| Association of metabolic syndrome with development of new-onset diabetes after transplantation. | |
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MedLine Citation:
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PMID: 20724958 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: New-onset diabetes after transplantation (NODAT) is a major posttransplant complication associated with lower allograft and recipient survival. Our objective was to determine whether metabolic syndrome pretransplant is independently associated with NODAT development. METHODS: We recruited 640 consecutive incident nondiabetic renal transplant recipients from three academic centers between 1999 and 2004. NODAT was defined as the use of hypoglycemic medication, a random plasma glucose level more than 200 mg/dL, or two fasting glucose levels more than or equal to 126 mg/dL beyond 30 days posttransplant. RESULTS: Metabolic syndrome was common pretransplant (57.2%). NODAT developed in 31.4% of recipients 1 year posttransplant. Participants with metabolic syndrome were more likely to develop NODAT compared with recipients without metabolic syndrome (34.4% vs. 27.4%, P=0.057). Recipients with increasing number of positive metabolic syndrome components were more likely to develop NODAT (metabolic syndrome score prevalence at 1 year: 0 components-0.0%, 1-24.2%, 2-29.3%, 3-31.0%, 4-34.8%, and 5-73.7%, P=0.001). After adjustment for demographics, age by decade (hazard ratio [HR] 1.34 [1.20-1.50], P<0.0001), African American race (HR 1.35 [1.01-1.82], P=0.043), cumulative prednisone dosage (HR 1.18 [1.07-1.30], P=0.001), and metabolic syndrome (HR 1.34 [1.00-1.79], P=0.047) were independent predictors of development of NODAT at 1 year posttransplant. In a multivariable analysis incorporating the individual metabolic syndrome components themselves as covariates, the only pretransplant metabolic syndrome component to remain an independent predictor of NODAT was low high-density lipoprotein (hazard ratio [HR] 1.37 [1.01-1.85], P=0.042). CONCLUSIONS: Metabolic syndrome is an independent predictor for NODAT and is a possible target for intervention to prevent NODAT. Future studies to evaluate whether modification of metabolic syndrome factors pretransplant reduces NODAT development are needed. |
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Authors:
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Nathaniel D Bayer; Philip T Cochetti; Mysore S Anil Kumar; Valerie Teal; Yonghong Huan; Cataldo Doria; Roy D Bloom; Sylvia E Rosas |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: Transplantation Volume: 90 ISSN: 1534-6080 ISO Abbreviation: Transplantation Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-21 Completed Date: 2010-11-16 Revised Date: 2011-10-27 |
Medline Journal Info:
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Nlm Unique ID: 0132144 Medline TA: Transplantation Country: United States |
Other Details:
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Languages: eng Pagination: 861-6 Citation Subset: IM |
Affiliation:
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Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Glucose
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metabolism Diabetes Mellitus / epidemiology, etiology* Fasting Female Humans Immunosuppressive Agents / therapeutic use Kidney Transplantation / adverse effects*, immunology Male Metabolic Syndrome X / epidemiology, etiology* Middle Aged Multivariate Analysis Polycystic Kidney Diseases / epidemiology Prevalence Regression Analysis Tacrolimus / therapeutic use |
| Grant Support | |
ID/Acronym/Agency:
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K08 DK002626-05/DK/NIDDK NIH HHS; R01 DK080033/DK/NIDDK NIH HHS; R01 DK080033-04/DK/NIDDK NIH HHS; UL1RR024134/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Immunosuppressive Agents; 109581-93-3/Tacrolimus |
| Comments/Corrections | |
Comment In:
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Transplantation. 2010 Oct 27;90(8):821-2
[PMID:
20686442
]
Transplantation. 2011 Mar 15;91(5):591-2 [PMID: 21336088 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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