#41
PREDICTING POSTTRANSPLANT DIABETES.
Mohsen I. Mabudian, M.D., Jessica L. Thomson, PhD, J. Sialkow, M.D., Beena Arora, MS, Kathleen R. Wiley, MS, Daniel Frey, M.D. and Prem Kumar, M.D.. New Orleans LA, USA, LSU Health Sciences Center, 70112, Medicine; New Orleans LA, USA, LSU Health Sciences Center, 70112, Public Health
Health Systems Research and New Orleans LA, USA, Transplant Institute of New Orleans, 70119.
PURPOSE: The development of posttransplant diabetes mellitis (PTDM) is associated with increased morbidity and impairment of both patient and graft survival. Identifying PTDM risk factors is of interest.
METHODS: The records of 181 renal transplant recipients between 1995-2002 were reviewed. PTDM was defined as fasting plasma glucose (FPG) >126 mg/dl on at least 3 occasions. Age, gender, ethnicity, family history (FHx), Body Mass Index(BMI), transplant type (living vs. deceased), FPG post transplant, HLA phenotypes, and the presence of CMV and HCV antibody were recorded.
RESULTS: From 181 patients, 50 had diabetes mellitus prior to transplantation, 29 developed PTDM (22%; Group I) and 102 did not develop PTDM (78%; Group II). Age, race, HCV, FHx, and HLA B 70 and HLA DR18 were significant (See Table). BMI was higher in Group I as compared to Group II (27.9 ± 0.16 vs. 25.3 ± 0.05; P=0.0117). Mean FPG were significantly elevated during day 0-3, 4-30 in Group I than Group II [153.0 ± 0.0025 vs. 133.5.6 ± 2.32 mg/dl (p=0.0025), 139.9 ± 3.80 vs. 115.7 ± 1.21 mg/dl (p<0.0001), respectively].
CONCLUSION: Age, African-American race (AFA), HCV, FHx, HLA-B70 and HLA-DR18, BMI > 26, and elevated FPG within first month are significantly associatd with PTDM.Variables Group I n(%) Group II n(%) p-value Age (45-59) yrs 16 (55.2) 29 (28.4) 0.0097 Race-AFA 21 (72.4) 51 (50.0) 0.0364 HCV 7 (24.1) 6 (6.0) 0.0095 FHx 12 (42.9) 19 (18.8) 0.0084 HLA B70 & DR 18 9 (31.0) 6 (5.9) 0.0008