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肾移植后移植后糖尿病与丙型肝炎病毒血清学阳性状态:临床研究的荟萃分析

Post-transplant diabetes mellitus and HCV seropositive status after renal transplantation: meta-analysis of clinical studies.

作者信息

Fabrizi Fabrizio, Martin Paul, Dixit Vivek, Bunnapradist Suphamai, Kanwal Fasiha, Dulai Gareth

机构信息

Division of Nephrology and Dialysis, Maggiore Hospital, IRCCS, Milano, Italy.

出版信息

Am J Transplant. 2005 Oct;5(10):2433-40. doi: 10.1111/j.1600-6143.2005.01040.x.

Abstract

Hepatitis C virus (HCV) infection has a detrimental role on patient and graft survival after renal transplantation (RT). Some studies have also implicated HCV in the development of post-transplant diabetes mellitus (PTDM). We conducted a systematic review of the published medical literature of the relationship between anti-HCV seropositive status and DM after RT. The risk of DM occurrence in anti-HCV-positive and -negative patients after RT was regarded as the most reliable outcome end-point. We used the random effects model of DerSimonian and Laird to generate a summary estimate of the Odds Ratio (OD) of new onset DM in HCV-positive and -negative patients after kidney transplantation. Ten studies involving 2502 unique RT recipients were identified. The incidence of PTDM after RT ranged between 7.9% and 50%. The summary estimate for adjusted OR was 3.97 with a 95% confidence interval (CI) of 1.83-8.61 (p-value for homogeneity <0.0473). Thus, pooling of study results demonstrated the presence of a significant link between anti-HCV seropositive status and DM after RT. This relationship provides one potential explanation for the adverse effects of HCV on patient and graft survival after RT.

摘要

丙型肝炎病毒(HCV)感染对肾移植(RT)后的患者及移植物存活具有不利影响。一些研究还表明HCV与移植后糖尿病(PTDM)的发生有关。我们对已发表的关于肾移植后抗HCV血清学阳性状态与糖尿病之间关系的医学文献进行了系统综述。肾移植后抗HCV阳性和阴性患者发生糖尿病的风险被视为最可靠的结局终点。我们使用DerSimonian和Laird的随机效应模型对肾移植后HCV阳性和阴性患者新发糖尿病的比值比(OR)进行汇总估计。共纳入了10项研究,涉及2502例独特的肾移植受者。肾移植后PTDM的发生率在7.9%至50%之间。调整后OR的汇总估计值为3.97,95%置信区间(CI)为1.83 - 8.61(同质性p值<0.0473)。因此,研究结果汇总表明肾移植后抗HCV血清学阳性状态与糖尿病之间存在显著关联。这种关系为HCV对肾移植后患者及移植物存活产生不利影响提供了一种潜在解释。

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