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成人肝移植受者移植后糖尿病的发病率及危险因素

Posttransplant Diabetes Mellitus Incidence and Risk Factors in Adult Liver Transplantation Recipients.

作者信息

Gulsoy Kirnap N, Kirnap M, Alshalabi O, Tutuncu N B, Haberal M

机构信息

Baskent University, Faculty of Medicine - Endocrinology and Metabolism, Ankara, Turkey.

Baskent University, Faculty of Medicine - General Surgery, Ankara, Turkey.

出版信息

Acta Endocrinol (Buchar). 2020 Oct-Dec;16(4):449-453. doi: 10.4183/aeb.2020.449.

Abstract

AIM

Posttransplant diabetes mellitus (PTDM) is a metabolic complication that usually occurs after liver transplantation (LT) due to immunosuppression. In this study, our aim was to identify PTDM incidence after LT in our center and the potential risk factors.

MATERIALS AND METHODS

In this study, 238 adult LT patients were evaluated in terms of PTDM development.

RESULTS

Of 238 patients included in the study, 170 (71.4%) were male, 68 (28.6%) were female and the mean age was 43.5± 13.7 years. Of all patients, PTDM developed in 24 (10.1%). Transient-Hyperglycemia (t-HG) was detected in 31 (13%) patients. PTDM and t-HG patients had a greater body weight than non-PTDM patients (BMI kg/m: 27.6± 5.3, 25.8± 4.3and 23.9± 3.3, respectively p<0.001 p= 0.028). PTDM and t-HG patients mean age was higher than non-PTDM patients (51.5± 9.68, 48.2± 11.1 and 41.5± 14 years, respectively, p= 0.002 p= 0.023). In the univariate analysis, the only independent risk factor for PTDM was age (OR 1.93, 95% CI 1.31-2.97).

CONCLUSION

Age is the most important risk factor for PTDM development after LT. PTDM was found more common in the patient group with greater body weight. Patients with older age and greater body weight should be examined more carefully for PTDM before LT.

摘要

目的

移植后糖尿病(PTDM)是一种代谢并发症,通常因免疫抑制发生于肝移植(LT)后。本研究旨在确定本中心肝移植后PTDM的发生率及潜在危险因素。

材料与方法

本研究对238例成年肝移植患者的PTDM发生情况进行了评估。

结果

纳入研究的238例患者中,男性170例(71.4%),女性68例(28.6%),平均年龄为43.5±13.7岁。所有患者中,24例(10.1%)发生了PTDM。31例(13%)患者检测到短暂性高血糖(t-HG)。PTDM和t-HG患者的体重高于非PTDM患者(体重指数kg/m:分别为27.6±5.3、25.8±4.3和23.9±3.3,p<0.001,p=0.028)。PTDM和t-HG患者的平均年龄高于非PTDM患者(分别为51.5±9.68、48.2±11.1和41.5±14岁,p=0.002,p=0.023)。单因素分析中,PTDM的唯一独立危险因素是年龄(比值比1.93,95%置信区间1.31-2.97)。

结论

年龄是肝移植后发生PTDM的最重要危险因素。PTDM在体重较大的患者组中更常见。年龄较大且体重较大的患者在肝移植前应更仔细地检查是否患有PTDM。

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本文引用的文献

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Exp Clin Transplant. 2017 Mar;15(Suppl 2):55-58. doi: 10.6002/ect.TOND16.L14.
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Liver Transpl. 2016 Aug;22(8):1129-35. doi: 10.1002/lt.24462.
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Nat Rev Gastroenterol Hepatol. 2015 Nov;12(11):639-48. doi: 10.1038/nrgastro.2015.172. Epub 2015 Oct 13.

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