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饮酒、移植后新发糖尿病与肾移植受者全因死亡率。

Alcohol consumption, new onset of diabetes after transplantation, and all-cause mortality in renal transplant recipients.

机构信息

Department of Nephrology, University Medical Center Groningen, Groningen, The Netherlands.

出版信息

Transplantation. 2011 Jul 27;92(2):203-9. doi: 10.1097/TP.0b013e318222ca10.

Abstract

BACKGROUND

Renal transplant recipients (RTR) are often advised to refrain from alcohol because of possible interaction with their immunosuppressive medication. Although moderate alcohol consumption is associated with reduced risk of diabetes and mortality in the general population, this is unknown for RTR. Therefore, we investigated the association of alcohol consumption with new onset of diabetes after transplantation (NODAT), mortality, and graft failure in RTR.

METHOD

RTR were investigated between 2001 and 2003. Alcohol consumption was assessed by self-report. Mortality and graft failure was recorded until May 2009.

RESULTS

Six hundred RTR were studied (age 51 ± 12 years, 55% men). Of these RTR, 48% were abstainers, 38% had light alcohol intake, 13% had moderate intake, and 1% were heavy consumers. Moderate alcohol consumption was associated with a lower risk of developing NODAT over the follow-up period than was abstention (OR = 0.36 [0.2-0.6], P = <0.001). During follow-up for 7.0 years [6.2-7.5 years], 133 recipients died. In Cox regression analyses, moderate alcohol consumption was associated with lower mortality period than was abstention (hazard ratio = 0.40 [0.2-0.8], P = 0.009). Adjustment for confounders, including age and smoking, did not materially change this association. No association was found between alcohol consumption and graft failure.

CONCLUSIONS

Moderate alcohol consumption is associated with low prevalence of NODAT and reduced risk for mortality in RTR, in line with findings in the general population. These findings refute the common advice to refrain from alcohol in RTR.

摘要

背景

肾移植受者(RTR)常因免疫抑制药物的相互作用而被建议戒酒。尽管在一般人群中,适量饮酒与降低糖尿病和死亡率的风险相关,但这在 RTR 中尚不清楚。因此,我们研究了饮酒与移植后新发糖尿病(NODAT)、死亡率和移植物失功的关系。

方法

我们在 2001 年至 2003 年间对 RTR 进行了研究。通过自我报告评估饮酒量。记录死亡率和移植物失功情况,直至 2009 年 5 月。

结果

我们研究了 600 名 RTR(年龄 51±12 岁,55%为男性)。其中,48%的人滴酒不沾,38%的人轻度饮酒,13%的人中度饮酒,1%的人重度饮酒。与戒酒相比,中度饮酒与随访期间 NODAT 的发病风险降低相关(OR=0.36[0.2-0.6],P<0.001)。在 7.0 年[6.2-7.5 年]的随访期间,有 133 名受者死亡。在 Cox 回归分析中,与戒酒相比,中度饮酒与较低的死亡率相关(危险比=0.40[0.2-0.8],P=0.009)。调整年龄和吸烟等混杂因素后,并未显著改变这种关联。饮酒与移植物失功之间没有关联。

结论

适量饮酒与 RTR 中 NODAT 的低患病率和死亡率降低相关,与一般人群的发现一致。这些发现驳斥了在 RTR 中戒酒的常见建议。

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