Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN 55902, USA.
Diabet Med. 2012 Jul;29(7):e1-12. doi: 10.1111/j.1464-5491.2012.03617.x.
New-onset diabetes after transplantation is recognized as one of the metabolic consequences which may increase the risk of morbidity and mortality after solid organ transplantation. The pathophysiology of new-onset diabetes after transplantation has not been clearly defined and may resemble that of Type 2 diabetes, characterized by predominantly insulin resistance or defective insulin secretion, or both. This review aims to summarize the current state of knowledge regarding the prevalence, consequences, pathogenesis, and management of new-onset diabetes after transplantation, with a major focus on the possible mechanisms involved in the pathogenesis of the disorder. The aetiology of new-onset diabetes after transplantation is multifactorial, with diabetogenic immunosuppressive drugs playing a major role. Multiple cellular and physiologic mechanisms are involved in the process. Selection of an appropriate maintenance immunosuppressive regimen should involve balancing the risk of patient and graft survival vs. the potential for new-onset diabetes after transplantation.
移植后新发糖尿病被认为是代谢后果之一，可能会增加实体器官移植后发病率和死亡率的风险。移植后新发糖尿病的病理生理学尚未明确，可能类似于 2 型糖尿病，其特征主要为胰岛素抵抗或胰岛素分泌缺陷，或两者兼有。本综述旨在总结目前关于移植后新发糖尿病的流行、后果、发病机制和管理的知识现状，主要关注该疾病发病机制中涉及的可能机制。移植后新发糖尿病的病因是多因素的，具有致糖尿病作用的免疫抑制剂药物起着重要作用。多种细胞和生理机制参与了这一过程。选择合适的维持性免疫抑制方案应涉及在患者和移植物生存的风险与移植后新发糖尿病的潜在风险之间取得平衡。
