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©The Author(s) 2016.
World J Gastroenterol. Feb 14, 2016; 22(6): 2133-2141
Published online Feb 14, 2016. doi: 10.3748/wjg.v22.i6.2133
Published online Feb 14, 2016. doi: 10.3748/wjg.v22.i6.2133
Table 1 Demographic and clinical characteristics of recipients with and without new-onset diabetes millitus after liver transplantation (n = 528) n (%)
Characteristics | Total (n = 528) | NODM group (n = 131) | Non-NODM group (n = 397) | P value |
Recipient characteristics | ||||
Age (yr) | 44.93 ± 9.41 | 46.24 ± 9.54 | 44.50 ± 9.34 | 0.068 |
Gender (male) | 446 (84.5) | 144 (87.0) | 332 (83.6) | 0.352 |
Child-Pugh (A/B/C) | 136/223/169 | 39/44/48 | 97/179/121 | 0.069 |
MELD Score | 13 (6-40) | 15 (6-40) | 13 (6-40) | 0.010 |
BMI ≥ 25 pre-LT | 110 (20.8) | 36 (27.5) | 74 (18.6) | 0.006 |
Hypertension pre-LT | 12 (2.3) | 7 (5.3) | 5 (1.3) | 0.017 |
Dyslipidemia pre-LT | 41 (8.2) | 15 (11.5) | 26 (6.5) | 0.069 |
Indications for LT | ||||
Hepatitis B virus disease | 420 (79.5) | 102 (77.9) | 318 (80.1) | 0.582 |
Hepatitis C virus disease | 6 (1.1) | 1 (0.8) | 5 (1.3) | > 0.990 |
Alcoholic cirrhosis | 16 (3.0) | 7 (5.3) | 9 (2.3) | 0.137 |
Tumors | 269 (50.9) | 56 (42.7) | 213 (53.7) | 0.030 |
Mean cTAC (ng/mL) | 5.26 ± 2.91 | 7.66 ± 3.41 | 4.47 ± 2.22 | < 0.001 |
Rapamycin administration | 129 (24.4) | 30 (22.9) | 99 (24.9) | 0.638 |
MMF administration | 322 (61.0) | 78 (59.5) | 244 (61.5) | 0.696 |
Complications post-LT | ||||
BMI ≥ 25 post-LT | 128 (24.2) | 40 (30.5) | 88 (22.2) | 0.053 |
Hypertension post-LT | 67 (12.7) | 22 (16.8) | 45 (11.3) | 0.104 |
Dyslipidaemia post-LT | 175 (33.1) | 63 (48.1) | 112 (28.2) | < 0.001 |
Cardio-cerebral events post-LT | 18 (3.4) | 10 (7.6) | 8 (2.0) | 0.005 |
CKD post-LT | 91 (17.2) | 28 (21.4) | 63 (15.9) | 0.148 |
AR post-LT | 58 (11.0) | 20 (15.3) | 38 (9.6) | 0.071 |
CR post-LT | 20 (3.8) | 9 (6.9) | 11 (2.8) | 0.062 |
Infection post-LT | 165 (28.7) | 65 (36.7) | 100 (25.2) | 0.042 |
Graft failure | 52 (9.8) | 20 (15.3) | 32 ( 8.1) | 0.016 |
Donor characteristics | ||||
Age (yr) | 34.01 ± 8.75 | 33.62 ± 8.33 | 34.13 ± 8.89 | 0.559 |
Gender (male) | 443 (84.5) | 108 (82.4) | 335 (84.4) | 0.600 |
Donor type (LDLT) | 158 (29.9) | 34 (26.0) | 124 (31.2) | 0.252 |
Table 2 Clinical complications associated with mean tacrolimus trough concentration n (%)
Complications post-LT | Low-cTAC group (n = 356) | High-cTAC group (n = 172) | P value |
Overweight/obesity (BMI ≥ 25) | 76 (21.3) | 52 (30.2) | 0.026 |
Hypertension | 48 (13.5) | 19 (11.0) | 0.431 |
Dyslipidaemia | 98 (27.5) | 77 (44.8) | < 0.001 |
Cardio-cerebral events | 12 (3.4) | 6 (3.5) | 0.944 |
CKD | 52 (14.6) | 39 (22.7) | 0.021 |
AR | 34 (9.6) | 24 (14.0) | 0.129 |
CR | 10 (2.8) | 10 (5.8) | 0.090 |
Infection | 88 (24.7) | 57 (33.1) | 0.042 |
New-onset malignance | 8 (2.2) | 1 (0.6) | 0.304 |
Table 3 Univariate analysis of risk factors for new-onset diabetes mellitus after liver transplantation
Clinical factor | HR | 95%CI | P value |
Recipient characteristics | |||
Elder recipient (age > 50 yr) | 1.568 | 1.096-2.245 | 0.014 |
Male recipient gender | 0.690 | 0.414-1.150 | 0.155 |
Child-Pugh (A/B/C) | 0.985 | 0.788-1.232 | 0.895 |
MELD Score | 1.107 | 0.997-1.037 | 0.088 |
BMI ≥ 25 pre-LT | 1.616 | 1.100-2.373 | 0.014 |
Hypertension pre-LT | 4.458 | 2.058-9.659 | < 0.001 |
Dyslipidaemia pre-LT | 2.064 | 1.201-3.549 | 0.009 |
Hepatitis B virus disease | 0.955 | 0.632-1.443 | 0.828 |
Hepatitis C virus disease | 0.699 | 0.098-5.007 | 0.722 |
Alcoholic cirrhosis | 2.307 | 1.076-4.948 | 0.032 |
Tumors | 0.961 | 0.676-1.304 | 0.822 |
With Rapamycin | 1.168 | 0.744-1.761 | 0.459 |
With MMF | 0.979 | 0.690-1.387 | 0.903 |
High mean cTAC (cTAC ≥ 5.89 ng/mL) | 8.709 | 5.873-12.915 | < 0.001 |
BMI ≥ 25 post-LT | 1.345 | 0.927-1.951 | 0.119 |
Hypertension post-LT | 1.278 | 0.808-2.021 | 0.294 |
Dyslipidaemia post-LT | 2.014 | 1.429-2.838 | < 0.001 |
CKD post-LT | 1.140 | 0.925-1.405 | 0.218 |
AR post-LT | 1.701 | 1.056-2.742 | 0.029 |
CR post-LT | 2.068 | 1.050-4.074 | 0.036 |
Donor characteristics | |||
Donor age at LT (per year) | 0.994 | 0.975-1.015 | 0.590 |
Male donor gender | 1.202 | 0.766-1.886 | 0.423 |
Donor type (LDLT) | 0.859 | 0.581-1.270 | 0.446 |
Table 4 Multivariate analysis of risk factors for new-onset diabetes mellitus after liver transplantation
Clinical factor | HR | 95%CI | P value |
Elder recipient (age > 50 yr) | 1.925 | 1.335-2.776 | < 0.001 |
Hypertension pre-LT | 4.220 | 1.931-9.226 | < 0.001 |
High mean cTAC (cTAC ≥ 5.89 ng/mL) | 9.474 | 6.357-14.119 | < 0.001 |
- Citation: Song JL, Gao W, Zhong Y, Yan LN, Yang JY, Wen TF, Li B, Wang WT, Wu H, Xu MQ, Chen ZY, Wei YG, Jiang L, Yang J. Minimizing tacrolimus decreases the risk of new-onset diabetes mellitus after liver transplantation. World J Gastroenterol 2016; 22(6): 2133-2141
- URL: https://www.wjgnet.com/1007-9327/full/v22/i6/2133.htm
- DOI: https://dx.doi.org/10.3748/wjg.v22.i6.2133