Sezer Siren, Erkmen Uyar Mehtap, Tutal Emre, Bal Zeynep, Guliyev Orhan, Colak Turan, Hasdemir Efe, Haberal Mehmet
Department of Nephrology, Baskent University Medical School, 06490 Ankara, Turkey.
Department of Internal Medicine, Baskent University Medical School, 06490 Ankara, Turkey.
J Diabetes Res. 2015;2015:293896. doi: 10.1155/2015/293896. Epub 2015 Apr 7.
New-onset diabetes after transplantation (NODAT) is associated with decreased graft survival and an increased risk for cardiovascular disease. The objective of this study was to evaluate the risk factors for development of NODAT and its' relationship with arterial stiffness and left ventricular mass index (LVMI) in kidney transplant recipients.
159 kidney transplant recipients were selected from our transplantation center who underwent renal transplantation between years 2007 and 2010.
Among 159 patients, 57 (32.2%) patients were with NODAT who were significantly older than patients without diabetes (P: 0.0001). Patients with NODAT had significantly higher pulse wave velocity (PWv) (P: 0.033) and left ventricular mass index LVMI (P: 0.001) compared to patients without NODAT. Further analysis was done according to LVMI as follows: LVMI > 130 g/m(2) (n: 57) and LVMI ≤ 130 g/m(2) (n: 102). We observed higher office systolic and diastolic BP, serum trygliceride, glucose, creatinine, age, and HbA1c (P: 0.0001) levels in patients with LVMI > 130 g/m(2). Linear regression analysis revealed that HbA1c was the major determinant of LVMI (P: 0.026, β: 0.361).
HbA1c is the major determinant of LVMI, so strict control of serum glucose levels is essential for preventing cardiovascular disease in patients with NODAT.
移植后新发糖尿病（NODAT）与移植肾存活期缩短及心血管疾病风险增加相关。本研究的目的是评估肾移植受者发生NODAT的危险因素及其与动脉僵硬度和左心室质量指数（LVMI）的关系。
从我们的移植中心选取了159例在2007年至2010年间接受肾移植的受者。
159例患者中，57例（32.2%）发生NODAT，这些患者的年龄显著高于未患糖尿病的患者（P：0.0001）。与未发生NODAT的患者相比，发生NODAT的患者的脉搏波速度（PWv）（P：0.033）和左心室质量指数LVMI（P：0.001）显著更高。根据LVMI进行了如下进一步分析：LVMI>130 g/m²（n：57）和LVMI≤130 g/m²（n：102）。我们观察到LVMI>130 g/m²的患者的诊室收缩压和舒张压、血清甘油三酯、血糖、肌酐、年龄和糖化血红蛋白（HbA1c）水平更高（P：0.0001）。线性回归分析显示，HbA1c是LVMI的主要决定因素（P：0.026，β：0.361）。
HbA1c是LVMI的主要决定因素，因此严格控制血清葡萄糖水平对于预防NODAT患者的心血管疾病至关重要。
