[肾移植患者中糖尿病与丙型肝炎之间的关联]
[Association between diabetes mellitus and hepatitis C in kidney transplant patients].
作者信息
López Hidalgo R, Gentil M A, Acosta D, Escobar M J, Sánchez Ibáñez R, Astorga R
机构信息
Servicio de Nefrología, Hospital Universitario Virgen del Rocío, Sevilla.
出版信息
Nefrologia. 2004;24(6):572-8.
BACKGROUND
Diabetes mellitus appearing after transplant (PTDM) has generally been attributed to immunosuppressive treatment. However, the findings of several studies suggest a possible relationship between hepatitis C virus (HCV) infection and diabetes mellitus, both in the general population and in liver or kidney transplant patients.
METHODS
We reviewed data corresponding to 325 kidney transplant patients who did not have diabetes before transplant and were treated with ciclosporin A posttransplant. We explored whether factors such as age, gender, weight, renal disease, immunosuppression, rejection episodes or HCV could be independent risk factors for PTDM.
RESULTS
Ninety four of the 325 patients were HCV positive and 231 were HCV negative. PTDM was observed in 22.3% of the HCV positive patients versus 6.5% of the HCV negative patients (p < 0.001). The independent factors found by multivariate analysis to be predictive of PTDM were: HCV positivity (OR: 5.65, IC 95%: 2.6-12), body mass index (OR: 1,10, IC 95%: 1.02-1.2) and age (OR: 1.07, IC 95%: 1.03-1.12).
CONCLUSIONS
Our findings support a link between HCV and PTDM.
背景
移植后出现的糖尿病（PTDM）通常归因于免疫抑制治疗。然而，多项研究结果表明，在普通人群以及肝或肾移植患者中，丙型肝炎病毒（HCV）感染与糖尿病之间可能存在关联。
方法
我们回顾了325例移植前无糖尿病且移植后接受环孢素A治疗的肾移植患者的数据。我们探究了年龄、性别、体重、肾脏疾病、免疫抑制、排斥反应或HCV等因素是否可能是PTDM的独立危险因素。
结果
325例患者中，94例HCV阳性，231例HCV阴性。HCV阳性患者中22.3%出现PTDM，而HCV阴性患者中这一比例为6.5%（p<0.001）。多变量分析发现，预测PTDM的独立因素为：HCV阳性（比值比：5.65，95%置信区间：2.6-12）、体重指数（比值比：1.10，95%置信区间：1.02-1.2）和年龄（比值比：1.07，95%置信区间：1.03-1.12）。
结论
我们的研究结果支持HCV与PTDM之间存在关联。
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