The impact of new onset diabetes on cardiovascular risks in orthotopic liver transplant recipients: findings from the COLT study.

Autor: Caturano A; Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, I-80138, Italy. alfredo.caturano@unicampania.it.; Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, I-80138, Italy. alfredo.caturano@unicampania.it.; Department of Internal Medicine, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic. alfredo.caturano@unicampania.it., di Martino A; Unit of Hepatology and Interventional Ultrasonography, Department of Internal Medicine, OORR Area Stabiese, Gragnano, 80054, Italy., Albanese G; Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, I-80138, Italy., Coppola C; Unit of Hepatology and Interventional Ultrasonography, Department of Internal Medicine, OORR Area Stabiese, Gragnano, 80054, Italy., Russo V; Department of Biology, College of Science and Technology, Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, PA, USA.; Division of Cardiology, Department of Medical Translational Sciences, University of Campania Luigi Vanvitelli, Naples, Italy., Koudelková K; Department of Internal Medicine, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic.; Team MetaDiab, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France., Galiero R; Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, I-80138, Italy., Rinaldi L; Department of Medicine and Health Sciences 'Vincenzo Tiberio', Università degli Studi del Molise, Campobasso, 86100, Italy. luca.rinaldi@unimol.it., Sardu C; Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, I-80138, Italy., Marrone A; Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, I-80138, Italy., Monda M; Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, I-80138, Italy., Marfella R; Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, I-80138, Italy., Gojda J; Department of Internal Medicine, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic., Sasso FC; Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, I-80138, Italy., Salvatore T; Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, I-80138, Italy.
Jazyk: angličtina
Zdroj: Acta diabetologica [Acta Diabetol] 2024 Nov 11. Date of Electronic Publication: 2024 Nov 11.
DOI: 10.1007/s00592-024-02406-x
Abstrakt: Background: Orthotopic liver transplantation (OLT) has greatly improved short-term survival for end-stage liver disease. However, cardiovascular events (CVE) still pose a significant threat to long-term post-transplant health. Aim of this study is to assess the occurrence of long-term cardiovascular events and whether it relates to new-onset diabetes after liver transplantation (NODALT).
Methods: We conducted a multicentric retrospective analysis of adult OLT recipients with regular follow-up visits spanning from January 1995 to December 2020. Data collection included anamnestic, clinical, anthropometric, and laboratory data from two centers. NODALT was diagnosed following ADA guidelines. The primary outcome was incident CVE (a composite of fatal and non-fatal stroke and myocardial infarction). CVE occurrence was analyzed in relation to NODALT diagnosis, along with clinical characteristics associated with its development.
Results: Ninety-three eligible Caucasian patients, with a median age of 57.0 years (IQR: 49.0-62.0, 69.9% male), were enrolled. Over the median follow-up period of 100.5 months, 29 patients (31.2%) developed NODALT, and 14 patients (15.1%) developed any CVE, with 9 being in the NODALT group. A significant association between NODALT and cardiovascular complications was confirmed by both generalized estimating equation (OR 5.31; 95% CI 1.59-17.72, p = 0.006) and Kaplan-Meier analysis (log-rank = 0.046). Metabolic syndrome and impaired fasting glucose were identified as baseline risk factors for the incident NODALT (OR 5.75; 95% CI 1.44-22.92, p = 0.013 and OR 7.29; 95% CI 1.46-36.41, p = 0.015, respectively).
Conclusions: Post-OLT cardiovascular events are less frequent than previously reported but are notably linked to NODALT, highlighting the interplay between metabolic syndrome and impaired fasting glucose.
Competing Interests: Declarations Conflict of interest The authors declare no conflict of interest. Ethical approval Our research adhered to the ethical principles outlined in the Declaration of Helsinki and followed Good Clinical Practice guidelines. Approval for the study protocol was obtained from the local Ethics Committee (University of Campania “Luigi Vanvitelli”, Azienda Ospedaliera Universitaria, “Luigi Vanvitelli”, Azienda Ospedaliera di Rilievo Nazionale “Ospedale dei Colli”; approval ID. 12771/i; approval date 2 May 2023). Prior to enrollment, all patients provided written informed consent. Consent for publication All authors had access to the study data, participated in the review process, and provided approval for the final manuscript.
(© 2024. Springer-Verlag Italia S.r.l., part of Springer Nature.)
Databáze: MEDLINE
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