Aleid Hassan, Alhuraiji Ahmad, Alqaraawi Abdullah, Abdulbaki Ammar, Altalhi Mai, Shoukri Mohamed, Abdelmoneim Eldali, Ali Tariq
Department of Kidney and Pancreas Transplantation, King Faisal Specialist Hospital, Riyadh, Saudi Arabia.
Department of Medicine, King Faisal Specialist Hospital, Riyadh, Saudi Arabia.
Saudi J Kidney Dis Transpl. 2016 Nov-Dec;27(6):1155-1161. doi: 10.4103/1319-2442.194603.
Many patients develop new-onset diabetes after kidney transplantation (NODAT). Its incidence and epidemiology are unknown in the Saudi population. We aimed to study the incidence, epidemiology, and outcomes of kidney transplant recipients who developed NODAT. This is a retrospective study of all adults who received kidney transplant between January 2003 and December 2009. NODAT was defined according to the criteria outlined in the 2003 International Consensus guidelines. A total of 500 patients were included in this study, 54% were male patients. One hundred thirty-six patients (27%) developed diabetes (NODAT group). In the univariate analysis, patients were older in the NODAT group (P <0.001), were of higher weight (P = 0.006), and had positive family history of diabetes (P = 0.002). Similarly, more patients in this group had impaired glucose tolerance before transplant (P = 0.01) and history of hepatitis C infection (P = 0.005). In the multivariate analysis, older age [odds ratio (OR) 1.06], family history of diabetes (OR 1.09), hepatitis C infection (OR 1.92), and impaired fasting glucose (OR 1.79) were significant risk factors for the development of NODAT. Mortality was 6% in the NODAT group and 0.5% in the non-diabetic group had died (P <0.001). Graft survival was not different between the groups (P = 0.35). In conclusion, there is a significant risk of developing diabetes after renal transplantation. Patients are at higher risk if they are older, have a family history of diabetes, pre-transplant impaired fasting/random glucose, and hepatitis C virus infection.
许多患者在肾移植后会出现新发糖尿病（NODAT）。在沙特人群中，其发病率和流行病学情况尚不清楚。我们旨在研究发生NODAT的肾移植受者的发病率、流行病学及转归。这是一项对2003年1月至2009年12月期间接受肾移植的所有成年人进行的回顾性研究。NODAT根据2003年国际共识指南中概述的标准进行定义。本研究共纳入500例患者，其中54%为男性患者。136例患者（27%）发生糖尿病（NODAT组）。在单因素分析中，NODAT组患者年龄较大（P<0.001）、体重较高（P = 0.006）且有糖尿病家族史（P = 0.002）。同样，该组中更多患者在移植前糖耐量受损（P = 0.01）且有丙型肝炎感染史（P = 0.005）。在多因素分析中，年龄较大[比值比（OR）1.06]、糖尿病家族史（OR 1.09）、丙型肝炎感染（OR 1.92）和空腹血糖受损（OR 1.79）是发生NODAT的显著危险因素。NODAT组的死亡率为6%，非糖尿病组的死亡率为0.5%（P<0.001）。两组间移植物存活率无差异（P = 0.35）。总之，肾移植后有发生糖尿病的显著风险。如果患者年龄较大、有糖尿病家族史、移植前空腹/随机血糖受损以及感染丙型肝炎病毒，则风险更高。
