Metabolic syndrome predicts worse perioperative outcomes in patients treated with partial nephrectomy for renal cell carcinoma

Urology
Stefano LuzzagoPierre I Karakiewicz

Abstract

To test the association between metabolic syndrome (MetS) and its components (high blood pressure, BMI ≥ 30, altered fasting glucose, low HDL cholesterol and high triglycerides) on perioperative outcomes after partial nephrectomy (PN). Within the NIS 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. 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 HDL cholesterol. One vs. two vs. three vs. four 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 (EAPC:+12.0%;p<0.001). The four tested MetS components (high blood pressure, BMI ≥ 30, altered fasting glucose and high triglycerides) achieved i...Continue Reading

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