Hu Wei-Syun, Lin Cheng-Li
School of Medicine, College of Medicine, China Medical University, Taichung, 40402, Taiwan.
Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung, 40447, Taiwan.
Naunyn Schmiedebergs Arch Pharmacol. 2025 Aug 13. doi: 10.1007/s00210-025-04496-y.
This study examined patients who underwent solid organ transplantation (SOT) within a large healthcare system in Taiwan, with the objective of comparing the risks of adverse outcomes, specifically end-stage renal disease (ESRD) and mortality. The study aimed to assess whether type 2 diabetes mellitus (T2DM), occurring either before or after SOT, serves as a prognostic factor in this particular population. The study cohort comprised 3,675 non-T2DM patients, 2,261 patients with pre-existing T2DM, and 358 patients who developed T2DM post-SOT. Univariable and multivariable Cox proportional hazards regression models were employed to evaluate the impact of risk factors on the likelihood of developing ESRD or death, with results expressed as hazard ratios (HR) accompanied by 95% confidence intervals (CI). The group with pre-existing T2DM exhibited a higher risk of ESRD and mortality compared to the non-T2DM group (adjusted HR (aHR) = 2.14, 95% CI (1.44, 3.19); aHR = 1.37, 95% CI (1.12, 1.68)). Conversely, the post-SOT T2DM group did not demonstrate an increased risk of ESRD and mortality relative to the non-T2DM group (aHR = 0.95, 95% CI (0.45, 1.59); aHR = 1.23, 95% CI (0.93, 1.61)). Additionally, the risk of ESRD and death was elevated in the pre-existing T2DM group within the liver transplant cohort (aHR = 2.07, 95% CI (1.28, 3.35); aHR = 1.35, 95% CI (1.07, 1.71)). Pre-SOT T2DM may serve as a predictor of ESRD and all-cause mortality, particularly for those undergoing liver transplantation.
本研究对台湾一个大型医疗保健系统内接受实体器官移植（SOT）的患者进行了调查，目的是比较不良结局的风险，特别是终末期肾病（ESRD）和死亡率。该研究旨在评估SOT之前或之后发生的2型糖尿病（T2DM）是否是这一特定人群的预后因素。研究队列包括3675例非T2DM患者、2261例既往有T2DM的患者以及358例SOT后发生T2DM的患者。采用单变量和多变量Cox比例风险回归模型评估风险因素对发生ESRD或死亡可能性的影响，结果以风险比（HR）及95%置信区间（CI）表示。与非T2DM组相比，既往有T2DM的组发生ESRD和死亡的风险更高（调整后HR（aHR）=2.14，95%CI（1.44，3.19）；aHR=1.37，95%CI（1.12，1.68））。相反，SOT后T2DM组相对于非T2DM组并未显示出ESRD和死亡风险增加（aHR=0.95，95%CI（0.45，1.59）；aHR=1.23，95%CI（0.93，1.61））。此外，肝移植队列中既往有T2DM的组发生ESRD和死亡的风险升高（aHR=2.07，95%CI（1.28，3.35）；aHR=1.35，95%CI（1.07，1.71））。SOT前的T2DM可能是ESRD和全因死亡率的预测指标，尤其是对于接受肝移植的患者。
