Metabolic syndrome: is immunosuppression to blame?

KEY POINTS: 1. Metabolic syndrome (MS) is common after liver transplantation and has been associated with increased risks of cardiovascular disease, cardiovascular death, liver-related death, and overall mortality. 2. Immunosuppression may increase the frequency of hyperlipidemia, diabetes, and hypertension and thus increase the risk and prevalence of MS after transplantation. 3. Corticosteroids are associated with increased rates of diabetes, hypertension, and hyperlipidemia in the short term. These agents are now being used perhaps less frequently and certainly for shorter durations; therefore, the long-term effects on metabolic morbidities may be reduced. 4. Calcineurin inhibitors and mammalian target of rapamycin inhibitors affect many MS parameters to various degrees and contribute to long-term morbidity after transplantation.