on World Health Organization (WHO), International Diabetic Federation (IDF), and The Adult Treatment Panel-III (ATP-III) classifications.

The prevalences at 3 and 12 months were as follows: WHO, 8.4% and 8.1%; IDF, 25.8% and 29.8%; and ATP-III, 34.3% and 36.6%, respectively. Change in MS status was noted in 9.7%, 16.4%, and 20.5% of subjects within WHO, IDF, and the ATP-III classifications, respectively. Prevalence was significantly lower with WHO than IDF and ATP-III. Prevalence was the highest with ATP-III. However, the difference with IDF was significant only at 3 months post-transplantation. Depending on the classification used, 10%-21% of subjects change MS status within the first year of transplantation.

Longitudinal analysis confirms the high prevalence of MS and also highlights the dynamics of MS. We think both prevalence and dynamics should be accounted for when studying outcomes.