Endocrinology and Nutrition Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Unidad Mixta de Investigación de Endocrinología, Nutrición y Dietética, Instituto de Investigación Sanitaria La Fe (Health Research Institute La Fe), Valencia, Spain.
J Endocrinol Invest. 2018 Jul;41(7):821-829. doi: 10.1007/s40618-017-0810-z. Epub 2017 Dec 30.
The debate about the impact of intensified hyperglycemia treatment is still ranging. The main objective was to assess whether intensive glycemic control in hospitalized diabetic patients undergoing a liver transplant is associated with a lower rate of graft rejection at 3 months and at 5 years post-transplant.
Cross-sectional study comparing a cohort of patients undergoing liver transplant in 2010 and 2011, in whom an intensive insulin protocol was applied, with a retrospective group of patients undergoing a liver transplant in 2005 and 2006, in whom a conventional insulin protocol was applied. Both diabetics and non-diabetics were compared. As intensive insulin therapy is applied mainly in diabetic patients, it is expected that, when comparing both periods, the treatment would only benefit those patients.
The logistic regression model showed a statistically significant interaction between the treatment group and the presence of diabetes for the rejection rate 3 months and 5 years post-transplant. At both time points, the intensive insulin treatment group had lower rejection rates in the case of diabetic patients, which did not occur in non-diabetic patients.
Our study shows a decrease in the rate of liver graft rejection in diabetic patients undergoing intensive insulin treatment.
关于强化高血糖治疗影响的争论仍在持续。主要目的是评估在接受肝移植的住院糖尿病患者中进行强化血糖控制是否与 3 个月和 5 年后移植物排斥率降低相关。
本研究为 2010 年和 2011 年接受肝移植的患者进行的一项横断面研究，这些患者接受了强化胰岛素方案，与 2005 年和 2006 年接受常规胰岛素方案的回顾性患者进行比较。比较了糖尿病患者和非糖尿病患者。由于强化胰岛素治疗主要应用于糖尿病患者，因此预计在比较两个时期时，该治疗仅对这些患者有益。
Logistic 回归模型显示，在移植后 3 个月和 5 年时，治疗组和糖尿病的存在之间存在统计学显著的交互作用。在这两个时间点，接受强化胰岛素治疗的糖尿病患者的排斥率较低，而非糖尿病患者则没有。
我们的研究表明，接受强化胰岛素治疗的糖尿病患者的肝移植物排斥率降低。
