Division of Gastroenterology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Division of Gastroenterology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Transpl Int. 2022 Feb 7;35:10023. doi: 10.3389/ti.2022.10023. eCollection 2022.
This retrospective study aimed to investigate the effect of diabetes mellitus (DM) on the risks of end-stage kidney disease (ESKD) and post-liver transplantation (post-LT) mortality. Using data from the National Health Insurance Research Database, Taiwan, 3,489 patients who received a LT between 1 January 2005, and 31 December 2015, were enrolled in this study and divided into the pre-existing DM, post-LT DM (PLTDM), and without DM groups. All subjects were followed up from 1 year after LT to the index date for ESKD, and the occurrence of death, or until 31 December 2016. Of the 3,489 patients with LT, 1,016 had pre-existing DM, 215 had PLTDM, and 2,258 had no DM pre- or post-LT. The adjusted HRs of ESKD were 1.77 (95% Confidence Interval [CI], .78-3.99) and 2.61 (95% CI, 1.63-4.18) for PLTDM group and pre-existing DM group compared to without DM group, respectively. For the risk of death, the adjusted HRs were 1.05 (95% CI, .72-1.55) and 1.28 (95% CI, 1.04-1.59) for PLTDM group and pre-existing DM group compared to those without DM group, respectively. The sensitivity analysis for the risk of ESKD and death also revealed the consistent result. Pre-existing DM has significant increase the risk of post-LT ESKD and mortality. The role of PLTDM should be explored to explain postoperative morbidity and mortality.
本回顾性研究旨在探讨糖尿病（DM）对终末期肾病（ESKD）和肝移植后（post-LT）死亡率风险的影响。利用来自台湾全民健康保险研究数据库的数据，共纳入了 3489 名于 2005 年 1 月 1 日至 2015 年 12 月 31 日期间接受肝移植的患者，并将他们分为存在 DM 病史组、post-LT DM（PLTDM）组和无 DM 组。所有患者均从肝移植后 1 年开始随访至 ESKD 发病日期或随访至 2016 年 12 月 31 日。3489 名接受肝移植的患者中，有 1016 名存在 DM 病史，215 名患有 PLTDM，2258 名患者无 DM 病史。与无 DM 组相比，PLTDM 组和存在 DM 病史组发生 ESKD 的调整后的 HR 分别为 1.77（95%置信区间 [CI]，.78-3.99）和 2.61（95% CI，1.63-4.18）。对于死亡风险，PLTDM 组和存在 DM 病史组调整后的 HR 分别为 1.05（95% CI，.72-1.55）和 1.28（95% CI，1.04-1.59）。ESKD 和死亡风险的敏感性分析也显示了一致的结果。存在 DM 病史显著增加 post-LT ESKD 和死亡率的风险。PLTDM 的作用应进一步探讨，以解释术后发病率和死亡率。
