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肾移植受者移植前高镁血症与移植后血糖异常之间的关联

Association Between Pre-Transplant Magnesemia and Post-Transplant Dysglycemia in Kidney Transplant Recipients.

作者信息

Alamdari Azam, Asadi Ghazal, Minoo Farzaneh Sadat, Khatami Mohammad-Reza, Gatmiri Seyed Mansour, Dashti-Khavidaki Simin, Heydari Seradj Saba, Naderi Neda

机构信息

Nephrology Research Center, Center of Excellence in Nephrology, Tehran University of Medical Sciences, Tehran, Iran.

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Int J Endocrinol Metab. 2020 Jan 14;18(1):e97292. doi: 10.5812/ijem.97292. eCollection 2020 Jan.

Abstract

BACKGROUND

Serum magnesium (Mg) status in kidney transplant recipients has been a center of attention in the past few years. Current evidence suggests an association between pre-transplant hypomagnesemia and post-transplant hyperglycemia.

OBJECTIVE

The purpose of this study was to assess the associations of pre-transplant magnesemia with blood glucose disturbances within 6 months post-kidney transplantation.

METHODS

In this retrospective cohort, 89 first-time kidney transplant recipients with 6 months of follow-up were included. None of the participants had a positive history of rejection, pre-transplant history of diabetes mellitus or fasting plasma glucose ≥ 100 mg/dL.

RESULTS

Post-transplant diabetes mellitus (PTDM) and impaired fasting glucose (IFG) 6 months post-transplant was found in 7.9% and 41.6% of the study group, respectively. The mean pre-transplant serum Mg level was 1.92 ± 0.30 mg/dL in the study population (n = 89), and it was significantly lower in IFG (n = 37) and IFG/PTDM (n = 44) groups compared to normoglycemic (n = 45) recipients (1.83 ± 0.31 mg/dL vs. 2.00 ± 0.27 mg/dL, P = 0.008, and 1.84 ± 0.31 mg/dL vs. 2.00 ± 0.27 mg/dL, P = 0.012, respectively). Patients with serum Mg less than 1.9 mg/dL were nearly 2.6 times more likely to develop IFG or IFG/PTDM within 6 months post-transplant (P = 0.044 and P = 0.040, respectively).

CONCLUSIONS

Pre-transplant hypomagnesemia may be considered a risk factor for developing post-transplant glycemic disturbances, and patients with lower pre-transplant Mg concentration could be at a higher risk for developing IFG.

摘要

背景

过去几年,肾移植受者的血清镁(Mg)状态一直备受关注。目前的证据表明,移植前低镁血症与移植后高血糖之间存在关联。

目的

本研究旨在评估肾移植前血镁水平与肾移植后6个月内血糖紊乱之间的关联。

方法

本回顾性队列研究纳入了89例首次接受肾移植且随访6个月的受者。所有参与者均无排斥反应阳性史、移植前糖尿病史或空腹血糖≥100mg/dL。

结果

研究组中,移植后糖尿病(PTDM)和移植后6个月空腹血糖受损(IFG)的发生率分别为7.9%和41.6%。研究人群(n = 89)移植前血清镁平均水平为1.92±0.30mg/dL,与血糖正常(n = 45)的受者相比,IFG组(n = 37)和IFG/PTDM组(n = 44)的血清镁水平显著更低(分别为1.83±0.31mg/dL对2.00±0.27mg/dL,P = 0.008;1.84±0.31mg/dL对2.00±0.27mg/dL,P = 0.012)。血清镁低于1.9mg/dL的患者在移植后6个月内发生IFG或IFG/PTDM的可能性几乎高出2.6倍(分别为P = 0.044和P = 0.040)。

结论

移植前低镁血症可能被视为移植后血糖紊乱的一个危险因素,移植前镁浓度较低的患者发生IFG的风险可能更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f1c/7138613/75e702f29873/ijem-18-1-97292-i001.jpg

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