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实体器官移植受者中的移植后糖尿病。

Posttransplantation Diabetes Mellitus Among Solid Organ Recipients in a Danish Cohort.

机构信息

Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Department of Nephrology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

出版信息

Transpl Int. 2022 Apr 5;35:10352. doi: 10.3389/ti.2022.10352. eCollection 2022.

Abstract

Post-transplant diabetes mellitus (PTDM) is associated with a higher risk of adverse outcomes. We aimed to describe the proportion of patients with diabetes prior to solid organ transplantation (SOT) and post-transplant diabetes mellitus (PTDM) in three time periods (early-likely PTDM: 0-45 days; 46-365 days and >365 days) post-transplant and to estimate possible risk factors associated with PTDM in each time-period. Additionally, we compared the risk of death and causes of death in patients with diabetes prior to transplant, PTDM, and non-diabetes patients. A total of 959 SOT recipients (heart, lung, liver, and kidney) transplanted at University Hospital of Copenhagen between 2010 and 2015 were included. The highest PTDM incidence was observed at 46-365 days after transplant in all SOT recipients. Age and the Charlson Comorbidity Index (CCI Score) in all time periods were the two most important risk factors for PTDM. Compared to non-diabetes patients, SOT recipients with pre-transplant diabetes and PTDM patients had a higher risk of all-cause mortality death (aHR: 1.77, 95% CI: 1.16-2.69 and aHR: 1.89, 95% CI: 1.17-3.06 respectively). Pre-transplant diabetes and PTDM patients had a higher risk of death due to cardiovascular diseases and cancer, respectively, when compared to non-diabetes patients.

摘要

移植后糖尿病(PTDM)与不良结局的风险增加相关。我们旨在描述三个时间段(早期可能的 PTDM:0-45 天;46-365 天和>365 天)移植后实体器官移植(SOT)前和移植后糖尿病(PTDM)患者的比例,并估计每个时间段与 PTDM 相关的可能危险因素。此外,我们比较了移植前糖尿病、PTDM 和非糖尿病患者的死亡风险和死亡原因。共纳入了 2010 年至 2015 年在哥本哈根大学医院接受心脏、肺、肝和肾 SOT 的 959 名患者。所有 SOT 受者中,移植后 46-365 天 PTDM 发生率最高。在所有时间段中,年龄和 Charlson 合并症指数(CCI 评分)都是 PTDM 的两个最重要的危险因素。与非糖尿病患者相比,移植前糖尿病和 PTDM 患者的全因死亡率死亡风险更高(aHR:1.77,95%CI:1.16-2.69 和 aHR:1.89,95%CI:1.17-3.06)。与非糖尿病患者相比,移植前糖尿病和 PTDM 患者死于心血管疾病和癌症的风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/450c/9016119/ab6b117d763a/ti-35-10352-g001.jpg

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