Comparison of post-transplantation diabetes mellitus incidence and risk factors between kidney and liver transplantation patients

English version

Autoři: Vidit N. Munshi ^aff001; Soroush Saghafian ^aff002; Curtiss B. Cook ^aff003; K. Tuesday Werner ^aff003; Harini A. Chakkera ^aff003
Působiště autorů: PhD Program in Health Policy, Harvard University, Cambridge, Massachusetts, United States of America ^aff001; Harvard Kennedy School, Harvard University, Cambridge, Massachusetts, United States of America ^aff002; Mayo Clinic Arizona, Scottsdale, Arizona, United States of America ^aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0226873

Souhrn

Background

Most prior studies characterizing post-transplantation diabetes mellitus (PTDM) have been limited to single-cohort, single-organ studies. This retrospective study determined PTDM across organs by comparing incidence and risk factors among 346 liver and 407 kidney transplant recipients from a single center.

Methods

Univariate and multivariate regression-based analyses were conducted to determine association of various risk factors and PTDM in the two cohorts, as well as differences in glucometrics and insulin use across time points.

Results

There was a higher incidence of PTDM among liver versus kidney transplant recipients (30% vs. 19%) at 1-year post-transplant. Liver transplant recipients demonstrated a 337% higher odds association to PTDM (OR 3.37, 95% CI (1.38–8.25), p<0.01). 1-month FBG was higher in kidney patients (135 mg/dL vs 104 mg/dL; p < .01), while 1-month insulin use was higher in liver patients (61% vs 27%, p < .01). Age, BMI, insulin use, and inpatient FBG were also significantly associated with differential PTDM risk.

Conclusions

Kidney and liver transplant patients have different PTDM risk profiles, both in terms of absolute PTDM risk as well as time course of risk. Management of this population should better reflect risk heterogeneity to short-term need for insulin therapy and potentially long-term outcomes.

Klíčová slova:

Hyperglycemia – Insulin – Steroids – Kidneys – Glucose – Renal transplantation – Liver transplantation – diabetes mellitus

Zdroje

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