Prediabetes in patients receiving tacrolimus in the first year after kidney transplantation: A prospective and multicenter study
Por:
Porrini, E, Moreno, JM, Osuna, A, Benitez, R, Lampreabe, I, Diaz, JM, Silva, I, Dominguez, R, Gonzalez-Cotorruelo, J, Bayes, B, Lauzurica, R, Ibernon, M, Moreso, F, Delgado, P and Torres, A
Publicada:
27 abr 2008
Categoría:
Transplantation
Resumen:
Background. Tacrolimus-based immunosuppression, the most widely used regimen in kidney transplantation, increases the risk of new onset diabetes after transplantation (NODAT). However, the prevalence, evolution and risk factors of different prediabetic alterations: impaired fasting glucose, impaired glucose tolerance, and provisional diabetes, have not been established.
Methods. In this multicenter and prospective study we evaluated 154 nondiabetic kidney transplant recipients receiving tacrolimus, mycophenolate mofetil and low dose steroids. An oral glucose tolerance test was performed 3 and 12 months after transplantation and prediabetes was defined by American Diabetes Association criteria.
Results. Prediabetes was highly prevalent and showed little variation between 3 and 12 months (36% and 33%, respectively). Impaired glucose tolerance was the most frequent abnormality observed (23% and 25%, respectively) observed. In addition, 20% of recipients showed NODAT by 1 year. Multivariate analysis showed that age (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.004-1.14), pretransplant body mass index (OR: 1.3, CI: 1.09-1.6) and triglyceride/high density lipoprotein -cholesterol ratio, a marker of insulin resistance, (OR: 1.4, CI: 1.05-1.9) were independent risk factors for prediabetes.
Conclusion. One in two recipients with tacrolimus-based immunosuppresion showed prediabetes or NODAT by I year posttransplantation when properly investigated. Older age and high pretransplant body mass index and triglyceride/high density lipoprotein-cholesterol ratio were risk factors for prediabetes. These findings may help applying early interventions to prevent the disorder.
Filiaciones:
Porrini, E:
Hosp Univ Canarias, Res Unit, San Cristobal la Laguna, Spain
Moreno, JM:
Hosp Nuestra Senora Virgen Nieves, Nephrol Sect, Granada, Spain
Osuna, A:
Hosp Nuestra Senora Virgen Nieves, Nephrol Sect, Granada, Spain
Benitez, R:
Hosp Cruces, Nephrol Sect, Bilbao, Spain
Lampreabe, I:
Hosp Cruces, Nephrol Sect, Bilbao, Spain
Diaz, JM:
Fdn Puigvert, Nephrol Sect, Barcelona, Spain
Silva, I:
Fdn Puigvert, Nephrol Sect, Barcelona, Spain
Dominguez, R:
Hosp Marques Valdecilla, Nephrol Sect, Santander, Spain
Gonzalez-Cotorruelo, J:
Hosp Marques Valdecilla, Nephrol Sect, Santander, Spain
Bayes, B:
Hosp Germans Trias & Puyol, Nephrol Sect, Badalona, Spain
:
Hosp Germans Trias & Puyol, Nephrol Sect, Badalona, Spain
Ibernon, M:
Hosp Llobregat, Bellvitge Hosp, Nephrol Sect, Barcelona, Spain
Moreso, F:
Hosp Llobregat, Bellvitge Hosp, Nephrol Sect, Barcelona, Spain
Delgado, P:
Hosp Univ Canarias, Res Unit, San Cristobal la Laguna, Spain
Univ La Laguna, Hosp Univ Canarias, Nephrol Sect, E-38207 San Cristobal la Laguna, Spain
Torres, A:
Hosp Univ Canarias, Res Unit, San Cristobal la Laguna, Spain
Univ La Laguna, Hosp Univ Canarias, Nephrol Sect, E-38207 San Cristobal la Laguna, Spain
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