New-onset diabetes after kidney transplantation: Incidence and associated factors.
New-onset diabetes after kidney transplantation: Incidence and associated factors.
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DOI：
10.4239/wjd.v9.i7.132
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发表时间：
2018-07-15
影响因子：
4.2
通讯作者：
Bugalho MJ
中科院分区：
文献类型：
--
作者：
Gomes V;Ferreira F;Guerra J;Bugalho MJ
目的：确定葡萄牙一家中心医院移植后新发糖尿病(NODAT)的发生率及其相关因素。这项单中心的回顾性研究涉及连续的成年非糖尿病移植受者，他们在2012年1月至2016年3月期间接受了肾移植。NODAT是根据美国糖尿病协会的标准诊断的。数据从肾脏和肾脏移植部门(葡萄牙里斯本圣玛丽亚医院)的机构数据库中收集，并使用从相应患者电子医疗记录中收集的实验室参数数据进行扩充。排除标准为既往糖尿病、遗漏信息、随访期<12个月。还收集了人口学和临床特征以及人体测量学和实验室参数的数据。患者被分成两组：NODAT组和非NODAT组，用于统计学比较。在研究期间，共有156名患者接受了肾移植，其中125人被纳入我们的分析范围。有27.2%的患者出现NODAT(n=34；女性53%；平均年龄49.5±10.8岁；平均随访36.4±2.5mo)。第一年发病率为24.8%。移植后中位诊断时间为3.68±5.7个月，76.5%的患者在移植后前3个月发生NODAT。未发生NODAT组(n=91)，女性占47%，平均年龄46.4±13.5岁，中位随访期35.5±1.6mo。NODAT组移植前空腹血糖显著高于移植前[101(96.1~105.7)mg/dL vs 92(91.4~95.8)mg/dL，P=0.007]，移植前空腹血糖受损的发生率显著高于移植前(51.5%vs 27.7%，P=0.0 1)。移植前空腹血糖水平和移植前空腹空腹血糖水平是NODAT发生的预测危险因素[优势比(OR)：1.059，P=0.003；OR：2.772，P=0.017]。在我们的肾移植受者中，NODAT的发生率很高，特别是在移植后的前3个月，移植前较高的空腹血糖和空腹血糖是危险因素。
To determine the incidence and associated factors of new-onset diabetes after transplantation (NODAT) in a Portuguese central hospital. This single-center retrospective study involved consecutive adult nondiabetic transplant recipients, who had undergone kidney transplantation between January 2012 and March 2016. NODAT was diagnosed according to the criteria of the American Diabetes Association. Data were collected from an institutional database of the Nephrology and Kidney Transplantation Department (Santa Maria Hospital, Lisbon, Portugal) and augmented with data of laboratorial parameters collected from the corresponding patient electronic medical records. Exclusion criteria were preexisting diabetes mellitus, missing information and follow-up period of less than 12 mo. Data on demographic and clinical characteristics as well as anthropometric and laboratorial parameters were also collected. Patients were divided into two groups: With and without NODAT - for statistical comparison. A total of 156 patients received kidney transplant during the study period, 125 of who were included in our analysis. NODAT was identified in 27.2% of the patients (n = 34; 53% female; mean age: 49.5 ± 10.8 years; median follow-up: 36.4 ± 2.5 mo). The incidence in the first year was 24.8%. The median time to diagnosis was 3.68 ± 5.7 mo after transplantation, and 76.5% of the patients developed NODAT in the first 3 mo. In the group that did not develop NODAT (n = 91), 47% were female, with mean age of 46.4 ± 13.5 years and median follow-up of 35.5 ± 1.6 mo. In the NODAT group, the pretransplant fasting plasma glucose (FPG) levels were significantly higher [101 (96.1-105.7) mg/dL vs 92 (91.4-95.8) mg/dL, P = 0.007] and pretransplant impaired fasting glucose (IFG) was significantly more frequent (51.5% vs 27.7%, P = 0.01). Higher pretransplant FPG levels and pretransplant IFG were found to be predictive risk factors for NODAT development [odds ratio (OR): 1.059, P = 0.003; OR: 2.772, P = 0.017, respectively]. NODAT incidence was high in our renal transplant recipients, particularly in the first 3 mo posttransplant, and higher pretransplant FPG level and IFG were risk factors.
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DOI：
10.1111/ajt.12850
发表时间：
2014-09
期刊：
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
影响因子：
--
作者：
Sharif A;Hecking M;de Vries AP;Porrini E;Hornum M;Rasoul-Rockenschaub S;Berlakovich G;Krebs M;Kautzky-Willer A;Schernthaner G;Marchetti P;Pacini G;Ojo A;Takahara S;Larsen JL;Budde K;Eller K;Pascual J;Jardine A;Bakker SJ;Valderhaug TG;Jenssen TG;Cohney S;Säemann MD
通讯作者：
Säemann MD
影响因子：
16.2
作者：
Ghisdal L;Van Laecke S;Abramowicz MJ;Vanholder R;Abramowicz D
通讯作者：
Abramowicz D
影响因子：
13.6
作者：
Rodrigo, Emilio;Fernandez-Fresnedo, Gema;Arias, Manuel
通讯作者：
Arias, Manuel
影响因子：
8.2
作者：
Hjelmesæth, J;Sagedal, S;Jenssen, T
通讯作者：
Jenssen, T
影响因子：
6.2
作者：
Mourad G;Glyda M;Albano L;Viklický O;Merville P;Tydén G;Mourad M;Lõhmus A;Witzke O;Christiaans MHL;Brown MW;Undre N;Kazeem G;Kuypers DRJ;Advagraf-based immunosuppression regimen examining new onset diabetes mellitus in kidney transplant recipients (ADVANCE) study investigators
通讯作者：
Advagraf-based immunosuppression regimen examining new onset diabetes mellitus in kidney transplant recipients (ADVANCE) study investigators