Is there a genetic predisposition to new-onset diabetes after kidney transplantation ?
Joint Authors
Reddy, Pooja P.
Mehra, Nikita
Ramachandran A.
Ali, Asik Ali Muhammad
Reddy, Yuvaram N. V.
Nagarajan, Prethivee
Sundaram, Varun
Mathew, Milly
Abraham, Georgi
Reddy, Yogesh N. V.
Source
Saudi Journal of Kidney Diseases and Transplantation
Issue
Vol. 26, Issue 6 (31 Dec. 2015), pp.1113-1120, 8 p.
Publisher
Saudi Center for Organ Transplantation
Publication Date
2015-12-31
Country of Publication
Saudi Arabia
No. of Pages
8
Main Subjects
Topics
Abstract EN
Kidney transplant recipients may develop new-onset diabetes after transplantation (NODAT) and transplant-associated hyperglycemia (TAH) (NODAT or new-onset impaired glucose tolerance-IGT).
We studied 251 consecutive renal transplant South Asian recipients for incidence of NODAT and its risk factors between June 2004 and January 2009.
Pre-transplant glucose tolerance test (GTT) identified non-diabetics (n = 102, IGT-24, NGT-78) for analysis.
Baseline immunosuppression along with either cyclosporine (CsA) (n = 70) or tacrolimus (Tac) (n = 32) was given.
Patients underwent GTT 20 days (mean) post-transplant to identify NODAT, normal (N) or IGT.
TAH was observed in 40.2% of the patients (40 % in CsA and 40.6 % in Tac) (P = 0.5).
NODAT developed in 13.7 % of the patients (12.9 % in CsA and 15.6% in Tac) (P = 0.5).
Overall, Hepatitis C (P = 0.007), human leukocyte antigen (HLA) B52 (P = 0.03) and lack of HLA A28 (A68/69) (P = 0.03) were associated with TAH.
In the Tac group, higher Day 1 dosage (P <0.001), HLA A1 (P = 0.04), B13 (P = 0.03) and lack of DR2 (P = 0.004) increased the risk of TAH.
In the CsA group, HLA A10 (P = 0.03), failure of triglyceride (P = 0.001) or low-density lipoprotein (LDL) (P = 0.03) to lower or high-density lipoprotein to rise (P = 0.001), and higher post-transplant LDL (P <0.001) and cholesterol levels (P = 0.02) were associated with NODAT or TAH.
Post-transplant fasting plasma glucose on Day 1 had sensitivity-54.5%, specificity- 50.1%, positive predictive value-18.1% and negative predictive value-84.8% for detecting NODAT.
In conclusion, there is a genetic predisposition to NODAT and TAH in South Asia as seen by the HLA associations, and a predisposition exists to the individual diabetogenic effects of Tac and CsA based on HLA type.
This could lead to more careful selection of calcineurin inhibitors based on HLA types in the South Asian population
American Psychological Association (APA)
Reddy, Yogesh N. V.& Abraham, Georgi& Sundaram, Varun& Reddy, Pooja P.& Mathew, Milly& Nagarajan, Prethivee…[et al.]. 2015. Is there a genetic predisposition to new-onset diabetes after kidney transplantation ?. Saudi Journal of Kidney Diseases and Transplantation،Vol. 26, no. 6, pp.1113-1120.
https://search.emarefa.net/detail/BIM-629560
Modern Language Association (MLA)
Reddy, Yogesh N. V.…[et al.]. Is there a genetic predisposition to new-onset diabetes after kidney transplantation ?. Saudi Journal of Kidney Diseases and Transplantation Vol. 26, no. 6 (Nov. / Dec. 2015), pp.1113-1120.
https://search.emarefa.net/detail/BIM-629560
American Medical Association (AMA)
Reddy, Yogesh N. V.& Abraham, Georgi& Sundaram, Varun& Reddy, Pooja P.& Mathew, Milly& Nagarajan, Prethivee…[et al.]. Is there a genetic predisposition to new-onset diabetes after kidney transplantation ?. Saudi Journal of Kidney Diseases and Transplantation. 2015. Vol. 26, no. 6, pp.1113-1120.
https://search.emarefa.net/detail/BIM-629560
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 1119-1120
Record ID
BIM-629560