Asymptomatic cytomegalovirus infection is associated with increased risk of new-onset diabetes mellitus and impaired insulin release after renal transplantation
Asymptomatic cytomegalovirus infection is associated with increased risk of new-onset diabetes mellitus and impaired insulin release after renal transplantation
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DOI：
10.1007/s00125-004-1499-z
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发表时间：
2004-09-01
期刊：
影响因子：
8.2
通讯作者：
Jenssen, T
中科院分区：
文献类型：
--
作者：
Hjelmesæth, J;Sagedal, S;Jenssen, T
目标/假设。人类巨细胞病毒（CMV）可能会增加患糖尿病的风险，但文献很少。本研究旨在检验无症状 CMV 感染与肾移植后新发糖尿病风险增加相关的假设，并评估无症状 CMV 感染对 OGTT 得出的胰岛素释放和胰岛素作用估计值的影响。方法。在移植后的前 3 个月内，对总共 160 名连续接受基于环孢素 (Sandimmun Neoral) 的免疫抑制的非糖尿病肾移植受者进行了 CMV 感染的密切监测。所有患者在 10 周时均接受 75 g OGTT。分析中排除了 36 名有症状的 CMV 感染（疾病）患者。结果。在未感染 CMV 的对照组中，新发糖尿病的发生率为 6% (4/63)，而在无症状 CMV 感染组中，新发糖尿病的发生率为 26% (16/61)。无症状巨细胞病毒感染与新发糖尿病风险显着增加相关（调整后的比值比：4.00；95% CI：1.19至13.43，p=0.025）。 CMV 感染患者组的胰岛素释放中值显着低于对照组。结论/解释。我们的研究结果支持以下假设：无症状 CMV 感染与新发移植后糖尿病风险增加相关，并表明胰岛素释放受损可能涉及一种发病机制。
Aims/hypothesis. The human cytomegalovirus (CMV) may increase the risk of diabetes mellitus, but the literature is scarce. The present study was designed to test the hypothesis that asymptomatic CMV infection is associated with increased risk of new-onset diabetes after renal transplantation, and to assess the impact of asymptomatic CMV infection on OGTT-derived estimates of insulin release and insulin action.Methods. A total of 160 consecutive non-diabetic renal transplant recipients on cyclosporine (Sandimmun Neoral)-based immunosuppression were closely monitored for CMV infection during the first 3 months after transplantation. All patients underwent a 75-g OGTT at 10 weeks. Excluded from the analyses were 36 patients with symptomatic CMV infection (disease).Results. The incidence of new-onset diabetes was 6% in a control group of recipients without CMV infection (4/63) and 26% in the group with asymptomatic CMV infection (16/61). Asymptomatic CMV infection was associated with a significantly increased risk of new-onset diabetes (adjusted odds ratio: 4.00; 95% CI: 1.19 to 13.43, p=0.025). The group of patients with CMV infection had a significantly lower median insulin release than controls.Conclusions/interpretation. Our findings support the hypothesis that asymptomatic CMV infection is associated with increased risk of new-onset post-transplant diabetes mellitus, and suggest that impaired insulin release may involve one pathogenetic mechanism.