Prevalence of metabolic syndrome and physical fitness in children and adolescents after renal transplantation - preliminary results
Abstract
INTRODUCTION: Prevalence of metabolic syndrome (MS) depends on its definition and varies about 1 % in European child and adolescent population. Like in adults it increases with increasing body weight.
In overweight and obese children prevalence of MS varies between 16 % and 36 % depending on used definition. Patients with chronic kidney disease are at higher risk of developing cardiovascular complications.
Reduction of this risk after renal transplan - tation is just partial. Prevalence of MS in this population reaches as far as 68 %.
METHODOLOGY: Cross-sectional survey of 28 kidney recipients (age 6-18, 16 girls). Metabolic syndrome was defined as a presence of three or more risk factors (RF): fasting glucose 3 6,1 mmol/l; BMI 3 2,0 SD of reference values for age and sex (> 25 for patients older than 18 years); triglycerides level 3 1,1 mmol/l; HDL-cholesterol level pounds 1,3 mmol/l ( pounds 1,17 mmol/l for boys aged 15-19); blood pressure values > 95. percentile or requirement of antihypertensive therapy.
In subgroup of 10 patients we performed exercise test. RESULTS: We found three or more RF for MS in 64 % of our sample.
Each proband had at least one RF. We found significant differences in frequency of patological BMI, HDL and TG between group with MS and group without MS.
We failed to prove significant difference in prevalence of MS and its RF between group treated with corticosteroids (CS) and group treated without CS. Five of ten probands who performed exercise test did not achieve average fitness (their VO 2max was < -2 SD of reference values).
No proband had fitness higher-than-average. Two probands showed exaggerated blood pressure response to exercise.
CONCLUSION: Preliminary data show, that metabolic syndrome in children and adolescents with transplanted kidney is substantially different from metabolic syndrome in general population and obesity is not the main risk factor. Controlled physical activity intervention is suggested due to low physical fitness of these patients.