Abbas Mohamed H, Ismail Mabrouk I, El Deeb Salem A, Nagib Ayman M, Hassan Nabil M, Refaie Ayman F, El Maghrabi Hanzada M, Denewar Ahmed A, Bakr Mohamed A
From the Department of Dialysis and Transplantation, The Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Exp Clin Transplant. 2015 Feb;13(1):26-34.
New-onset diabetes mellitus after transplant is a common complication in renal allograft recipients. Recently, a high prevalence of diabetes mellitus has been reported in patients with chronic hepatitis C virus. The association between hepatitis C and diabetes mellitus is well demonstrated in the general population, but some controversy still exists. This work aimed to study the effect of pretransplant hepatitis C virus on the development of new-onset diabetes mellitus after transplant in Egyptian living-donor renal allotransplant recipients.
This retrospective single center study included 913 kidney transplant recipients who were transplanted at Mansoura Urology and Nephrology Center between 2000 and 2010. The patients were divided into 4 groups according to their hepatitis C virus serology and diabetic status.
Pretransplant dialysis duration and number of blood transfusion units were statistically significant among both viremic and nonviremic groups. With respect to induction therapy, a highly statistical significance was observed between the 4 groups regarding presence and type of adjuvant therapy (P < .001). With respect to maintenance immunosuppression, high statistically significant results were observed regarding steroid and rapamycin between the 4 groups (P < .001) with lower significance regarding mycophenolate mofetil (P = .04) but no significance regarding azathioprine, cyclosporine, or tacrolimus therapy. Incidence of new-onset diabetes mellitus after transplant was statistically higher in the viremic than nonviremic group (P < .001).
There was a positive correlation between incidence of new-onset diabetes mellitus after transplant and positive pretransplant hepatitis C virus status.
移植后新发糖尿病是肾移植受者常见的并发症。最近，慢性丙型肝炎病毒患者中糖尿病的高患病率已有报道。丙型肝炎与糖尿病之间的关联在普通人群中已得到充分证实，但仍存在一些争议。这项研究旨在探讨移植前丙型肝炎病毒对埃及活体供肾移植受者移植后新发糖尿病发生发展的影响。
这项回顾性单中心研究纳入了2000年至2010年间在曼苏拉泌尿外科和肾脏病中心接受肾移植的913名受者。根据丙型肝炎病毒血清学和糖尿病状态将患者分为4组。
病毒血症组和非病毒血症组的移植前透析时间和输血单位数在统计学上具有显著差异。在诱导治疗方面，4组在辅助治疗的存在和类型上观察到高度统计学意义（P < 0.001）。在维持免疫抑制方面，4组在类固醇和雷帕霉素方面观察到高度统计学显著结果（P < 0.001），在霉酚酸酯方面差异较小（P = 0.04），但在硫唑嘌呤、环孢素或他克莫司治疗方面无显著差异。移植后新发糖尿病的发生率在病毒血症组中统计学上高于非病毒血症组（P < 0.001）。
移植后新发糖尿病的发生率与移植前丙型肝炎病毒阳性状态呈正相关。
