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肝移植术后患者血清三酰甘油水平预测新发糖尿病风险。

Postoperative serum triglyceride levels in predicting risk of new-onset diabetes mellitus in patients following liver transplantation.

机构信息

Department of Gastroenterology.

出版信息

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2021 Apr 25;50(2):239-244. doi: 10.3724/zdxbyxb-2021-0114.

Abstract

To investigate the postoperative serum triglyceride (TG) levels in predicting the risk of new-onset diabetes mellitus (NODM) in patients following allogeneic liver transplantation. One hundred and forty three patients undergoing allogeneic liver transplantation in Shanghai General Hospital from July 2007 to July 2014 were enrolled in this study. The NODM developed in 33 patients after liver transplantation. The curve of dynamic TG levels in the early period after liver transplantation was generated. Independent risk factors of NODM were determined by univariate and multivariant logistic regression analyses. The clinical value of TG in predicting NODM was analyzed by area under the ROC curve (AUC). Serum TG levels were gradually rising in the first week and then reached the plateau phase (stable TG, sTG) in patients after surgery. The sTG in NODM group were significantly higher than that in non-NODM group (=-2.31, <0.05). Glucocorticoid therapy (=4.054, <0.01), FK506 drug concentration in the first week after operation (=3.482, <0.05) and sTG (=3.156, <0.05) were independent risk factors of NODM. ROC curve analysis showed that the AUC of sTG in predicting NODM was 0.72. TG shows a gradual recovery process in the early period after liver transplantation, and the higher TG level in stable phase may significantly increase the risk of NODM in patients.

摘要

为了探讨肝移植术后血清三酰甘油(TG)水平对新发糖尿病(NODM)的预测价值。本研究纳入了 2007 年 7 月至 2014 年 7 月在上海交通大学附属第一人民医院行同种异体肝移植的 143 例患者。其中术后发生 NODM 的患者有 33 例。生成了肝移植后早期 TG 水平的动态曲线。采用单因素和多因素逻辑回归分析确定 NODM 的独立危险因素。通过 ROC 曲线下面积(AUC)分析 TG 预测 NODM 的临床价值。术后患者的血清 TG 水平在第 1 周逐渐升高,然后达到平台期(稳定 TG,sTG)。NODM 组的 sTG 明显高于非 NODM 组(=-2.31,<0.05)。糖皮质激素治疗(=4.054,<0.01)、术后第 1 周 FK506 药物浓度(=3.482,<0.05)和 sTG(=3.156,<0.05)是 NODM 的独立危险因素。ROC 曲线分析表明,sTG 预测 NODM 的 AUC 为 0.72。TG 在肝移植后早期呈现逐渐恢复的过程,稳定期较高的 TG 水平可能显著增加患者发生 NODM 的风险。

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