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性别在移植后糖尿病发病中的作用:男性和女性平等吗?

Role of sex in post-transplant diabetes mellitus development: Are men and women equal?

机构信息

Department of Surgery and Transplantation Centre, University Hospital Martin and Jessenius Medical Faculty of Comenius University, Slovak Republic.

Department of Surgery and Transplantation Centre, University Hospital Martin and Jessenius Medical Faculty of Comenius University, Slovak Republic.

出版信息

J Diabetes Complications. 2019 Apr;33(4):315-322. doi: 10.1016/j.jdiacomp.2018.12.017. Epub 2019 Jan 4.

Abstract

INTRODUCTION

Sex differences are defined as biology-linked differences between women and men that occur through the sex chromosomes and their effects on organ systems.

MATERIAL AND METHODS

The objective of this prospective study was to determine risk factors for post-transplant diabetes mellitus (PTDM) in men and women.

RESULTS

A total of 417 patients (271 men and 146 women) were included in the monitored group. Age at the time of kidney transplantation (KT) >60 years and hypovitaminosis D at the time of KT (<20 μg/l) were identified as independent risk factors for PTDM in both men and women. It was further confirmed as an independent risk factor for men a waist circumference at the time of KT >94 cm, C-peptide at the time of KT >5 ng/ml, HOMA-IR >2 and triacylglycerols at the time of KT >1.7 mmol/l. In case of women, the dominant factor was BMI at the time of KT >30 kg/m2 and menopause at the time of KT. A significant decrease in C-peptide was recorded in women with PTDM.

CONCLUSION

It was confirmed that there are gender differences with regard to the development of PTDM after KT. Women show pancreas β cell dysfunction, whereas insulin resistance and metabolic syndrome are dominant in men.

摘要

简介

性别差异是指女性和男性之间由性染色体及其对器官系统的影响所导致的生物学差异。

材料与方法

本前瞻性研究旨在确定男性和女性移植后糖尿病(PTDM)的危险因素。

结果

共纳入 417 例(271 例男性和 146 例女性)患者作为监测组。研究发现,肾移植(KT)时年龄>60 岁和 KT 时维生素 D 缺乏(<20μg/l)是男性和女性 PTDM 的独立危险因素。进一步证实,男性 KT 时腰围>94cm、C 肽>5ng/ml、HOMA-IR>2 和三酰甘油>1.7mmol/l 也是 PTDM 的独立危险因素。对于女性,主要危险因素是 KT 时 BMI>30kg/m2 和 KT 时绝经。患有 PTDM 的女性 C 肽显著下降。

结论

证实了男性和女性在 KT 后发生 PTDM 方面存在性别差异。女性表现为胰腺β细胞功能障碍,而男性则以胰岛素抵抗和代谢综合征为主。

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