The combined effect of pre-transplant triglyceride levels and the type of calcineurin inhibitor in predicting the risk of new onset diabetes after renal transplantation
| Autor: | Domingo Hernández, Patricia Delgado, Esteban Porrini, María Dolores Checa, Eduardo Salido, Marian Cobo, José J. García, Armando Torres, Luis Hortal, Adelaida Morales, L. Perez, Alejandra Alvarez, José Manuel González-Posada, Roberto Gallego |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Graft Rejection
Male medicine.medical_specialty Time Factors medicine.medical_treatment Calcineurin Inhibitors Population Methylprednisolone Gastroenterology Tacrolimus Insulin resistance Risk Factors Internal medicine Diabetes mellitus Diabetes Mellitus medicine Humans Risk factor education Glucocorticoids Triglycerides Retrospective Studies Hypertriglyceridemia Transplantation education.field_of_study business.industry Calcineurin Incidence Insulin Middle Aged Prognosis medicine.disease Kidney Transplantation Endocrinology Spain Nephrology Cyclosporine Female Insulin Resistance business Biomarkers Immunosuppressive Agents Follow-Up Studies |
| Zdroj: | Nephrology Dialysis Transplantation. 23:1436-1441 |
| ISSN: | 1460-2385 0931-0509 |
| Popis: | Background. Insulin resistance precedes overt diabetes in the general population and hypertriglyceridemia is a reliable marker of the disorder. Thus, patients in the waiting list with hypertriglyceridemia may be at risk for new-onset diabetes after transplantation (NODAT). Objectives. We investigate whether pre-transplant triglyceride (TG) levels are a risk factor for NODAT and whether they exert a combined effect with the type of calcineurin inhibitor (CNI). Methods. We analysed 314 consecutive non-diabetic recipients [215 cyclosporine A (CsA); 99 tacrolimus (Tacro)] transplanted between 1999 and 2003 with a mean follow-up of 34 months. Outcome was NODAT defined by ADA criteria. Results. NODAT developed in 81 recipients (25.8%). Multivariate analysis which included a propensity score for factors determining CNI allocation showed that age (OR: 1.06; 95% CI: 1.03-1.09), pre-transplant BMI (OR: 1.1; 95% CI: 1.02-1.17),TG levels (OR: 1.3 per 50 mg/dl increment, 95% CI: 1.07-1.6) and treated acute rejection (OR: 4.8, 95% CI: 3-11), but not the type of CNI, were independent risk factors for NODAT. A significant interaction between pre-transplant TG and type of CNI was observed. Using CsA as the reference, the combination of Tacro plus pre-transplant hypertriglyceridemia (≥200 mg/dl) showed an OR of 3.26 (1.4-7.8) to develop NODAT, contrasting with an OR of 0.75 (0.34-1.6) in Tacro recipients with pre-transplant TG levels |
| Databáze: | OpenAIRE |
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