ENPP1/PC-1 K121Q and other predictors of posttransplant diabetes.
ENPP1/PC-1 K121Q and other predictors of posttransplant diabetes.
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ENPP1/PC-1 K121Q 和移植后糖尿病的其他预测因子。
DOI：
10.1089/met.2010.0041
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发表时间：
2011
影响因子：
2.1
通讯作者：
Abate,Nicola
中科院分区：
文献类型：
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作者：
Szuszkiewicz,Magdalene;Bell,Jason;Vazquez,Miguel;Adams-Huet,Beverley;Grundy,ScottM;Chandalia,Manisha;Abate,Nicola
糖尿病是移植患者发病和死亡的主要原因。本研究评估了在我院接受肾移植并同意使用遗传物质的115例非糖尿病和非糖尿病患者（30%白人，48%黑人，22%西班牙裔）中，enpp1k121q多态性和其他已知影响糖尿病风险的变量的作用。其中36例（30%）在移植后1年内发生移植后糖尿病（PTDM）。在logistic回归和受试者操作特征（ROC）分析中发现，黑人种族、ENPP1K121Q多态性、年龄、体重指数（BMI）和免疫抑制药物与PTDM的相关性最强。然而，由于enpp1k121q在西班牙裔和黑人中更常见，他们也有更高的PTDM患病率，因此研究的遗传多态性没有发挥独立的预测作用，而种族，特别是黑人与非黑人，是PTDM最可靠的预测因子。该模型的最大ROC曲线下面积（AUC）为0.80，由黑人/非黑人、年龄、BMI和他克莫司治疗作为显著预测因子组成。一个仅包含种族（黑人/非黑人）和年龄作为预测因子的简化模型也得到了类似的结果（ROC AUC 0.78）。我们得出结论，黑人种族和年龄是PTDM的主要且不可改变的危险因素。enpp1k121q在PTDM种族易感性中的具体作用值得在更大的移植患者队列中进一步研究。
Diabetes mellitus is a major cause of morbidity and mortality among transplanted patients. This study evaluated the role of theENPP1K121Q polymorphism and other variables known to affect diabetes risk in 115 nondiabetic and unrelated patients who underwent kidney transplant at our institution and had consented for use of genetic material (30% whites, 48% blacks, and 22% Hispanics). Thirty-six of these patients (30%) developed posttransplant diabetes mellitus (PTDM) within 1 year of observation from transplant. Black race,ENPP1K121Q polymorphism, age, body mass index (BMI), and immunosuppressive medications were found to have the strongest associations with PTDM in the logistic regression and receiver operator characteristic (ROC) analysis. However, becauseENPP1K121Q is more common in Hispanics and in blacks, who also have higher PTDM prevalence, the studied genetic polymorphism did not exert independent predictive effect, whereas ethnicity, specifically black versus non-black, was the most robust predictor of PTDM. The model with the largest ROC area under the curve (AUC) of 0.80 was comprised of black/non-black, age, BMI, and tacrolimus treatment as significant predictors. A reduced model containing only ethnicity (black/non-black) and age as predictors yielded similar results (ROC AUC 0.78). We conclude that black race and age are major and not modifiable risk factors for PTDM. The specific role ofENPP1K121Q on ethnic susceptibility to PTDM deserves further investigation in larger cohorts of transplanted patients.