Clin Nephrol. 2021;96(1):114-118. doi: 10.5414/CNP96S20.
To find possible associations between new-onset diabetes after transplantation and polymorphisms in glucocorticoid pathway.
A total of 290 patients from our national cohort of kidney transplant patients with functioning graft transplanted in 6 consecutive years (2010 - 2015) were included in the study. All patients were genotyped for polymorphisms in genes coding for glucocorticoid receptor ( rs33389, rs6198 and rs33388), P-glycoprotein ( rs1045642, rs1128503, and rs2032582), and glutathione S-transferase P1 ( rs1695 and rs1138272). For interim analysis, clinical data were obtained from medical records for 79 patients.
22.8% of patients developed NODAT in the first post-transplant year. and polymorphisms were associated with an increased risk for NODAT. rs6198 polymorphism was associated with higher serum glucose at the end of the first post-transplant year.
The observed incidence of NODAT in the first post-transplant year is in accordance with the literature data. genotypes leading to decreased conjugation capacity were associated with higher probability of NODAT. As these polymorphisms can be determined already before kidney transplantation, they can help planning early glucocorticoid withdrawal if a favorable post-transplant course permits it.
探讨糖皮质激素通路基因多态性与移植后新发糖尿病（NODAT）之间的可能关联。
本研究纳入了 290 名在连续 6 年（2010-2015 年）期间接受同种异体肾移植且移植物功能正常的患者。所有患者均进行了糖皮质激素受体（rs33389、rs6198 和 rs33388）、P 糖蛋白（rs1045642、rs1128503 和 rs2032582）和谷胱甘肽 S-转移酶 P1（rs1695 和 rs1138272）编码基因多态性的基因分型。为了进行中期分析，从病历中获取了 79 名患者的临床数据。
22.8%的患者在移植后第一年发生 NODAT。rs1045642、rs1128503、rs2032582、rs1695 和 rs1138272 多态性与 NODAT 风险增加相关。rs6198 多态性与移植后第一年结束时的血清葡萄糖水平升高相关。
观察到的移植后第一年 NODAT 的发生率与文献数据一致。导致结合能力降低的基因型与 NODAT 的发生概率增加相关。由于这些多态性在肾移植前即可确定，因此如果移植后情况良好，可以帮助计划早期停用糖皮质激素。
