Pretransplant fasting glucose predicts new-onset diabetes after liver transplantation.
Pretransplant fasting glucose predicts new-onset diabetes after liver transplantation.
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DOI：
10.1155/2012/614781
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发表时间：
2012
影响因子：
2.5
通讯作者：
Chakkera HA
中科院分区：
文献类型：
--
作者：
Carey EJ;Aqel BA;Byrne TJ;Douglas DD;Rakela J;Vargas HE;Moss AA;Mulligan DC;Reddy KS;Chakkera HA
移植后新发糖尿病(NODAT)在肝移植后很常见，且与较差的预后相关。这项研究的目的是确定肝移植受者在停用糖皮质激素后发生NODAT的危险因素。在225名成年非糖尿病肝移植受者中，平均年龄为51.7岁，大多数为男性(71%)，一半患有丙型肝炎病毒(49%)。移植时计算的平均MELD评分为18.7分，其中19%接受了活体供体移植(LDLT)。移植后一年，17%的患者出现NODAT，另外16%的患者空腹血糖受损。丙型肝炎患者NODAT的发生率为26%。在多因素分析中，丙型肝炎病毒、移植前空腹血糖和低密度脂蛋白是有意义的。移植前空腹血糖每增加10 mg/dL，NODAT的未来发展就会增加两倍。停用糖皮质激素的患者肝移植后NODAT的发生率为17%。发生NODAT的危险因素包括丙型肝炎病毒和移植前空腹血糖；低密度脂蛋白移植是保护性的。
New-onset diabetes after transplantation (NODAT) is common after liver transplant and associated with poorer outcomes. The aim of this study was to identify risk factors for NODAT in liver transplant recipients off corticosteroids. In 225 adult nondiabetic liver transplant recipients, the mean age was 51.7 years, the majority were men (71%), and half had HCV (49%). The mean calculated MELD score at transplantation was 18.7, and 19% underwent living-donor transplant (LDLT). One year after transplantation, 17% developed NODAT, and an additional 16% had impaired fasting glucose. The incidence of NODAT in patients with HCV was 26%. In multivariate analysis, HCV, pretransplant FPG, and LDLT were significant. Each 10 mg/dL increase in pretransplant FPG was associated with a twofold increase in future development of NODAT. The incidence of NODAT after liver transplant in patients off corticosteroids is 17%. Risk factors for developing NODAT include HCV and pretransplant FPG; LDLT is protective.