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肾移植后新发糖尿病(NODAT)的危险因素:一项巴西单中心研究。

Risk factors for new-onset diabetes mellitus after kidney transplantation (NODAT): a Brazilian single center study.

作者信息

Lima Camila, Grden Amanda, Skare Thelma, Jaworski Paulo, Nisihara Renato

机构信息

Universidade Evangélica, Departamento de Medicina, Curitiba, PR, Brasil.

Universidade Positivo, Departamento de Medicina, Curitiba, PR, Brasil.

出版信息

Arch Endocrinol Metab. 2018;62(6):597-601. doi: 10.20945/2359-3997000000084.

Abstract

OBJECTIVES

This study aims to verify the new-onset diabetes after kidney transplant (NODAT) incidence in recipients within 1 year after kidney transplantation from a single center in Southern Brazil and to assess the associated conditions.

SUBJECTS AND METHODS

A retrospective study of 258 post-renal transplant patients was performed. Demographic (gender, age, ethnic background) and clinical (origin of graft, associated infections, body mass index (BMI) at transplant time and 6 and 12 months after, causes of renal failure, and comorbidities) data were analyzed. All patients were on tacrolimus, mycophenolate mofetil, and prednisone treatment. Patients with and without NODAT were compared.

RESULTS

A NODAT incidence of 31.2% was noted 1 year post transplantation. In the univariate analysis, patients with NODAT were older (p = 0.001), mostly had African-American ethnic background (p = 0.02), and had renal failure secondary to high blood pressure (HBP) (p = 0.001). The group of patients with NODAT also had more incidence of post-transplant HBP (p = 0.01), heart failure (p = 0.02), and dyslipidemia (p = 0.001). Logistic regression showed that African-American ethnic background, post-transplant HBP, and dyslipidemia were independently associated with NODAT.

CONCLUSION

This study shows a NODAT incidence that is greater in patients with African-American ethnic background and that is associated with HBP and dyslipidemia.

摘要

目的

本研究旨在核实巴西南部单一中心肾移植受者在肾移植后1年内新发糖尿病(NODAT)的发病率,并评估相关情况。

对象与方法

对258例肾移植术后患者进行回顾性研究。分析了人口统计学数据(性别、年龄、种族背景)和临床数据(移植物来源、相关感染、移植时以及移植后6个月和12个月时的体重指数(BMI)、肾衰竭原因和合并症)。所有患者均接受他克莫司、霉酚酸酯和泼尼松治疗。对发生和未发生NODAT的患者进行比较。

结果

移植后1年时NODAT发病率为31.2%。单因素分析显示,发生NODAT的患者年龄较大(p = 0.001),大多具有非裔美国人种族背景(p = 0.02),且继发于高血压(HBP)的肾衰竭发生率较高(p = 0.001)。发生NODAT的患者组移植后HBP、心力衰竭和血脂异常的发生率也更高(p分别为0.01、0.02和0.001)。逻辑回归分析显示,非裔美国人种族背景、移植后HBP和血脂异常与NODAT独立相关。

结论

本研究表明,具有非裔美国人种族背景的患者NODAT发病率更高,且与HBP和血脂异常有关。

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