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Risk markers for later cardiovascular diseases in liver‐transplanted children and adolescents
Author(s) -
Naeser Vibeke,
Brandt Andreas Hjelm,
Nyhuus Bo,
Borgwardt Lise,
Jørgensen Marianne Hørby,
Rasmussen Allan
Publication year - 2018
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13298
Subject(s) - medicine , pulse wave velocity , intima media thickness , metabolic syndrome , liver transplantation , body mass index , transplantation , gastroenterology , obesity , cystic fibrosis , population , cardiology , blood pressure , carotid arteries , environmental health
Background Increased risk of cardiovascular diseases is well described after adult liver transplantation, whereas the risk in the pediatric population still is discussed. The aim of this study was to investigate the prevalence of metabolic syndrome in pediatric liver transplant recipients and whether measurements of carotid intima media thickness and pulse wave velocity were increased compared to healthy controls. Methods We included 42 pediatric liver transplantation recipients and examined them for markers of metabolic syndrome, liver fibrosis measured by shear wave velocity, body fat measured by DXA scans and carotid intima‐media thickness, and pulse wave velocity (n = 41 for the carotid scans). The ultrasound measurements of carotid intima‐media thickness and pulse wave velocity were also conducted on 82 healthy children and adolescents matched on height and age, respectively. Results Participants had a median age of 13.03 years, and median time since transplantation was 8.54 years. Compared to healthy controls, liver‐transplanted patients had significantly increased intima‐media thickness measurements in both control groups whereas there was no significant difference with regard to pulse wave velocity. Two patients (6.25%) were diagnosed with metabolic syndrome. Within the group of liver‐transplanted pediatric patients, only elevated body mass index was associated with elevated carotid intima‐media thickness measurement. Elevated pulse wave velocity was only associated with abdominal obesity. Factors not significantly correlated with either were age, sex, metabolic syndrome, hyperglycemia, triglycerides, years since transplantation, fibrosis of the liver, body fat content, smoking habits, HDL cholesterol levels, hypertension, and mono‐drug versus multi‐drug therapies. Conclusion Pediatric liver transplant recipients do have an increased risk of increased carotid intima‐media thickness.