Inflammatory and related biomarkers are associated with post-transplant diabetes mellitus in kidney recipients: a retrospective study

Heldal, Torbjørn Fossum; Ueland, Thor; Jenssen, Trond; Hartmann, Anders; Reisæter, Anna Varberg; Aukrust, Pål; Michelsen, Annika; Åsberg, Anders

doi:10.1111/tri.13116

Cited by 25 publications

(25 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…TNFα mRNA expression is higher in renal transplant patients who develop PTDM, and adiponectin mRNA is lower (60). In a recent study on inflammation related biomarkers in 852 renal transplant recipients, a proinflammatory pattern involving activation of tumor necrosis factor, macrophages and endothelial cells was associated with hyperglycemia and PTDM (27).…”

Section: Predisposing Factors Common With Type 2 Diabetesmentioning

confidence: 99%

“…PTDM has over the years been considered a diagnostic entity on its own (16,17,26). It is evident that it shares many characteristics with type 2 diabetes, e.g., insulin resistance and decompensated insulin release, hypertriglyceridemia, obesity, hypertension and low-grade inflammation (5,27) . Even if these characteristics are in common for PTDM and type 2 diabetes, the underlying mechanisms may be different.…”

Section: Pathogenesismentioning

confidence: 99%

See 1 more Smart Citation

Post-transplant diabetes mellitus in patients with solid organ transplants

2019

Self Cite

View full text Add to dashboard Cite

Solid organ transplantation (SOT) is an established treatment for patients with end-organ disease. SOT is also a life-saving procedure although kidney failure patients may survive with dialysis treatment. However, transplantation is accompanied by associated cardiovascular risk factors, and post-transplant diabetes mellitus (PTDM) is one of the most important ones. PTDM develops in 10-20% of kidney transplanted patients and in some 20-40% of other SOT patients. PTDM patients have twice as high mortality as other SOT patients at least in kidney and heart transplanted patients. PTDM is elicited both by predisposing factors as in type2 diabetes but also by specific post-transplant risk factors. Even though PTDM has many characteristics in common with type 2 diabetes, prevention and treatment is often different. SOT patients have improved their lifespan over the last twenty years, and PTDM accumulates over time in these patients. Accordingly PTDM becomes and important condition not only to be aware of, but also to handle. The aim of this review is to present current knowledge on PTDM in kidney, heart, liver and lung transplant recipients, not only for transplant health providers, but also for endocrinologists and others who will meet these patients in their clinic.

show abstract

Section: Predisposing Factors Common With Type 2 Diabetesmentioning

confidence: 99%

Section: Pathogenesismentioning

confidence: 99%

Post-transplant diabetes mellitus in patients with solid organ transplants

2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Other emerging risk factors for PTDM include genetic factors, such as leptin receptor [53] and cytochrome CY2224A1 [54] gene polymorphisms, and require further studies to be evaluated in the light of immunosuppressive regimen and other risk factors. Likewise, the identification of inflammation-related biomarkers and the risk of PTDM entail novel perspectives for early detection and treatment of that disease [55].…”

Section: Journal Of Diabetes Researchmentioning

confidence: 99%

Modifiable Variables Are Major Risk Factors for Posttransplant Diabetes Mellitus in a Time-Dependent Manner in Kidney Transplant: An Observational Cohort Study

Lucena

Sá

Medina‐Pestana

et al. 2020

Journal of Diabetes Research

View full text Add to dashboard Cite

Modifiable and nonmodifiable risk factors for developing posttransplant diabetes mellitus (PTDM) have already been established in kidney transplant setting and impact adversely both patient and allograft survival. We analysed 450 recipients of living and deceased donor kidney transplants using current immunosuppressive regimen in the modern era and verified PTDM prevalence and risk factors over three-year posttransplant. Tacrolimus (85%), prednisone (100%), and mycophenolate (53%) were the main immunosuppressive regimen. Sixty-one recipients (13.5%) developed PTDM and remained in this condition throughout the study, whereas 74 (16.5%) recipients developed altered fasting glucose over time. Univariate analyses demonstrated that recipient age (46.2±1.3vs. 40.7±0.6 years old, OR 1.04; P=0.001) and pretransplant hyperglycaemia and BMI≥25 kg/m2 (32.8% vs. 21.6%, OR 0.54; P=0.032 and 57.4% vs. 27.7%, OR 3.5; P<0.0001, respectively) were the pretransplant variables associated with PTDM. Posttransplant transient hyperglycaemia (86.8%. 18.5%, OR 0.03; P=0.0001), acute rejection (P=0.021), calcium channel blockers (P=0.014), TG/HDL (triglyceride/high-density lipoprotein cholesterol) ratio≥3.5 at 1 year (P=0.01) and at 3 years (P=0.0001), and tacrolimus trough levels at months 1, 3, and 6 were equally predictors of PTDM. In multivariate analyses, pretransplant hyperglycaemia (P=0.035), pretransplant BMI≥25 kg/m2 (P=0.0001), posttransplant transient hyperglycaemia (P=0.0001), and TG/HDL ratio≥3.5 at 3-year posttransplant (P=0.003) were associated with PTDM diagnosis and maintenance over time. Early identification of risk factors associated with increased insulin resistance and decreased insulin secretion, such as pretransplant hyperglycaemia and overweight, posttransplant transient hyperglycaemia, tacrolimus trough levels, and TG/HDL ratio may be useful for risk stratification of patients to determine appropriate strategies to reduce PTDM.

show abstract

“…In one study, Heldal et al[ 87 ] studied 20 plasma biomarkers in 852 KTRs and found 6/20 significantly associated with the development of PTDM[ 87 ].…”

Section: Novel Biomarker Classificationmentioning

confidence: 99%

Role of novel biomarkers in kidney transplantation

Swanson

Aziz

Garg

et al. 2020

WJT

View full text Add to dashboard Cite

Clinical application of biomarkers is an integral component of transplant care. Clinicians and scientists alike are in search of better biomarkers than the current serologic (serum creatinine, donor-specific antibodies), urine-derived (urinalysis, urine protein), and histologic ones we now use. The science behind recent biomarker discovery spans across multiple molecular biologic disciplines, including transcriptomics, proteomics, and metabolomics. Innovative methodology and integration of basic and clinical approaches have allowed researchers to unearth molecular phenomena preceding clinical disease. Biomarkers can be classified in several ways. In this review, we have classified them via their origin and outcome: Primarily immunologic, i.e ., representative of immune regulation and dysfunction and non-immunologic, pertaining to delayed graft function, cardiovascular events/mortality, infection, malignancy, post-transplant diabetes, graft, and patient survival. Novel biomarker uses to guide the diagnosis and management of transplant-related outcomes is a promising area of research. However, the use of biomarkers to predict outcomes after kidney transplantation is not well studied. In this review, we summarize the recent studies illustrating biomarker use and transplant outcomes.

show abstract

Inflammatory and related biomarkers are associated with post-transplant diabetes mellitus in kidney recipients: a retrospective study

Cited by 25 publications

References 52 publications

Post-transplant diabetes mellitus in patients with solid organ transplants

Post-transplant diabetes mellitus in patients with solid organ transplants

Modifiable Variables Are Major Risk Factors for Posttransplant Diabetes Mellitus in a Time-Dependent Manner in Kidney Transplant: An Observational Cohort Study

Role of novel biomarkers in kidney transplantation

Contact Info

Product

Resources

About