New Onset Diabetes and Impaired Fasting Glucose After Liver Transplant: Risk Analysis and the Impact of Tacrolimus Dose
New Onset Diabetes and Impaired Fasting Glucose After Liver Transplant: Risk Analysis and the Impact of Tacrolimus Dose
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DOI：
10.6002/ect.2013.0047
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发表时间：
2014-02-01
影响因子：
0.9
通讯作者：
Malek-Hosseini, Seyed Ali
中科院分区：
文献类型：
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作者：
Lankarani, Kamran Bagheri;Eshraghian, Ahad;Malek-Hosseini, Seyed Ali
目的：移植后新发糖尿病是肝移植后主要的代谢并发症之一。肝移植后空腹血糖受损被认为与心血管死亡风险增加有关，但之前尚未得到充分研究。本研究的目的是评估肝移植患者移植后新发糖尿病和空腹血糖受损的发生率和危险因素。 材料和方法：在一项横断面研究中，对 2002 年 6 月至 2010 年 9 月在设拉子肝移植中心因慢性肝病接受移植的所有成年患者（年龄 >= 18 岁）进行了糖尿病和糖尿病的评估。 结果：肝移植术后共有86例患者（18.81%）发现糖尿病。 40 名患者（27 名男性和 13 名女性；8.75%）在移植后出现新发糖尿病，36 名患者（7.87%）在肝移植后出现空腹血糖受损。移植后新发糖尿病患者的平均年龄高于非糖尿病患者 (P = .001)。与非糖尿病患者相比，糖尿病患者肝移植前的平均空腹血糖显着较高 (P = .002) (5.20 +/- 0.93 mmol/L vs 4.44 +/- 0.56 mmol/L) (93.86 +/- 16.80 mg/dL vs 80 +/- 10,44 mg/dL)。移植后新发糖尿病患者比非糖尿病患者接受更高剂量的他克莫司作为免疫抑制药物 (P = .001)。结论：移植前空腹血糖可以预测移植后新发糖尿病的发生。年龄和他克莫司剂量是患者移植后新发糖尿病的独立危险因素。
Objectives: New onset diabetes mellitus after transplant is one of the major metabolic complications after liver transplant. Development of impaired fasting glucose after liver transplant is thought to be associated with increased risk of cardiovascular mortality and has not been well studied before. The aim of this study was to evaluate incidence and risk factors of new onset diabetes mellitus after transplant and impaired fasting glucose in liver transplant patients.Materials and Methods: In a cross-sectional study, all adult patients (aged >= 18 years) who were transplanted because of chronic liver diseases from June 2002 to September 2010 at Shiraz Liver Transplant Center were evaluated for developing diabetes and impaired fasting glucose.Results: Totally, 86 patients (18.81%) were found to have diabetes after liver transplant. Forty patients (27 men and 13 women; 8.75%) developed new onset diabetes mellitus after transplant and 36 patients (7.87%) developed impaired fasting glucose after liver transplant. The mean age of patients with new onset diabetes mellitus after transplant was higher than that of nondiabetic patients (P = .001). Mean fasting plasma glucose before liver transplant was significantly higher in diabetic patients compared with nondiabetic patients (P = .002) (5.20 +/- 0.93 mmol/L vs 4.44 +/- 0.56 mmol/L) (93.86 +/- 16.80 mg/dL vs 80 +/- 10,44 mg/dL). Patients with new onset diabetes mellitus after transplant received higher doses of tacrolimus as immunosuppressive medication than nondiabetic patients (P = .001).Conclusions: Fasting plasma glucose before transplant can predict development of new onset diabetes mellitus after transplant. Age and tacrolimus dosage are independent risk factors for new onset diabetes mellitus after transplant in our patients.