Risk factors for new-onset diabetes mellitus after kidney transplantation: a retrospective study

doi:10.3969/j.issn.2095-4344.2017.20.025

Abstract

Abstract:

BACKGROUND: Effect of metabolic disorders after kidney transplantation on prognosis, especially new-onset diabetes after transplantation (NODAT), has aroused concerns.
OBJECTIVE: To investigate the risk factors for NODAT in renal transplant recipients, thus providing reference for identifying high-risk patients and taking active prevention measures.
METHODS: Clinical data of 365 patients undergoing allograft renal transplantation were analyzed retrospectively. According to whether NODAT occurred or not, all the patients were assigned to NODAT (n=71) and non-NODAT (n=294) groups. The independent risk factors for NODAT were determined using univariate
and non-conditional multivariate logistic regression analysis.
RESULTS AND CONCLUSION: The cumulative incidence of NODAT in renal transplant recipients within year postoperatively was 19.45%. Non-conditional multivariate logistic regression analysis showed that age ≥ 45 years old, body mass index ≥ 25 kg/m2, family history of diabetes mellitus and acute rejection were associated with NODAT in renal transplant recipients. To conclude, the age, family history of diabetes mellitus, high body mass index and acute rejection can increase the incidence of NODAT in renal transplant recipients.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Kidney Transplantation, Diabetes Mellitus, Risk Factors, Tissue Engineering

CLC Number:

R318

Yang Jin, Fang Fang, Yang Fu. Risk factors for new-onset diabetes mellitus after kidney transplantation: a retrospective study[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(20): 3275-3280.

Figures/Tables 2

2.1 参与者数量分析纳入患者365例，按意向性处理分析，全部进入结果分析。 2.2 两组患者一般资料分析符合研究筛选标准有365例，移植术后新发糖尿病组共71例，其中男45例，女26例；平均年龄(46.73±10.11)岁；原发病为IgA肾病6例，慢性肾小球肾炎10例，多囊肾8例，其他47例。非移植术后新发糖尿病组共294例，其中男185例，女109例；平均年龄(38.33±10.96)岁；慢性肾小球肾炎80例，IgA肾病22例，多囊肾34例，其他158例。具体见表1。 2.3 移植术后新发糖尿病的发病率根据本研究采用的移植术后新发糖尿病的诊断标准，共有71例发生了移植术后新发糖尿病，肾移植后1年内移植术后新发糖尿病的累积发病率为19.45%。 2.4 肾移植术后新发糖尿病危险因素的单因素分析比较结果 2组患者相关的临床资料，结果显示，影响移植术后新发糖尿病发生有9个危险因素，包括移植前年龄、体质量指数、空腹血糖、透析时间、糖尿病家族史、乙肝感染、巨细胞病毒感染和术后免疫抑制方案、急性排斥反应(P < 0.05)，而性别、高血压、吸烟、术前血脂、有无透析及透析方式、移植后1个月他克莫司血药浓度、糖皮质激素累积剂量等差异无显著性意义(P > 0.1)，具体见表1。 2.5 肾移植后糖尿病多因素非条件Logistic回归分析结果将上述单因素分析中P < 0.1的变量，即年龄、体质量指数、急性排斥反应、免疫抑制方案等9项潜在危险因素纳入非条件logistic回归中进行分析，结果显示，移植时年龄≥45岁(OR：2.713，95%CI 1.451-5.070，P < 0.05)、移植前体质量指数≥25 kg/m2(OR：2.812 1，95%CI 1.276-6.195，P < 0.05)、糖尿病家族史(OR：8.579，95%CI 3.464-21.244，P < 0.05)、急性排斥反应(OR：3.195，95% CI 1.493-6.839，P < 0.05)是影响移植术后新发糖尿病发生的独立危险因素，具体见表2。"

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