New-onset diabetes after renal transplantation : Diagnosis, incidence, and long-term effect on patient survival
Year: 2012
Type: dissertation
Study design: Observational Study
Abstract: Aims/objective We aimed to assess the long-term effects of post-transplant glycaemia on long-term survival after renal transplantation. Methods Study participants were 1,410 consecutive trans- plant recipients without known diabetes who underwent an OGTT 10 weeks post-transplant and were observed for a median of 6.7 years (range 0.3–13.8 years). The HRs adjusted for age, sex, traditional risk factors and transplant-related risk factors were estimated. Results Each 1mmol/l increase in fasting plasma glucose (fPG) or 2 h plasma glucose (2hPG) was associatedwith 11% (95%CI −1%, 24%) and 5% (1%, 9%) increments in all-cause mortality risk and 19% (1%, 39%) and 6% (1%, 12%) increments in cardiovascular (CV) mortality risk, respectively. Including both fPG and 2hPG in the multi-adjusted model the HR for 2hPG remained unchanged, while the HR for fPG was attenuated (1.05 [1.00, 1.11] and 0.97 [0.84, 1.14]). Compared with recipients with normal glucose tolerance, patients with post- transplant diabetes mellitus had higher all-cause and CV mortality (1.54 [1.09, 2.17] and 1.80 [1.10, 2.96]), while patients with impaired glucose tolerance (IGT) had higher all-cause, but not CV mortality (1.39 [1.01, 1.91] and 1.04 [0.62, 1.74]). Conversely, impaired fasting glucose was not associated with increased all-cause or CV mortality (0.79 [0.52, 1.23] and 0.76 [0.39, 1.49]). Post-challenge hyperglycaemia predicted death from any cause and infectious disease in the multivariable analyses (1.49 [1.15, 1.95] and 1.91 [1.09, 3.33]). Conclusions/interpretation For predicting all-cause and CV mortality, 2hPG is superior to fPG after renal transplantaT. G. Valderhaug and J. Hjelmesaeth contributed equally to this study. T. G. Valderhaug :A. Hartmann :H. A. Bergrem : T. Jenssen Section for Nephrology, Department for Organ Transplantation, Gastroenterology and Nephrology, Division for Specialized Medicine and Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway T. G. Valderhaug :A. Hartmann Institute of Clinical Medicine, Faculty Division Rikshospitalet, University of Oslo, Oslo, Norway T. G. Valderhaug (*) Department of Thoracic and Cardiovascular Surgery, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0027 Oslo, Norway e-mail: [email protected] J. Hjelmesaeth : J. Roislien Morbid Obesity Centre, Vestfold Hospital Trust, Tonsberg, Norway J. Roislien Department of Biostatistics, Institute of Basic Medical Science, University of Oslo, Oslo, Norway T. Leivestad Institute of Immunology, Oslo University Hospital, Rikshospitalet, Oslo, Norway P. D. Line Section for Transplantation Surgery, Department for Organ Transplantation, Gastroenterology and Nephrology, Division for Specialized Medicine and Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway T. Jenssen Institute of Clinical Medicine, University of Tromso, Tromso, Norway Diabetologia (2011) 54:1341–1349 DOI 10.1007/s00125-011-2105-9
Author: Tone Gretland Valderhaug
Language: English
Subfield: Transplantation
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2460964044