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台湾实体器官移植后发生移植后糖尿病的风险:一项基于人群的队列研究。

Risk of Incident Post-Transplantation Diabetes Mellitus After Solid Organ Transplantation in Taiwan: A Population-Based Cohort Study.

作者信息

Tai Chih-Jaan, Huang Kuang-Hua, Wang Jiun-Yi, Gau Shuo-Yan, Huang Shiang-Wen, Su Kun-Yu, Tsai Tung-Han, Wu Chun-Nan, Lee Chien-Ying

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 404327, Taiwan.

School of Medicine, China Medical University, Taichung 404328, Taiwan.

出版信息

Healthcare (Basel). 2025 Feb 27;13(5):523. doi: 10.3390/healthcare13050523.

Abstract

Solid organ transplant (SOT) recipients have an elevated risk of diabetes mellitus (DM). This study investigated the risk of posttransplant DM (PTDM) in a retrospective cohort study. We analyzed patients aged over 18 years who received an SOT between 2002 and 2013. Each patient was matched with four control individuals by age, sex, insured salary, urbanization level, Charlson's comorbidity index (CCI), and year of inclusion in the study. After matching, the study comprised 6874 patients who underwent an SOT and 27,496 matched general patients as the comparison. The risk of DM among the SOT recipients was assessed using a Cox proportional hazards model after adjustment for all relevant variables. The SOT cohort had a significantly higher risk of DM than general patients (adjusted hazard ratio [aHR], 1.61; 95% confidence interval [CI], 1.51-1.72). Kidney and liver recipients, respectively, had DM incidence rates 1.57 (95% CI, 1.46-1.70) and 1.73 (95% CI, 1.53-1.94) times that of the general patients. SOT recipients had an elevated risk of DM. Among various organ recipients, liver recipients had the highest PTDM risk. Kidney and liver recipients demonstrated the highest DM risk at 6 months after their SOT. The risk of PTDM following an SOT may result in long-term consequences. Hence, we advise the critical need for proper management to mitigate related complications after transplantation.

摘要

实体器官移植(SOT)受者患糖尿病(DM)的风险较高。本研究在一项回顾性队列研究中调查了移植后糖尿病(PTDM)的风险。我们分析了2002年至2013年间接受SOT的18岁以上患者。根据年龄、性别、参保工资、城市化水平、查尔森合并症指数(CCI)和纳入研究的年份,为每位患者匹配了四名对照个体。匹配后,该研究包括6874例接受SOT的患者和27496例匹配的普通患者作为对照。在对所有相关变量进行调整后,使用Cox比例风险模型评估SOT受者中DM的风险。SOT队列患DM的风险显著高于普通患者(调整后风险比[aHR],1.61;95%置信区间[CI],1.51 - 1.72)。肾移植和肝移植受者的DM发病率分别是普通患者的1.57倍(95%CI,1.46 - 1.70)和1.73倍(95%CI,1.53 - 1.94)。SOT受者患DM的风险较高。在各种器官受者中,肝移植受者的PTDM风险最高。肾移植和肝移植受者在SOT后6个月时DM风险最高。SOT后PTDM的风险可能会导致长期后果。因此,我们建议迫切需要进行适当管理,以减轻移植后的相关并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/194e/11898666/d990a7599f29/healthcare-13-00523-g001.jpg

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