ABSTRACT
OBJECTIVE
To test the association between metabolic syndrome (MetS) and its components (high
blood pressure, body mass index [BMI] ≥ 30, altered fasting glucose, low high-density
lipoprotein cholesterol and high triglycerides) on perioperative outcomes after partial
nephrectomy (PN).
METHODS
Within the National Inpatient Sample database (2000-2015) we identified all PN patients.
First, temporal trends of MetS were reported. Second, the effect of MetS components
was tested in multivariable logistic regression models predicting overall and specific
perioperative complications. Third, we tested for dose-response from the concomitant
effect of multiple MetS components. All models were weighted and adjusted for clustering,
as well as all available patient and hospital characteristics.
RESULTS
Of 25,875 patients: (1) 59.3% had high blood pressure, (2) 14.7% had BMI ≥ 30, (3)
21.7% had altered fasting glucose, (4) 20.2% had high triglycerides, and (5) <0.01%
had low high-density lipoprotein cholesterol. One vs 2 vs 3 vs 4 MetS components were
recorded in 34.9% vs 22.9% vs 8.9% vs 2.2% patients. Of all, 11.1% exhibited ≥ 3
components and qualified for MetS. The rates of MetS increased over time (estimated
annual percentage changes: +12.0%;P <.001). The 4 tested MetS components (high blood pressure, BMI ≥ 30, altered fasting
glucose, and high triglycerides) achieved independent predictor status in multivariable
models predicting overall, cardiac, miscellaneous medical, vascular, and respiratory
complications, as well as transfusions. Moreover, a statistically significant dose-response
was confirmed for the same endpoints.
CONCLUSION
MetS and its components consistently and strongly predict perioperative complications
after PN. Moreover, the strength of the effect was directly proportional to the number
of MetS components exhibited by each individual patient, even if formal MetS diagnosis
of ≥ 3 components has not been met.
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Article info
Publication history
Published online: March 06, 2020
Accepted:
February 22,
2020
Received:
November 7,
2019
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
