Risk Factors for New-Onset Diabetes Mellitus after Heart Transplantation in Chinese Patients: A Single Center Experience

Abstract

Background: New-onset diabetes after transplantation ­(NODAT) is a frequent complication after heart transplantation (HT) and is associated with graft loss and patient survival. Objectives: The aim of this study was to identify the incidence and associated factors contributing to NODAT in Chinese heart transplant recipients. Methods: Adult patients without diabetes mellitus before HT were enrolled in this study. NODAT was diagnosed according to the criteria recommended by the American Diabetes Association. The cumulative incidence was determined at 3, 6, and 12 months, respectively. The risk factors of NODAT were estimated by logistic regression analysis. Results: A total of 154 adults who first received HT were included. Among them, 50 (32.5%) recipients were diagnosed with NODAT after a median follow-up time of 611 days. The cumulative incidence of NODAT was 27.3% at 3 months, 29.9% at 6 months, and 30.5% at 12 months, respectively. Independent risk factors for NODAT included age ≥45 years (OR 3.82, 95% CI 1.57–9.31; p = 0.003), hypertension (OR 3.28, 95% CI 1.17–9.20; p= 0.024), and transient hyperglycemia (OR 12.13, 95% CI 3.35–43.92; p < 0.001). Moreover, recipients treated with both acarbose and insulin for transient hyperglycemia had a significantly higher prevalence of NODAT than those without any anti-diabetic agents (OR 5.35, 95% CI 1.21–23.64; p = 0.027). Conclusions: Age ≥45 years, hypertension, transient hyperglycemia, and associated treatment strategies are imperative to identify recipients at high risk of developing ­NODAT.

Analysis of risk factors and establishment of a risk prediction model for post-transplant diabetes mellitus after kidney transplantation

“…A large number of studies have reported that age is a risk factor for PTDM, which selected the age of 45 years as the cutoff to study the relationship between age and PTDM. Studies have reported that kidney transplant patients aged ≥ 45 years have a higher risk of developing PTDM than patients aged < 45 years in Chinese heart transplant ( Zhang et al, 2019 ). In addition, age ≥ 45 years increases PTDM risk 2.2 times when compared to individuals of 18–44 years old in American kidney transplant recipients ( Cosio et al, 2001 ).…”

Comparison of a Point-of-Care Testing with Enzyme-Multiplied Immunoassay Technique and Liquid Chromatography Combined With Tandem Mass Spectrometry Methods for Therapeutic Drug Monitoring of Mycophenolic Acid: A Preliminary Study

“…All enrolled patients received triple immunosuppressive regimens according to the local protocol, consisting of tacrolimus (Prograf; Astellas Pharma, Dublin, Ireland), MMF (MMF; CellCept; Roche, Shanghai, China), and glucocorticoid (Prednisone; Huazhong Pharmaceutical, Xiangyang, Hubei, China). 14 Patients received a dense sampling with 10 points, before medication, and 0.5, 1, 1.5, 2, 4, 6, 8, 10, and 12 hours after dosing. Blood samples were collected in ethylenediaminetetraacetic acid tubes.…”

Association of body mass index and fasting plasma glucose concentration with post-transplantation diabetes mellitus in Chinese heart transplant recipients

“…1,13 The incidence of PTDM in HTRs ranges from 15.7% to 40.0%. 13,21–24 The registry of the ISHLT reported an incidence of PTDM of 21.0% at 1 year and 34.5% at 5 years after HT. 25 Ethnicity may play a role in the development of PTDM; non-white race has been identified as an independent risk factor for PTDM in HTRs.…”