Souqiyyeh M Z, Shaheen F A, Shiek I A, Al-Khader A A, Fedhail H, Al-Sulaiman M, Mousa D, Al-Hawas F
Saudi Center for Organ Transplantation, Saudi Arabia.
Saudi J Kidney Dis Transpl. 2000 Jan-Mar;11(1):25-30.
We conducted this study to evaluate the prevalence and risk factors of diabetes mellitus (DM) in our renal transplant population. We retrospectively reviewed the records of the active renal transplant patients at two large transplant centers in Riyadh and Jeddah in Saudi Arabia, transplanted between 1979 and November 1998. The recipients were grouped according to the diagnosis of diabetes; group I: diabetes developed before transplantation (BTDM), group II: diabetes developed only after transplantation (ATDM) and group III: did not have diabetes (NDM). There were 1112 patients' records included in the study. The mean age was 38.2 years and the mean duration of transplantation was 66.9 months. There were 113(10.2%) patients in BTDM group, 134 (12.1%) patients in the ATDM group and 865 (77.8%) patients in the NDM group. There was no significant difference in the prevalence of hypertension among the study groups. In comparison to the other groups, the BTDM group had significantly more males (78.8%), more patients who were transplanted after 1990 (pre-cyclosporin era), more patients with grafts from living non-related donors (46%), higher incidence of acute rejection episodes (39%), higher mean serum creatinine and more patients treated with azathioprine (71%). The ATDM group had significantly higher mean age (46.4 years), higher mean duration of transplantation (91.5 months), higher rate of retransplantation (8.2%), higher mean serum cholesterol level (6.0mmol/L) and more frequently abnormal electrocardiogram (24.6%) than the other two groups. The ATDM group had comparable mean weight (70.2 kg) to the BTDM group but significantly higher than the NDM group (66.1kg). The NDM group had significantly higher mean dose of cyclosporine (3.3 mg/kg/day) and higher mean dose of prednisone (0.16 mg/kg/day) than the other groups. The only independent risk factor for developing DM after transplantation was advancing age. The currently used low-dose steroid therapy was not significantly associated with development of DM after renal transplantation. Nevertheless DM is an important co-morbid condition in the transplant population and is associated with increased risk for cardiovascular and cerebrovascular events.
我们开展这项研究以评估沙特阿拉伯利雅得和吉达两个大型移植中心肾移植人群中糖尿病（DM）的患病率及危险因素。我们回顾性分析了1979年至1998年11月期间在这两个中心接受肾移植且仍在接受治疗的患者记录。根据糖尿病诊断情况将受者分组：第一组：移植前患糖尿病（BTDM）；第二组：仅在移植后患糖尿病（ATDM）；第三组：无糖尿病（NDM）。本研究共纳入1112例患者记录。平均年龄为38.2岁，平均移植时长为66.9个月。BTDM组有113例（10.2%）患者，ATDM组有134例（12.1%）患者，NDM组有865例（77.8%）患者。各研究组间高血压患病率无显著差异。与其他组相比，BTDM组男性比例显著更高（78.8%），1990年后（环孢素时代之前）接受移植的患者更多，接受来自非亲属活体供者移植物的患者更多（46%），急性排斥反应发生率更高（39%），平均血清肌酐水平更高，接受硫唑嘌呤治疗的患者更多（71%）。ATDM组的平均年龄显著更高（46.4岁），平均移植时长更长（91.5个月），再次移植率更高（8.2%），平均血清胆固醇水平更高（6.0mmol/L），心电图异常更频繁（24.6%）。ATDM组的平均体重（70.2kg）与BTDM组相当，但显著高于NDM组（66.1kg）。NDM组的环孢素平均剂量（3.3mg/kg/天）和泼尼松平均剂量（0.16mg/kg/天）显著高于其他组。移植后发生DM的唯一独立危险因素是年龄增长。目前使用的低剂量类固醇疗法与肾移植后DM的发生无显著关联。然而，DM在移植人群中是一种重要的合并症，与心血管和脑血管事件风险增加相关。
