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肾移植后新发糖尿病的危险因素:系统评价和荟萃分析。

Risk factors for new-onset diabetes mellitus after kidney transplantation: A systematic review and meta-analysis.

机构信息

First Clinical Medical College, Shanxi Medical University, Taiyuan, China.

Kidney Transplantation Center, Shanxi Second People's Hospital, Taiyuan, China.

出版信息

J Diabetes Investig. 2021 Jan;12(1):109-122. doi: 10.1111/jdi.13317. Epub 2020 Jul 12.

Abstract

AIMS/INTRODUCTION: To systematically review the risk factors for new-onset diabetes mellitus after kidney transplantation, and to provide a theoretical basis for the prevention and management of new-onset diabetes mellitus after kidney transplantation.

MATERIALS AND METHODS

We searched PubMed, Web of Science, Embase, the Cochrane Library databases and other databases for case-control studies related to risk factors for new-onset diabetes mellitus after kidney transplantation published between January 2005 and July 2019. A meta-analysis of data on risk factors for new-onset diabetes mellitus after kidney transplantation from the included studies was carried out. A narrative review of risk factors for new-onset diabetes mellitus after kidney transplantation was also carried out.

RESULTS

A total of 24 case-control studies were included in the meta-analysis, with a total of 7,140 patients. There were 1,598 patients with new-onset diabetes mellitus after kidney transplantation, and 5,542 patients without new-onset diabetes mellitus after kidney transplantation. The meta-analysis results showed that age, polycystic kidney disease, family history of diabetes, body mass index, acute rejection, tacrolimus use, hepatitis B virus infection, hepatitis C virus infection and hypertension were associated with new-onset diabetes mellitus after kidney transplantation, whereas sex, sirolimus use, cyclosporin A use, steroid use and cytomegalovirus infection were not associated with new-onset diabetes mellitus after kidney transplantation.

CONCLUSIONS

Older age, body mass index, family history of diabetes, tacrolimus use, history of hypertension, polycystic kidney disease, acute rejection, hepatitis B virus infection and hepatitis C virus infection are risk factors for new-onset diabetes mellitus after kidney transplantation. Therefore, the clinical implications of these factors warrant attention.

摘要

目的/引言:系统回顾肾移植后新发糖尿病的危险因素,为肾移植后新发糖尿病的预防和管理提供理论依据。

材料与方法

检索 2005 年 1 月至 2019 年 7 月发表的与肾移植后新发糖尿病危险因素相关的病例对照研究,包括 PubMed、Web of Science、Embase、Cochrane 图书馆等数据库。对纳入研究的肾移植后新发糖尿病危险因素进行数据的 meta 分析,并对肾移植后新发糖尿病的危险因素进行叙述性综述。

结果

共纳入 24 项病例对照研究,共 7140 例患者。其中 1598 例患者发生肾移植后新发糖尿病,5542 例患者未发生肾移植后新发糖尿病。meta 分析结果显示,年龄、多囊肾病、糖尿病家族史、体重指数、急性排斥反应、他克莫司使用、乙型肝炎病毒感染、丙型肝炎病毒感染和高血压与肾移植后新发糖尿病相关,而性别、西罗莫司使用、环孢素 A 使用、激素使用和巨细胞病毒感染与肾移植后新发糖尿病无关。

结论

年龄较大、体重指数、糖尿病家族史、他克莫司使用、高血压病史、多囊肾病、急性排斥反应、乙型肝炎病毒感染和丙型肝炎病毒感染是肾移植后新发糖尿病的危险因素。因此,这些因素的临床意义值得关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42cf/7779280/5b4b27bae01d/JDI-12-109-g001.jpg

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