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哥伦比亚一家高复杂性大学医院20年经验:肾移植后新发糖尿病的相关危险因素

Risk Factors Related to New-Onset Diabetes after Renal Transplantation in Patients of a High Complexity University Hospital in Colombia, 20 Years of Experience.

作者信息

Guzmán Guillermo E, Victoria Angela M, Ramos Isabella, Maldonado Alejandro, Manzi Eliana, Contreras-Valero Juan F, Mesa Liliana, Schweineberg Johanna, Posada Juan G, Villegas Jorge I, Caicedo Luis A, Durán Carlos E

机构信息

Fundación Valle del Lili, Departamento de Endocrinología, Cra 98, No. 18-49, Cali 760032, Colombia.

Universidad Icesi, Facultad de Ciencias de la Salud, Calle 18, No. 122-135, Cali, Colombia.

出版信息

Int J Endocrinol. 2020 Aug 30;2020:8297192. doi: 10.1155/2020/8297192. eCollection 2020.

Abstract

INTRODUCTION

New-onset diabetes after transplantation (NODAT) is associated with immunosuppression. Its complications can negatively influence patients' quality of life, which is why it is important to study the associated risk factors and expand the possible therapies in this particular group of patients. . Case-control study nested in a retrospective cohort. It included patients who received kidney transplantation at the high complexity University Hospital Fundación Valle del Lili in Cali, Colombia, between 1995 and 2014. Two controls were assigned for each case, depending on the type of donor and the date of the surgery. Information was collected from clinical records and the institutional TRENAL registry. We carried out a descriptive analysis of the selected variables and identified the risk factors with conditional logistic regression.

RESULTS

122 cases were identified to which 224 controls were assigned. The median age was 44 years (IQR: 34-55), and 54% were men. Having >50 years of age at the time of transplantation (OR: 3.18, 95% CI: 1.6-6.3, = 0.001), body mass index >30 kg/m (OR: 3.6, 95% CI: 1.3-9.7, = 0.010) and being afro-descendant (OR: 2.74, 95% CI: 1.1-6.5, = 0.023) were identified as risk factors for the development of NODAT. Pretransplant fasting plasma glucose >100 mg/dl (OR: 2.9, 95% CI: 1.4-6.4, = 0.005) and serum triglycerides >200 mg/dl (OR: 2.5, 95% CI: 1.4-4.4, = 0.002) were also reported as independent risk factors.

CONCLUSION

We ratify some risk factors for the development of this important disease, which include certain modifiable characteristics. Interventions aimed at changes in lifestyle could be established in a timely manner before transplant surgery.

摘要

引言

移植后新发糖尿病(NODAT)与免疫抑制相关。其并发症会对患者的生活质量产生负面影响,这就是研究相关危险因素并拓展针对这一特定患者群体的可能治疗方法为何重要的原因。

嵌套于回顾性队列中的病例对照研究。研究对象包括1995年至2014年间在哥伦比亚卡利市高复杂性的瓦莱德尔利利基金会大学医院接受肾脏移植的患者。根据供体类型和手术日期,为每个病例分配两名对照。从临床记录和机构肾脏登记处收集信息。我们对选定变量进行了描述性分析,并通过条件逻辑回归确定了危险因素。

结果

共确定了122例病例,并为其分配了224名对照。中位年龄为44岁(四分位间距:34 - 55岁),54%为男性。移植时年龄>50岁(比值比:3.18,95%置信区间:1.6 - 6.3,P = 0.001)、体重指数>30 kg/m²(比值比:3.6,95%置信区间:1.3 - 9.7,P = 0.010)以及为非洲裔(比值比:2.74,95%置信区间:1.1 - 6.5,P = 0.023)被确定为发生NODAT的危险因素。移植前空腹血糖>100 mg/dl(比值比:2.9,95%置信区间:1.4 - 6.4,P = 0.005)和血清甘油三酯>200 mg/dl(比值比:2.5,95%置信区间:1.4 - 4.4,P = 0.002)也被报告为独立危险因素。

结论

我们证实了这种重要疾病发生的一些危险因素,其中包括某些可改变的特征。可在移植手术前及时采取旨在改变生活方式的干预措施。

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本文引用的文献

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Diabetes Care. 2020 Jan;43(Suppl 1):S14-S31. doi: 10.2337/dc20-S002.
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New-onset Diabetes Mellitus After Kidney Transplantation-A Paired Kidney Analysis.肾移植术后新发糖尿病——配对肾脏分析
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Clinical evolution of post-transplant diabetes mellitus.移植后糖尿病的临床演变
Nephrol Dial Transplant. 2016 Mar;31(3):495-505. doi: 10.1093/ndt/gfv368. Epub 2015 Nov 3.
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Outcomes in obese kidney transplant recipients.肥胖肾移植受者的预后。
Transplant Proc. 2014 Dec;46(10):3416-9. doi: 10.1016/j.transproceed.2014.09.112.

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