Effect of Demographic and Clinical Factors on New- Onset Diabetes Mellitus after Liver Transplantation in Iranian Patients
BACKGROUNDS: New- onset diabetes after transplantation (NODAT) is a serious complication which runs the risk of infections, morbidity and mortality. Older age, male sex, immunosuppressive agents and hepatitis C are reported as risk factors. The focus of this research is evaluating some demographic and clinical factors in development of NODAT in hepatic transplanted patients. This study aims to help identifying high risk recipients in order to prevent NODAT and improve transplantation prognosis.
METHODS: In this study 134 liver recipients without pre- transplantation diabetes were investigated; 70 euglycemic and 64 with NODAT within 2 years after transplantation. All the patients were on tacrolimus- based immunosuppressive regimen. The role of recipients’ age, sex, body mass index (BMI), model for end- stage liver disease (MELD) score, blood group, diseases leading to transplantation, tacrolimus dose and serum level, mycophenolate mofetil (MMF) and prednisolone dose in the incidence of NODAT were assessed.
RESULTS: The prevalence of NODAT in this study was 17.92%. The means of duration after transplantation that NODAT occurred, was 98.36± 21.62 days. The mean age of all patients was 37.83±16.26 years and 60.40% were females. Two groups were similar in terms of pre- transplantation fasting blood sugar (FBS) (P=0.091). Age (P=0.001,OR=1.063,CI:1.025-1.102) and prednisolone dose (P<0.0001,OR=1.270,CI:1.163-1.388) the only independent predictors of NODAT, while tacrolimus daily dose and plasma level, MMF daily dose, sex, BMI and underlying diseases were not risk factors for NODAT.
CONCLUSIONS: Recipients with older age and higher prednisolone dose are more prone to NODAT and need more accurate monitoring.
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