Pretransplant metabolic syndrome and its components predict post-transplantation diabetes mellitus in Chinese patients receiving a first renal transplant
Pretransplant metabolic syndrome and its components predict post-transplantation diabetes mellitus in Chinese patients receiving a first renal transplant
复制标题
移植前代谢综合征及其组成部分可预测接受首次肾移植的中国患者的移植后糖尿病
DOI：
10.2147/tcrm.s190185
复制
发表时间：
2019-01-01
影响因子：
2.8
通讯作者：
Xing, Yanfang
中科院分区：
文献类型：
--
作者：
Cai, Ruiming;Wu, Meng;Xing, Yanfang
背景肾移植后糖尿病（PTDM）仍然是肾移植后的主要临床挑战。移植前可改变的危险因素的识别可能允许及时干预，以防止PTDM。本研究旨在确定移植前代谢综合征及其组分是否能够预测首次肾移植患者的PTDM。患者和方法我们对633例接受首次肾移植的非糖尿病患者进行了单中心回顾性研究。PTDM在移植后1个月至1年之间被诊断。采用多因素Logistic回归和考克斯比例风险模型分析移植前PTDM的潜在危险因素。结果移植后1年，26.2%的受者发生PTDM。PTDM患者的空腹血糖（FPG）（P=0.026）和体重指数（BMI）（P=0.006）显著高于非PRDM患者，而高密度脂蛋白胆固醇水平较低（P=0.015）。多因素Logistic回归分析（OR 1.28，95%CI 1.04-1.51，P=0.038）和考克斯比例风险模型（OR 2.75，95%CI 1.45-6.05，P=0.021）显示代谢综合征是PTDM的独立危险因素。FPG > 5.6mmol/L和BMI >28 kg/m2（肥胖）均能预测PTDM。结论首次肾移植患者合并代谢综合征、空腹血糖受损和肥胖是PTDM的独立危险因素。旨在改善移植前代谢综合征的干预措施可能会降低PTDM的发病率。
Background Post-transplantation diabetes mellitus (PTDM) remains a major clinical challenge following renal transplant. Identification of pretransplant modifiable risk factors may allow timely interventions to prevent PTDM. This study aims to determine whether pretransplant metabolic syndrome and its components are able to predict PTDM in Chinese patients receiving their first renal transplant. Patients and methods We conducted a single-center retrospective study of 633 non-diabetic patients receiving a first kidney transplant. PTDM was diagnosed between 1 month and 1 year post-transplant. Multivariable logistic regression and Cox proportional hazards model were applied to detect potential pretransplant risk factors for PTDM. Results One year post-transplant, 26.2% of recipients had developed PTDM. PTDM patients had significantly higher fasting plasma glucose (FPG) (P=0.026) and body mass index (BMI) (P=0.006) than non-PRDM patients, and lower levels of high-density lipoprotein cholesterol (P=0.015). The presence of metabolic syndrome was an independent risk factor for PTDM, as assessed by multivariable logistic regression analysis (OR 1.28, 95% CI 1.04–1.51, P=0.038) and Cox proportional hazards model (OR 2.75, 95% CI 1.45–6.05, P=0.021). Moreover, both FPG >5.6 mmol/L and BMI >28 kg/m2 (obesity) were able to predict PTDM. Conclusion Our results suggest that the presence of metabolic syndrome and its components, impaired fasting glycemia and obesity, are independent risk factors for PTDM in Chinese non-diabetic patients receiving a first renal transplant. Interventions aimed at improving pretransplant metabolic syndrome may reduce the incidence of PTDM.