Obesity – Key risk factor for diabetes mellitus after kidney transplantation


Authors: Ivana Dedinská 1;  Ľudovít Laca 1;  Juraj Miklušica 1;  Peter Galajda 2;  Marián Mokáň 2
Authors‘ workplace: Chirurgická klinika a transplantačné centrum Jesséniovej LF UK a Univerzitnej nemocnice Martin 1;  I. Interná klinika Jesséniovej LF UK a Univerzitnej nemocnice Martin 2
Published in: Forum Diab 2015; 4(3): 191-194
Category: Main Theme: Review

Overview

Purpose:
New-onset diabetes mellitus after transplantation (NODAT) is a serious and frequent complication of solid organ transplantations. NODAT leads to 2–3 times higher cardiovascular morbidity and mortality. Visceral obesity is a key factor for diabetes mellitus type 2 and metabolic syndrome development and represents an independent risk factor for cardiovascular diseases.

Materials and methods:
The set consisted of 210 patients after primary kidney transplantation from a dead donor (90 patients had developed NODAT), average age of the set was 48.1 ± 9.9 years. We have examined age at the time of transplantation, body mass index at the time of transplantation. We have examined waist circumference, body mass index and weight gain in the 12th month after transplantation.

Results:
We have identified following independent risk factors for NODAT: age at the time of transplantation 50–59 years (HR = 2.5038 [95 % CI: 1.7179 to 3.6492], P < 0.0001), age at the time of transplantation higher than 60 years (HR = 1,1376 [95 % CI: 1,0437 – 1,23399], P < 0,0034), body mass index at the time of transplantation more than 30 kg/m2 (HR = 1,5986 [95 % CI: 1,0650 – 2,3997], P < 0,0236), waist circumference in men greater than 94 cm (HR = 1,9492 [95 % CI: 1,1697 to 3,2480], P < 0,0104), ), in women greater than 80 cm (HR = 4,5018 [95 % CI: 1,8669 to 10,8553], P < 0,009). By using correlation coefficient we have proved that greater waist circumference related to higher incidence of NODAT (r = 0.1935, [95 % CI: 0.01156 to 0.3630], P = 0.0374).

Conclusion:
We have identified waist circumference as an independent risk factor for NODAT in our analysis. Regular weight and waist circum­ference control in patients after kidney transplantation leads to identification of risk patients for NODAT.

Key words:
body mass index – New-onset diabetes after transplantation – waist circumference – kidney transplantation


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Labels
Diabetology Endocrinology Internal medicine
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