Sinangil Ayse, Celik Vedat, Barlas Soykan, Koc Yener, Basturk Taner, Sakaci Tamer, Akin Emin Baris, Ecder Tevfik
Division of Nephrology, Department of Internal Medicine, Istanbul Bilim University, Istanbul, Turkey.
Division of Nephrology, Department of Internal Medicine, Istanbul Bilim University, Istanbul, Turkey.
Nefrologia. 2017 Mar-Apr;37(2):181-188. doi: 10.1016/j.nefro.2016.11.022. Epub 2017 Mar 2.
New-onset diabetes after transplantation (NODAT) is a frequent metabolic complication and is considered a risk factor for patients undergoing renal transplant. The aim of this study was to evaluate the incidence and developing duration of new-onset diabetes after transplant (NODAT) and influencing factors.
All patients' data was investigated retrospectively. Diabetics, follow-up period<6 months, age<18years were excluded. Demographic, clinical and laboratory data was recorded. Patients were divided into two groups: with/without NODAT. NODAT group was divided into four subgroups according to the time of developing NODAT, which were 0-3, 3-6, 6-12 and 12 months later. Two groups were compared, to investigate the incidence of NODAT and risk factors associated with the occurrence of NODAT.
We retrospectively analyzed the records of 570 patients, of which 420 patients were included. Seventy (16.6%) patients had NODAT (36 female, mean age 51.7±8.2 years, mean follow-up 41.6±21.5 months), 52.8% of patients developed NODAT within the first three months of being diagnosed. 350 patients (116 female, mean age 43.2±12.5 years, mean follow-up 41.6±21.5 months) were without NODAT. The incidence of impaired fasting glucose (IFG) during the first week after transplant was found to be higher in the patients with NODAT (p<0.001). There was positive correlation between NODAT and older age, obesity, family history of diabetes, presence of IFG, fasting plasma glucose, total and LDL-cholesterol, triglycerides, parathormone. Old age, obesity, presence of IFG, pretransplant hypertriglyceridemia and hyperparathyroidism were predictors of development of NODAT.
Incidence of NODAT, especially the first six months, was high. All patients should be screened for IFG within the first week. Patients with dyslipidemia, elderly and obese patients should be closely monitored for the risk of development of NODAT.
移植后新发糖尿病（NODAT）是一种常见的代谢并发症，被认为是肾移植患者的一个危险因素。本研究的目的是评估移植后新发糖尿病（NODAT）的发病率、发病持续时间及影响因素。
对所有患者的数据进行回顾性调查。排除糖尿病患者、随访期<6个月、年龄<18岁的患者。记录人口统计学、临床和实验室数据。患者分为两组：有/无NODAT。NODAT组根据发生NODAT的时间分为四个亚组，分别为0 - 3、3 - 6、6 - 12和12个月后。比较两组，以调查NODAT的发病率及与NODAT发生相关的危险因素。
我们回顾性分析了570例患者的记录，其中420例患者被纳入研究。70例（16.6%）患者发生了NODAT（36例女性，平均年龄51.7±8.2岁，平均随访41.6±21.5个月），52.8%的患者在确诊后的前三个月内发生了NODAT。350例患者（116例女性，平均年龄43.2±12.5岁，平均随访41.6±21.5个月）未发生NODAT。发现NODAT患者移植后第一周空腹血糖受损（IFG）的发生率更高（p<0.001）。NODAT与年龄较大、肥胖、糖尿病家族史、IFG的存在、空腹血糖、总胆固醇和低密度脂蛋白胆固醇、甘油三酯、甲状旁腺激素之间存在正相关。老年、肥胖、IFG的存在、移植前高甘油三酯血症和甲状旁腺功能亢进是NODAT发生的预测因素。
NODAT的发病率，尤其是前六个月，较高。所有患者应在第一周内筛查IFG。血脂异常患者、老年和肥胖患者应密切监测发生NODAT的风险。
