Post-transplant diabetes mellitus incidence and risk factors in adult liver transplantation recipients
Nazli Gulsoy Kirnap1, Pulat Sultanov2, Omar AlShalabi2, Mahir Kirnap2, Neslihan Bascıl Tutuncu1, Mehmet A. Haberal2.
1Endocrinology, Baskent University, Ankara, Turkey; 2Transplant Surgery, Baskent University, Ankara, Turkey
Aim: Posttransplant diabetes mellitus (PTDM) is a metabolic complication that usually occurs after liver transplantation (LT) due to immunosuppression. It is associated with increased mortality and morbidity. In this study, our aim was to identify PTDM incidence after LT in our center and the potential risk factors.
Materials and Methods: Our group performed 654 LT procedures on 627 patients in our centers between 8 December 1988 and 20 January 2020. In this study, 238 adult LT patients operated between January 2001 and January 2020 were evaluated in terms of PTDM development.
Results: Of 238 patients included in the study, 170 (%71.4) were male, 68 (%28.6) were female and the mean age was 43.5± 13.7 years. The patients were divided into PTDM, Transient-Hyperglycemia (t-HG) and non-PTDM groups. Of all patients, PTDM developed in 24 (%10.1). Transient-Hyperglycemia was detected in 31 (13%) patients. PTDM and t-HG patients had a greater body weight than non-PTDM patients (BMI kg/m2: 27.6± 5.3, 25.8± 4.3 and 23.9± 3.3, respectively, p<0.001 p= 0.028). PTDM and t-HG patients were older than non-PTDM patients (51.5± 9.68 years, 48.2± 11.1 years, 41.5± 14 years, respectively, p= 0.002 p= 0.023). In the univariate analysis, the only independent risk factor for PTDM was age (OR 1.93, %95 CI 1.31-2.97).
Conclusion: Age is the most important risk factor for PTDM development after liver transplantation. PTDM was found more common in the patient group with greater body weight. Patients with older age and greater body weight should be examined more carefully for PTDM before LT.
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