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体重指数与肾移植后新发糖尿病风险的关联:一项荟萃分析。

Association of Body Mass Index and the Risk of New-Onset Diabetes After Kidney Transplantation: A Meta-analysis.

作者信息

Chang S, Jiang J

机构信息

Key Lab of Organ Transplantation, Ministry of Education; Key Lab of Organ Transplantation, Ministry of Health; Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.

Key Lab of Organ Transplantation, Ministry of Education; Key Lab of Organ Transplantation, Ministry of Health; Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.

出版信息

Transplant Proc. 2018 Jun;50(5):1316-1325. doi: 10.1016/j.transproceed.2018.02.075. Epub 2018 Mar 10.

Abstract

OBJECTIVE

To comprehensively examine the correlation between body mass index (BMI) and the risk of new-onset diabetes after kidney transplantation (NODAT).

METHODS

The electronic databases Pubmed, Embase, and Cochrane Library, updated in December 2016, were searched, and a literature review was conducted as well to identify relevant research studies. With the use of R 3.12 software, the association between BMI and NODAT risk was analyzed by means of a meta-analysis, with the mean differences (MDs) and their 95% confidence intervals (CIs) as effect indexes. Publication bias was assessed with the use of the Egger test. A sensitivity analysis was performed by excluding 1 study at a time. And the overall morbidity of NODAT was calculated.

RESULTS

In the meta-analysis, 55 eligible studies involving 15,458 kidney transplantation cases were included. After the heterogeneity test, the random-effects model was used to calculate the pooled results of the effect indexes. The results of the meta-analysis showed that BMI was an independent risk factor of NODAT (MD, 1.88; 95% CI, 1.48-2.27). No publication bias was found among the included studies (t = 0.3417; P = 0.7339). The sensitivity analysis revealed that the pooled MD did not reverse after ignoring 1 study at a time. In addition, the overall morbidity of NODAT was 21% (95% CI, 21%-23%).

CONCLUSIONS

Our results suggest that BMI is an independent risk factor for NODAT.

摘要

目的

全面研究体重指数(BMI)与肾移植后新发糖尿病(NODAT)风险之间的相关性。

方法

检索2016年12月更新的电子数据库PubMed、Embase和Cochrane图书馆,并进行文献综述以确定相关研究。使用R 3.12软件,通过荟萃分析分析BMI与NODAT风险之间的关联,以平均差(MDs)及其95%置信区间(CIs)作为效应指标。使用Egger检验评估发表偏倚。通过每次排除1项研究进行敏感性分析。并计算NODAT的总体发病率。

结果

在荟萃分析中,纳入了55项涉及15458例肾移植病例的合格研究。经过异质性检验后,采用随机效应模型计算效应指标的合并结果。荟萃分析结果显示,BMI是NODAT的独立危险因素(MD,1.88;95%CI,1.48 - 2.27)。纳入研究中未发现发表偏倚(t = 0.3417;P = 0.7339)。敏感性分析显示,每次忽略1项研究后,合并MD未发生反转。此外,NODAT的总体发病率为21%(95%CI,21% - 23%)。

结论

我们的结果表明,BMI是NODAT的独立危险因素。

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