Gomes Vânia, Ferreira Florbela, Guerra José, Bugalho Maria João
Endocrinology, Diabetes and Metabolism Department, Santa Maria Hospital, Lisbon 1649-035, Portugal.
Nephrology and Kidney Transplantation Department, Santa Maria Hospital, Lisbon 1649-035, Portugal.
World J Diabetes. 2018 Jul 15;9(7):132-137. doi: 10.4239/wjd.v9.i7.132.
To determine the incidence and associated factors of new-onset diabetes after transplantation (NODAT) in a Portuguese central hospital.
This single-center retrospective study involved consecutive adult nondiabetic transplant recipients, who had undergone kidney transplantation between January 2012 and March 2016. NODAT was diagnosed according to the criteria of the American Diabetes Association. Data were collected from an institutional database of the Nephrology and Kidney Transplantation Department (Santa Maria Hospital, Lisbon, Portugal) and augmented with data of laboratorial parameters collected from the corresponding patient electronic medical records. Exclusion criteria were preexisting diabetes mellitus, missing information and follow-up period of less than 12 mo. Data on demographic and clinical characteristics as well as anthropometric and laboratorial parameters were also collected. Patients were divided into two groups: With and without NODAT - for statistical comparison.
A total of 156 patients received kidney transplant during the study period, 125 of who were included in our analysis. NODAT was identified in 27.2% of the patients ( = 34; 53% female; mean age: 49.5 ± 10.8 years; median follow-up: 36.4 ± 2.5 mo). The incidence in the first year was 24.8%. The median time to diagnosis was 3.68 ± 5.7 mo after transplantation, and 76.5% of the patients developed NODAT in the first 3 mo. In the group that did not develop NODAT ( = 91), 47% were female, with mean age of 46.4 ± 13.5 years and median follow-up of 35.5 ± 1.6 mo. In the NODAT group, the pretransplant fasting plasma glucose (FPG) levels were significantly higher [101 (96.1-105.7) mg/dL 92 (91.4-95.8) mg/dL, = 0.007] and pretransplant impaired fasting glucose (IFG) was significantly more frequent (51.5% 27.7%, = 0.01). Higher pretransplant FPG levels and pretransplant IFG were found to be predictive risk factors for NODAT development [odds ratio (OR): 1.059, = 0.003; OR: 2.772, = 0.017, respectively].
NODAT incidence was high in our renal transplant recipients, particularly in the first 3 mo posttransplant, and higher pretransplant FPG level and IFG were risk factors.
确定葡萄牙一家中心医院移植后新发糖尿病（NODAT）的发病率及相关因素。
本单中心回顾性研究纳入了2012年1月至2016年3月期间接受肾移植的成年非糖尿病连续移植受者。NODAT根据美国糖尿病协会的标准进行诊断。数据从肾脏病和肾移植科（葡萄牙里斯本圣玛丽亚医院）的机构数据库中收集，并补充从相应患者电子病历中收集的实验室参数数据。排除标准为既往糖尿病、信息缺失以及随访期少于12个月。还收集了人口统计学和临床特征以及人体测量和实验室参数的数据。患者分为两组：发生NODAT组和未发生NODAT组，用于统计比较。
研究期间共有156例患者接受了肾移植，其中125例纳入我们的分析。27.2%的患者被诊断为NODAT（n = 34；53%为女性；平均年龄：49.5±10.8岁；中位随访时间：36.4±2.5个月）。第一年的发病率为24.8%。诊断的中位时间为移植后3.68±5.7个月，76.5%的患者在移植后的前3个月发生NODAT。在未发生NODAT的组（n = 91）中，47%为女性，平均年龄为46.4±13.5岁，中位随访时间为35.5±1.6个月。在NODAT组中，移植前空腹血糖（FPG）水平显著更高[101（96.1 - 105.7）mg/dL对92（91.4 - 95.8）mg/dL，P = 0.007]，移植前空腹血糖受损（IFG）更为常见（51.5%对27.7%，P = 0.01）。移植前FPG水平升高和移植前IFG被发现是NODAT发生的预测危险因素[优势比（OR）：1.059，P = 0.003；OR：2.772，P = 0.017，分别]。
我们的肾移植受者中NODAT发病率较高，尤其是在移植后的前3个月，移植前FPG水平升高和IFG是危险因素。
