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中国心脏移植受者的体重指数和空腹血糖浓度与移植后糖尿病的关联

Association of body mass index and fasting plasma glucose concentration with post-transplantation diabetes mellitus in Chinese heart transplant recipients.

作者信息

Zhao Tian, Zhao Yinan, Zong Ailun, Tang Yadi, Shi Xiaopeng, Zhou Yingsheng

机构信息

Department of Endocrinology and Metabolism, Beijing Anzhen Hospital, Capital Medical University, Beijing, PR China.

出版信息

J Int Med Res. 2020 Mar;48(3):300060520910629. doi: 10.1177/0300060520910629.

Abstract

OBJECTIVE

Post-transplantation diabetes mellitus (PTDM) is a frequent complication after heart transplantation. We investigated the specific predictors of PTDM in Chinese heart transplant recipients and the prognostic value of these predictors.

METHODS

We retrospectively analyzed 122 adult patients who underwent heart transplantation. Comparisons were made between patients with PTDM (n = 44) and those without PTDM (n = 78).

RESULTS

During the median follow-up of 44 months, the cumulative incidence of PTDM was 19.7% at 1 year after transplantation and 36.1% at the endpoint. PTDM was associated with a significantly higher preoperative body mass index (BMI) (odds ratio [OR] = 1.349), fasting plasma glucose (FPG) concentration (OR = 2.538), and serum uric acid concentration (OR = 1.005) after transplantation. The area under the receiver operating characteristic curve was 0.708 and 0.763 for the BMI and FPG concentration, respectively. The incidence of acute rejection and infection were higher and the all-cause mortality rate was considerably greater in patients with than without PTDM.

CONCLUSIONS

A higher preoperative BMI (>23 kg/m), FPG concentration (>5.2 mmol/L), and uric acid concentration could potentially predict PTDM in Chinese heart transplant recipients. PTDM influences long-term survival after heart transplantation.

摘要

目的

移植后糖尿病(PTDM)是心脏移植术后常见的并发症。我们研究了中国心脏移植受者中PTDM的特定预测因素以及这些预测因素的预后价值。

方法

我们回顾性分析了122例接受心脏移植的成年患者。对发生PTDM的患者(n = 44)和未发生PTDM的患者(n = 78)进行了比较。

结果

在中位随访44个月期间,移植后1年PTDM的累积发生率为19.7%,随访终点时为36.1%。PTDM与移植后术前较高的体重指数(BMI)(比值比[OR]=1.349)、空腹血糖(FPG)浓度(OR = 2.538)和血清尿酸浓度(OR = 1.005)相关。BMI和FPG浓度的受试者工作特征曲线下面积分别为0.708和0.763。发生PTDM的患者急性排斥反应和感染的发生率更高,全因死亡率也显著高于未发生PTDM的患者。

结论

术前较高的BMI(>23kg/m²)、FPG浓度(>5.2mmol/L)和尿酸浓度可能预测中国心脏移植受者发生PTDM。PTDM影响心脏移植后的长期生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3915/7132567/fc1de8a4ad0a/10.1177_0300060520910629-fig1.jpg

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