Risk factors for new-onset diabetes mellitus after kidney transplantation (NODAT): a Brazilian single center study

ABSTRACT Objectives: This study aims to verify the new-onset diabetes after kidney transplant (NODAT) incidence in recipients within 1 year after kidney transplantation from a single center in Southern Brazil and to assess the associated conditions. Subjects and methods: A retrospective study of 258 post-renal transplant patients was performed. Demographic (gender, age, ethnic background) and clinical (origin of graft, associated infections, body mass index (BMI) at transplant time and 6 and 12 months after, causes of renal failure, and comorbidities) data were analyzed. All patients were on tacrolimus, mycophenolate mofetil, and prednisone treatment. Patients with and without NODAT were compared. Results: A NODAT incidence of 31.2% was noted 1 year post transplantation. In the univariate analysis, patients with NODAT were older (p = 0.001), mostly had African–American ethnic background (p = 0.02), and had renal failure secondary to high blood pressure (HBP) (p = 0.001). The group of patients with NODAT also had more incidence of post-transplant HBP (p = 0.01), heart failure (p = 0.02), and dyslipidemia (p = 0.001). Logistic regression showed that African–American ethnic background, post-transplant HBP, and dyslipidemia were independently associated with NODAT. Conclusion: This study shows a NODAT incidence that is greater in patients with African–American ethnic background and that is associated with HBP and dyslipidemia.

摘要
研究目的：本研究旨在明确巴西南部单中心肾移植受者肾移植术后1年内的肾移植术后新发糖尿病（New-Onset Diabetes After Transplantation, NODAT）发生率，并评估其相关关联因素。
研究对象与方法：本研究为回顾性研究，共纳入258例肾移植术后患者。对其人口学资料（性别、年龄、种族背景）及临床资料（移植肾来源、合并感染情况、移植时及术后6、12个月的体质量指数（Body Mass Index, BMI）、肾衰竭病因及合并症）进行分析。所有患者均采用他克莫司、吗替麦考酚酯及泼尼松进行免疫抑制治疗。对比合并与未合并NODAT的患者临床特征。
研究结果：肾移植术后1年时，NODAT发生率为31.2%。单因素分析结果显示，合并NODAT的患者年龄更大（p=0.001）、以非裔美国人种族背景居多（p=0.02），且肾衰竭病因多为高血压（High Blood Pressure, HBP）所致（p=0.001）。此外，合并NODAT的患者术后高血压（p=0.01）、心力衰竭（p=0.02）及血脂异常（p=0.001）的发生率更高。Logistic回归分析显示，非裔美国人种族背景、术后高血压及血脂异常为NODAT的独立危险因素。
研究结论：本研究结果表明，巴西南部单中心肾移植受者中，非裔美国人种族背景人群的NODAT发生率更高，且该疾病与高血压及血脂异常存在显著相关性。