Cardiovascular diseases are currently one of the most important causes of morbidity and mortality in liver transplant patients over the long term. Therefore, evaluating prognostic factors for cardiovascular events (CVEs) in this population is essential for taking preventive measures. The aim of this study was to identify the impact of diabetes and other metabolic disorders on CVEs in liver transplant patients. Three hundred fifty-six liver transplant recipients who survived at least 6 months after surgery were enrolled. Patients were followed for a median time of 118 months (12–250 months). All cardiovascular events were carefully recorded and detailed in the patients’ charts. Demographic data, diabetes, hypertension, dyslipidemia, weight changes, and a diagnosis of metabolic syndrome both before and after transplantation were noted to assess their possible relationship with CVE. The presence of a diagnosis of metabolic-associated fatty liver disease (MAFLD) was also evaluated. Immunosuppressive therapy was included in the analysis. Diabetes mellitus (DM), especially when present before transplantation, was strongly associated with CVEs (hazard risk HR 3.10; 95% confidence interval CI: 1.60–6.03). Metabolic syndrome was found to be associated with CVEs in univariate analysis (HR 3.24; 95% CI: 1.36–7.8), while pretransplantation and de novo MAFLD were not. Immunosuppressive therapy had no influence on predisposing transplanted patients to CVEs during follow-up. Further prospective studies may be useful in investigating the risk factors for CVEs after liver transplantation and improving the long-term survival of transplant patients.

中文翻译：

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糖尿病和代谢紊乱：对肝移植患者心血管事件的影响

心血管疾病目前是肝移植患者长期发病和死亡的最重要原因之一。因此，评估该人群心血管事件（CVE）的预后因素对于采取预防措施至关重要。本研究的目的是确定糖尿病和其他代谢紊乱对肝移植患者 CVE 的影响。纳入手术后至少存活 6 个月的 356 名肝移植受者。患者的中位随访时间为 118 个月（12-250 个月）。所有心血管事件都被仔细记录并详细记录在患者图表中。人口统计数据、糖尿病、高血压、血脂异常、体重变化、并记录移植前后代谢综合征的诊断，以评估其与 CVE 的可能关系。还评估了是否存在代谢相关脂肪肝病（MAFLD）的诊断。分析中包括免疫抑制治疗。糖尿病 (DM)，尤其是移植前出现的糖尿病，与 CVE 密切相关（危险风险 HR 3.10；95% 置信区间 CI：1.60-6.03）。单变量分析发现代谢综合征与 CVE 相关（HR 3.24；95% CI：1.36-7.8），而移植前和新发 MAFLD 则不然。免疫抑制治疗对随访期间移植患者易发生 CVE 没有影响。