Liang Jing, Yi Xilu, Xue Mengjuan, Chen Xianying, Huang Xiaowu, Sun Qiman, Wang Ting, Zhao Chenhe, Yang Yinqiu, Gao Jian, Zhou Jian, Fan Jia, Yu Mingxiang
Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Endocrinology and Metabolism, Central Hospital of Songjiang District, Shanghai, China.
J Clin Lab Anal. 2020 May;34(5):e23192. doi: 10.1002/jcla.23192. Epub 2020 Jan 24.
The correlation between preoperative lipid profiles and new-onset diabetes after transplantation (NODAT) remains relatively unexplored in liver transplant recipients (LTRs). Thus, we aimed to investigate the preoperative lipid profiles in Chinese LTRs and evaluate the different influences of preoperative total cholesterol, total triglycerides (TG), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol on the development of NODAT in both sexes.
A total of 767 Chinese LTRs from Zhongshan Hospital were retrospectively evaluated. NODAT was defined according to the American Diabetes Association guidelines; the relationship between each preoperative lipid index and NODAT development was analyzed separately in men and women.
Pretransplant hypotriglyceridemia was observed in 35.72% of the total LTRs. In men, only the preoperative TG level was significantly associated with incident NODAT after adjusting for potential confounders (hazard ratio 1.37, 95% confidence interval 1.13-1.66, P = .001). There was a nonlinear relationship between the preoperative TG level and NODAT risk. The risk of NODAT significantly increased with preoperative a TG level above 0.54 mmol/L (log-likelihood ratio test, P = .043). In women, no significant association was observed.
Among male LTRs, a higher preoperative TG level, even at a low level within the normal range, was significantly and nonlinearly associated with an increased risk of NODAT.
肝移植受者(LTRs)术前血脂谱与移植后新发糖尿病(NODAT)之间的相关性仍未得到充分研究。因此,我们旨在研究中国LTRs的术前血脂谱,并评估术前总胆固醇、总甘油三酯(TG)、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇对两性NODAT发生发展的不同影响。
对中山医院的767例中国LTRs进行回顾性评估。根据美国糖尿病协会指南定义NODAT;分别分析男性和女性术前各血脂指标与NODAT发生发展的关系。
在所有LTRs中,35.72%的患者术前存在低甘油三酯血症。在男性中,调整潜在混杂因素后,仅术前TG水平与NODAT的发生显著相关(风险比1.37,95%置信区间1.13-1.66,P = 0.001)。术前TG水平与NODAT风险之间存在非线性关系。术前TG水平高于0.54 mmol/L时,NODAT风险显著增加(对数似然比检验,P = 0.043)。在女性中,未观察到显著相关性。
在男性LTRs中,术前较高的TG水平,即使在正常范围内处于较低水平,也与NODAT风险增加显著且呈非线性相关。