Cardiovascular risk after orthotopic liver transplantation, a review of the literature and preliminary results of a prospective study

Table 1 Incidence or prevalence of risk factors of the different manifestations of the metabolic syndrome after orthotopic liver transplantation

Disease	Incidence/prevalence	Risk factors	Ref.
Diabetes mellitus	9%-21% (incidence)	Male gender	[65,105-107]
		High pre-LT BMI
		Family history
		Hepatitis C
		Older age immunosuppressants rapamycin gene polymorphisms
		TCF7L2 gene polymorphisms (donor)
Hyperlipidemia	45%-69% (prevalence)	Diet	[38,108-110]
		Older age
		High BMI
		DM
		Renal impairment, immunosuppressants
		low-density lipoprotein receptor gene polymorphism (donor)
Arterial hypertension	60%-70% (prevalence)	Obesity	[106,111,112]
		Older age
		Impaired glycemia
		Immunosuppressants
Overweight-obesity	24%-31% (prevalence)	High BMI before LT	[113-116]
		Diet
		Immunosuppressants
Metabolic syndrome	40%-60% (prevalence)	Older age	[33,106,117,118]
		Obesity and increased BMI
		pre-LT DM
		Genetic polymorphisms in the living donor
		High-dosage immunosuppressive drugs
		Changes in intestinal microbiota
NAFLD/NASH	18%-100% (incidence of NAFLD in NASH and cryptogenic recipients)	DM	[18,33,80,119-124]
	0%-14% (incidence of NASH in NASH and cryptogenic recipients)	Obesity and weight gain, dyslipidemia
	10%-40% (incidence of NAFLD in non-NASH or cyptogenic recipients)	Genetic predisposition (presence of the rs738409-G allele of the Patatin-like phospholipase)
		Arterial hypertension
		Immunosuppressant
		pre-LT alcoholic cirrhosis
		Liver graft steatosis

NAFLD: Non-alcoholic fatty liver disease; NASH: Non-alcoholic steatohepatitis.