Analysis of predictive factors associated with the reversibility of post-transplantation diabetes mellitus
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摘要:
目的 探讨肝移植术后糖尿病(post-transplantation diabetes mellitus, PTDM)的可逆性预测因子。 方 法 回顾性分析中山大学附属第三医院肝移植中心2004年4月至2009年6月实施肝移植的618例患者的临床资料,最终纳入研究190例。根据其高血糖状态是否为持续性分为可逆性PTDM组和不可逆性PTDM组。对可能影响两组患者糖代谢情况的术前资料(年龄、性别、体重指数、术前空腹血糖、肝硬化病史、高血压病史)和术后资料(排斥反应、激素用量、钙神经蛋白抑制剂的选择)进行单因素统计学分析。 结果 102例患者的PTDM是可逆的,占69.9%,与不可逆组相比,可逆组患者年龄较轻[(43±11)比(52±10)岁,P<0.05],其余相关因素差异无统计学意义(P>0.05)。 结论 患者接受器官移植时的年龄是PTDM可逆性的预测因子。 Abstract:Objective To investigate the predictive factors associated with the reversibility of post-transplantation diabetes mellitus(PTDM). Method Clinical data of 618 patients who underwent liver transplantation from April 2004 to June 2009 in the Liver Transplantation Center of the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed, in which 190 patients were included in the study. According to the persistence of hyperglycemia, patients were divided into two groups: reversible PTDM group and irreversible PTDM group. Preoperative data (age, gender, body mass index, pre-transplantation fasting plasma glucose, liver cirrhosis history, hypertension history) and postoperative data (rejection, dose of glucocorticoid, choice of calcineurin inhibitor) which might affect the glycometabolism of patients between two groups were analyzed by univariate factor analysis. Result PTDM in 102 patients (69.9%) was reversible. Compared with irreversible PTDM group, age of patients was younger in reversible PTDM group[(43±11)years old vs. (52±10)years old, P<0.05]. And there was no significant difference in the other factors(all in P>0.05). Conclusion Age of patients received organ transplantation is the predictive factor associated with the reversibility of PTDM. -
Key words:
- Post-transplantation diabetes mellitus /
- Reversibility /
- Predictive factor /
- Age
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表 1 两组PTDM患者的临床资料比较(计数资料)
Table 1. Comparison of clinical data of PTDM patients between two groups(count data)
项目 可逆组(n=102) 不可逆组(n=44) χ2值 P值 性别(男性) 90 42 1.848 0.174 术前肝硬化病史 75 30 0.324 0.569 术前高血压病史 8 6 1.190 0.275 术后排斥反应 8 5 0.470 0.493 应用大剂量激素 52 27 1.335 0.248 应用CNI(含FK506) 92 43 2.503 0.114 表 2 两组PTDM患者的临床资料比较(计量资料)
Table 2. Comparison of clinical data of PTDM patients between two groups(measurement data)
项目 可逆组(n=102) 不可逆组(n=44) t值 P值 平均年龄(岁) 43±11 52±10 -0.875 <0.05 体重指数(kg/m2) 23±3 24±4 -1.616 0.228 术后空腹血糖(mmol/L) 4.5±1.2 5.3±1.3 -3.609 0.271 -
[1] Moon JI, Barbeito R, Faradji RN, et al. Negative impact of new-onset diabetes mellitus on patient and graft survival after liver transplantation: long-term follow up[J]. Transplantation,2006,82(12):1625-1628. doi: 10.1097/01.tp.0000250361.60415.96 [2] Bodziak KA, Hricik DE. New-onset diabetes mellitus after solid organ transplantation[J]. Transpl Int,2009,22(5):519-530. doi: 10.1111/j.1432-2277.2008.00800.x [3] Prokai A, Fekete A, Pasti K, et al. The importance of different immunosuppressive regimens in the development of posttransplant diabetes mellitus[J]. Pediatr Diabetes,2012,13(1):81-91. doi: 10.1111/pedi.2012.13.issue-1 [4] 范连慧,刘龙,向军,等.肾移植术后新发糖尿病危险因素分析[J].器官移植,2011,2(5):273-275,279. http://www.organtranspl.com/browse/detail/qkid/54/id/525.htmlFan LH, Liu L,Xiang J, et al. Analysis of risk factors for new-onset diabetes mellitus after renal transplantation[J]. Organ Transplant, 2011, 2(5):273-275,279. http://www.organtranspl.com/browse/detail/qkid/54/id/525.html [5] Perkins JD. Reversibility of posttransplantation diabetes mellitus following liver transplantation[J]. Liver Transpl,2009,15(11):1631-1632. doi: 10.1002/lt.v15:11 [6] Davidson J, Wilkinson A, Dantal J, et al. New-onset diabetes after transplantation: 2003 international consensus guidelines. proceedings of an international expert panel meeting. Barcelona, Spain, 19 February 2003[J]. Transplantation,2003,75(10 Suppl):SS3-SS24. http://cn.bing.com/academic/profile?id=157250738&encoded=0&v=paper_preview&mkt=zh-cn [7] Wilkinson A, Davidson J, Dotta F, et al. Guidelines for the treatment and management of new-onset diabetes after transplantation[J]. Clin Transplant,2005,19(3):291-298. doi: 10.1111/ctr.2005.19.issue-3 [8] Gomes MB, Cobas RA. Post-transplant diabetes mellitus[J]. Diabetol Metab Syndr,2009,1(1):14. doi: 10.1186/1758-5996-1-14 [9] Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China[J]. N Engl J Med,2010,362(12):1090-1101. doi: 10.1056/NEJMoa0908292 [10] Mirabella S, Brunati A, Ricchiuti A, et al. New-onset diabetes after liver transplantation[J]. Transplant Proc,2005,37(6):2636-2637. doi: 10.1016/j.transproceed.2005.06.084 [11] Ahn HY, Cho YM, Yi NJ, et al. Predictive factors associated with the reversibility of post-transplantation diabetes mellitus following liver transplantation[J]. J Korean Med Sci,2009,24(4):567-570. doi: 10.3346/jkms.2009.24.4.567 [12] Weiler N, Thrun I, Hoppe-Lotichius M, et al. Early steroid-free immunosuppression with FK506 after liver transplantation: long-term results of a prospectively randomized double-blinded trial[J]. Transplantation,2010,90(12):1562-1566. doi: 10.1097/TP.0b013e3181ff8794 [13] Yao B, Chen X, Shen FX, et al. The incidence of posttransplantation diabetes mellitus during follow-up in kidney transplant recipients and relationship to Fokl vitamin D receptor polymorphism[J]. Transplant Proc,2013,45(1):194-196. doi: 10.1016/j.transproceed.2012.08.019 [14] Xu X, Ling Q, He ZL, et al. Post-transplant diabetes mellitus in liver transplantation: Hangzhou experience[J]. Hepatobiliary Pancreat Dis Int,2008,7(5):465-470. http://cn.bing.com/academic/profile?id=13650667&encoded=0&v=paper_preview&mkt=zh-cn [15] Tian YF, Tsai CS, Lee PC, et al. New-onset diabetes mellitus in cyclosporine-treated organ transplant patients in Taiwan: interim analysis (6 months) of postmarketing surveillance[J]. Transplant Proc,2012,44(3):661-666. doi: 10.1016/j.transproceed.2012.01.099
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