Endocrine disorders after heart transplantation: national cohort study

Autor: Bojan Vrtovec, Matej Rakusa, Andrej Janez, Gregor Poglajen, Mojca Jensterle
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Slovenia
Osteoporosis
Osteoporotic fractures
030209 endocrinology & metabolism
Heart transplantation
030230 surgery
Endocrine System Diseases
lcsh:Diseases of the endocrine glands. Clinical endocrinology
Hyperthyroidism
vitamin D deficiency
Cohort Studies
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Hypothyroidism
Internal medicine
medicine
Vitamin D and neurology
Humans
Hypoglycemic Agents
Endocrine system
Retrospective Studies
lcsh:RC648-665
Bone Density Conservation Agents
business.industry
Hypogonadism
Retrospective cohort study
General Medicine
Middle Aged
Vitamin D Deficiency
medicine.disease
Osteopenia
Transplantation
Bone Diseases
Metabolic
Diabetes Mellitus
Type 2
Endocrine disorders
Female
Hyperparathyroidism
Secondary
business
Multiple endocrine disorder
Research Article
Zdroj: BMC Endocrine Disorders
BMC Endocrine Disorders, Vol 20, Iss 1, Pp 1-10 (2020)
ISSN: 1472-6823
DOI: 10.1186/s12902-020-0533-6
Popis: Background Endocrine disorders in patients after heart transplantation (HT) remain understudied. We aimed to assess endocrine profiles and management of HT recipients in the early post- transplant period. Methods We conducted a retrospective cohort study on 123 consecutive HT recipients in the Advanced Heart Failure and Transplantation Programme between 2009 and 2018. All recipients had per-protocol endocrine follow-up within the first postoperative year. The median time to first post-transplant endocrine follow-up was 3 months (IQR 2–4). We assessed the incidence of vitamin D deficiency, bone mineral density, history of low energy fractures, hypogonadism in male recipients, posttransplant diabetes mellitus, and thyroid and parathyroid function. Results We enrolled 22 women and 101 men of median age 57 years (IQR 50–63). Post-transplant diabetes mellitus developed in 14 patients (11.4%). 18 of 25 patients (14.6%) with preexisting type 2 diabetes mellitus required intensification of antidiabetic therapy. 38 male patients (40.4%) had hypogonadism. 5 patients (4.6%) were hypothyroid and 10 (9.3%) latent hyperthyroid. Secondary hyperparathyroidism was present in 19 (17.3%), 25-hydroxyvitamin D deficiency in 64 (54.7%) of patients. Osteoporosis was present in 26 (21.1%), osteopenia in 59 (48.0%) patients. 47 vertebral fractures, 3 hip and 1 humerus fractures occurred in 21 patients. Most of the patients had coincidence of two or three disorders, while less than 5% did not have any endocrine irregularities. All patients received calcium and vitamin D supplements. Forty-six patients (37.4%) were treated with zoledronic acid, 12 (9.8%) with oral bisphosphonates. Two patients were treated with teriparatide. Conclusions The prevalence of multiple endocrine disorders early after heart transplantation is high. Assessment and management of increased fracture risk and all other potentially affected endocrine axes should be considered as a standard of care in this early period.
Databáze: OpenAIRE
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