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肾移植后新发糖尿病及其相关因素。

New-onset Diabetes after Renal Transplant and Associated Factors.

机构信息

Department of Nephrology, Zayed Hospital, Lahore, Pakistan.

出版信息

J Coll Physicians Surg Pak. 2021 Dec;31(12):1482-1486. doi: 10.29271/jcpsp.2021.12.1482.

Abstract

OBJECTIVE

To assess the frequency and time of onset of new-onset diabetes after transplant (NODAT) and its associated factors.

STUDY DESIGN

Observational study.

PLACE AND DURATION OF STUDY

Department of Nephrology, Bahria International Hospital, Lahore, Pakistan, from April 2016 to April 2018.

METHODOLOGY

NODAT was diagnosed according to American Diabetes Association Criteria with fasting plasma glucose >126 mg/dl or random plasma glucose >200 mg/dl. Those with pre-existing diabetes and follow-up duration less than 12months, were excluded. Patients were divided in two groups: with and without NODAT, for statistical comparison.

RESULTS

The study included 115 patients, 101 were males and the median age was 35.0 (29.0-46.0) years. During the one-year period of follow-up, 28 (24.3%) patients developed NODAT. The mean time of onset of NODAT was 5.3 ± 3.6 months. Family history of diabetes was positive in 46% patients in NODAT group, which was significantly higher as compared to 5.7% in non-NODAT group with p-value of <0.001, which is significant. All patients with more than three HLA mismatches developed NODAT. The mean fasting glucose levels (FPG) before transplant in NODAT group was 96.6 ± 15.4 mg/dl, which was significantly higher than FPG of non-NODAT group, where it was 80.5 ± 12.2 mg/dl. It was interesting to note that 35.7% of hepatitis patients developed NODAT as compared to 6 % in non-NODAT group with p =  0.001.

CONCLUSION

NODAT was observed in 24.3% patients. The pre-transplant FPG, family history of diabetes, increased HLA mismatches, and hepatitis C infection were the major associated factors. Key Words: New onset diabetes after transplant, Fasting plasma glucose, Renal transplant.

摘要

目的

评估移植后新发糖尿病(NODAT)的发生频率和时间及其相关因素。

研究设计

观察性研究。

研究地点和时间

巴基斯坦拉合尔的巴里亚国际医院肾病科,2016 年 4 月至 2018 年 4 月。

方法

根据美国糖尿病协会标准,空腹血糖>126mg/dl 或随机血糖>200mg/dl 诊断 NODAT。排除有既往糖尿病和随访时间<12 个月的患者。将患者分为两组:有 NODAT 和无 NODAT,进行统计学比较。

结果

本研究共纳入 115 例患者,其中 101 例为男性,中位年龄为 35.0(29.0-46.0)岁。在为期一年的随访期间,28 例(24.3%)患者发生 NODAT。NODAT 的平均发病时间为 5.3±3.6 个月。NODAT 组有 46%的患者有糖尿病家族史,明显高于非 NODAT 组的 5.7%(p<0.001),差异有统计学意义。所有 HLA 错配超过 3 个的患者均发生 NODAT。NODAT 组移植前空腹血糖(FPG)水平为 96.6±15.4mg/dl,明显高于非 NODAT 组的 80.5±12.2mg/dl。有趣的是,35.7%的肝炎患者发生 NODAT,而非 NODAT 组为 6%(p=0.001)。

结论

本研究中 24.3%的患者发生了 NODAT。移植前 FPG、糖尿病家族史、HLA 错配增加和丙型肝炎感染是主要的相关因素。关键词:移植后新发糖尿病;空腹血糖;肾移植。

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