This article has been retracted. See "Retraction: Contributing Factors to Different Natural Courses of Posttansplantation Diabetes Mellitus in Renal Allograft Recipients" in Volume 22 on page 479.
Abstract
Background
New onset diabetes is a major complication after kidney transplantation. However, the natural course of posttransplantation diabetes mellitus (PTDM) remains unclear. The aim of this study was to demonstrate the detailed natural courses of PTDM according to the onset and persistency of hyperglycemia, and to investigate risk factors for development of different courses of PTDM in renal allograft recipients.
Methods
A total of 77 renal allograft recipients without previously known diabetes were enrolled and performed a serial 75 g oral glucose tolerance test at 0, 1, and 7 years after kidney transplantation. Patients were classified according to the onset and persistency of PTDM: early PTMD (E-PTDM), late PTDM (L-PTDM), persistent PTDM (P-PTDM), transient PTMD (T-PTDM), and non-PTDN (N-PTDM).
Results
The incidence of each group was as follows: E-PTDM, 39%; L-PTDM, 11.7%; P-PTDM, 23.4% T-PTDM, 15.6%; N-PTDM, 49.3%. Tacrolimus and female gender were associated with the development of E-PTDM. Among E-PTDM, age at transplantation was a high risk factor for the development of P-PTDM. Higher BMI at year1 was associated with the development of L-PTDM.
Figures and Tables
Fig. 1
Different clinical courses of posttransplantation diabetes mellitus (PTDM) in renal allograft recipients. E-PTDM, early PTDM NGT; L-PTDM, late PTDM NGT, normal glucose tolerance; N-PTDM, non-PTDM until 7 year posttrnasplant; P-PTDM, persistent PTDM; T-PTDM, transient PTDM.
Fig. 2
Serial changes in insulin secretion, SecrAUC (A), insulin sensitivity (ISI) (B), ΔSecrAUC (C), and ΔISI (D). ISI,
insulin sensitivity index (µmolkg-1ㆍmin-1pmol-1); ΔISI, ISI (at year 1 or 7) - ISI (at baseline); L-PTDM, late posttransplantation diabetes mellitus (PTDM); N-PTDM, non-PTDM until 7 year posttransplant; P-PTDM, persistent PTDM; SecrAUC, index of β-cell function (SecrAUCInsulin / SecrAUCGlucose); ΔSecrAUC, SecrAUC (at year 1 or 7) - SecrAUC (at baseline); T-PTDM, transient PTDM.
*P < 0.05 compared with N-PTDM at each time point by the Kruskal-Wallis test.
**P < 0.001 compared with N-PTDM at each time point by the Kruskal-Wallis test.
Table 1
Baseline clinical characteristics in E-PTDM vs. non-PTDM
Data are means ± SD or n (%) unless otherwise indicated.
E-PTDM, early posttransplantation diabetes mellitus (PTDM); HCV, hepatitis C virus FPG, fasting plasma glucose SecrAUC, index of β-cell function (SecrAUCInsulin / SecrAUCGlucose); ISI, insulin sensitivity index (µmolkg-1ㆍmin-1 pmol-1).
*Family history of diabetes in a first-degree relative.
Table 4
Clinical characteristics of different courses of PTDM at 1 year posttransplant
Data are means ± SD or n (%) unless otherwise indicated.
CsA, cyclosporine A; E-PTDM, early posttransplantation diabetes mellitus (PTDM); FPG, fasting plasma glucose HCV, hepatitis C virus; ISI, insulin sensitivity index (µmolkg-1min-1pmol-1); L-PTDM, late PTDM; MMF, mycophenolate mofetil. N-PTDM, non-PTDN until 7 year posttransplant; P-PTDM, persistent PTDM; SecrAUC, index of β-cell function (SecrAUCInsulin / SecrAUCGlucose); T-PTDM, transient PTDM.
*Family history of diabetes in a first-degree relative.
†data are at 1 year posttransplant.
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