Modifiable Variables Are Major Risk Factors for Posttransplant Diabetes Mellitus in a Time-Dependent Manner in Kidney Transplant: An Observational Cohort Study
Joint Authors
Medina-Pestana, José Osmar
Rangel, Érika B.
de Lucena, Débora Dias
de Sá, João Roberto
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-10, 10 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-03-20
Country of Publication
Egypt
No. of Pages
10
Main Subjects
Abstract EN
Modifiable and nonmodifiable risk factors for developing posttransplant diabetes mellitus (PTDM) have already been established in kidney transplant setting and impact adversely both patient and allograft survival.
We analysed 450 recipients of living and deceased donor kidney transplants using current immunosuppressive regimen in the modern era and verified PTDM prevalence and risk factors over three-year posttransplant.
Tacrolimus (85%), prednisone (100%), and mycophenolate (53%) were the main immunosuppressive regimen.
Sixty-one recipients (13.5%) developed PTDM and remained in this condition throughout the study, whereas 74 (16.5%) recipients developed altered fasting glucose over time.
Univariate analyses demonstrated that recipient age (46.2±1.3 vs.
40.7±0.6 years old, OR 1.04; P=0.001) and pretransplant hyperglycaemia and BMI≥25 kg/m2 (32.8% vs.
21.6%, OR 0.54; P=0.032 and 57.4% vs.
27.7%, OR 3.5; P<0.0001, respectively) were the pretransplant variables associated with PTDM.
Posttransplant transient hyperglycaemia (86.8%.
18.5%, OR 0.03; P=0.0001), acute rejection (P=0.021), calcium channel blockers (P=0.014), TG/HDL (triglyceride/high-density lipoprotein cholesterol) ratio≥3.5 at 1 year (P=0.01) and at 3 years (P=0.0001), and tacrolimus trough levels at months 1, 3, and 6 were equally predictors of PTDM.
In multivariate analyses, pretransplant hyperglycaemia (P=0.035), pretransplant BMI≥25 kg/m2 (P=0.0001), posttransplant transient hyperglycaemia (P=0.0001), and TG/HDL ratio≥3.5 at 3-year posttransplant (P=0.003) were associated with PTDM diagnosis and maintenance over time.
Early identification of risk factors associated with increased insulin resistance and decreased insulin secretion, such as pretransplant hyperglycaemia and overweight, posttransplant transient hyperglycaemia, tacrolimus trough levels, and TG/HDL ratio may be useful for risk stratification of patients to determine appropriate strategies to reduce PTDM.
American Psychological Association (APA)
de Lucena, Débora Dias& de Sá, João Roberto& Medina-Pestana, José Osmar& Rangel, Érika B.. 2020. Modifiable Variables Are Major Risk Factors for Posttransplant Diabetes Mellitus in a Time-Dependent Manner in Kidney Transplant: An Observational Cohort Study. Journal of Diabetes Research،Vol. 2020, no. 2020, pp.1-10.
https://search.emarefa.net/detail/BIM-1182913
Modern Language Association (MLA)
de Lucena, Débora Dias…[et al.]. Modifiable Variables Are Major Risk Factors for Posttransplant Diabetes Mellitus in a Time-Dependent Manner in Kidney Transplant: An Observational Cohort Study. Journal of Diabetes Research No. 2020 (2020), pp.1-10.
https://search.emarefa.net/detail/BIM-1182913
American Medical Association (AMA)
de Lucena, Débora Dias& de Sá, João Roberto& Medina-Pestana, José Osmar& Rangel, Érika B.. Modifiable Variables Are Major Risk Factors for Posttransplant Diabetes Mellitus in a Time-Dependent Manner in Kidney Transplant: An Observational Cohort Study. Journal of Diabetes Research. 2020. Vol. 2020, no. 2020, pp.1-10.
https://search.emarefa.net/detail/BIM-1182913
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1182913