Risk factors in and long-term survival of patients with post-transplantation diabetes mellitus: a retrospective cohort study
Open accessAbstract
Post-transplant diabetes mellitus (PTDM) is associated with infection, cardiovascular morbidity, and mortality. A retrospective cohort study involving patients who underwent renal transplantation in a transplantation center in Taiwan from January 2000 to December 2018 was conducted to investigate the incidence and risk factors of PTDM and long-term patient and graft survival rates. High age (45–65 vs. <45 years, adjusted odds ratio (aOR) = 2.90, 95% confidence interval (CI) = 1.64–5.13, p < 0.001), high body mass index (>27 vs. <24 kg/m2, aOR = 5.35, 95% CI = 2.75–10.42, p < 0.001), and deceased organ donor (cadaveric vs. living, aOR = 2.01, 95% CI = 1.03–3.93, p = 0.04) were the three most important risk factors for the development of PTDM. The cumulative survival rate of patients and allografts was higher in patients without PTDM than in those with PTDM (p = 0.007 and 0.041, respectively). Concurrent use of calcineurin inhibitors and mammalian target of rapamycin inhibitors (mTORis) decreased the risk of PTDM (tacrolimus vs. tacrolimus with mTORi, aOR = 0.28, 95% CI = 0.14–0.55, p < 0.001). Investigating PTDM risk factors before and modifying immunosuppressant regimens after transplantation may effectively prevent PTDM development.
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Risk factors for PTDM include general diabetes risks (such as age, family history of diabetes, obesity) and transplant-specific factors, such as use of immunosuppressant agents.
“Risk factors for PTDM include both general diabetes risks (such as age, family history of diabetes, obesity, etc.) and transplant-speci fi c factors, such as use of immunosuppressant agents (144 -146).”
From 2. Diagnosis and Classification of Diabetes: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [146]
The Results (§3.3; page unavailable) identify age, higher BMI, and tacrolimus use as PTDM risk factors, supporting the general-versus-transplant-specific distinction. The Introduction (§1; page unavailable) also lists obesity and diabetogenic immunosuppressants. Our copy does not identify family history of diabetes as a PTDM risk factor, so that example is unsupported. (LLM, conf=0.88)
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Cites
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.11.004 · Cited by 4,058 · see citing works
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437739.71477.ee · Cited by 2,735 · see citing works
Diabetes Mellitus after Kidney Transplantation in the United States
Kasiske, B. L., Snyder, J. J., Gilbertson, D. T., & Matas, A. J. (2003) · American Journal of Transplantation · doi:10.1034/j.1600-6143.2003.00010.x · Cited by 1,286 · see citing works
NEW-ONSET DIABETES AFTER TRANSPLANTATION: 2003 INTERNATIONAL CONSENSUS GUIDELINES1
Davidson, J. A., Wilkinson, A. H., Dantal, J., Dotta, F., Haller, H. G., Hernández, D., Kasiske, B. L., KIBERD, B. A., Krentz, A. J., Legendre, C. M., et al. (2003) · Transplantation · doi:10.1097/01.tp.0000069952.49242.3e · Cited by 675 · see citing works
Webster, A. C., Woodroffe, R., Taylor, R. S., Chapman, J. R., & Craig, J. C. (2005) · BMJ · doi:10.1136/bmj.38569.471007.ae · Cited by 585 · see citing works
Sharif, A., Hecking, M., de Vries, A. P. J., Porrini, E., Hornum, M., Rasoul-Rockenschaub, S., Berlakovich, G., Krebs, M., Kautzky-Willer, A., Schernthaner, G., et al. (2014) · American Journal of Transplantation · doi:10.1111/ajt.12850 · Cited by 532 · cited 1× · see citing works
“Patients with PTDM were defined as those with a fasting blood glucose level of ≥140 mg/dL recorded on at least two consecutive measurements, or those who required the administration of an oral anti-diabetic drug or insulin for ≥3 months, as described in the World Health Organization/American Diabetes Association inter…”
MethodAbuissa, H. S., Jones, P. G., Marso, S. P., & O’Keefe, J. H. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.05.051 · Cited by 449 · see citing works
Sirolimus Is Associated with New-Onset Diabetes in Kidney Transplant Recipients
Johnston, O., Rose, C., Webster, A. C., & Gill, J. S. (2008) · Journal of the American Society of Nephrology · doi:10.1681/asn.2007111202 · Cited by 425 · see citing works
Cosio, F. G., Kudva, Y. C., van der Velde, M., Larson, T. S., Textor, S. C., Griffin, M. D., & Stegall, M. D. (2005) · Kidney International · doi:10.1111/j.1523-1755.2005.00349.x · Cited by 397 · see citing works
Cosio, F. G., Pesavento, T. E., Osei, K., Henry, M. L., & Ferguson, R. M. (2001) · Kidney International · doi:10.1046/j.1523-1755.2001.059002732.x · Cited by 377 · see citing works
Post-Transplant Diabetes Mellitus: Causes, Treatment, and Impact on Outcomes
Shivaswamy, V., Boerner, B., & Larsen, J. (2016) · Endocrine Reviews · doi:10.1210/er.2015-1084 · Cited by 328 · see citing works
Diabetes Mellitus and Cause-Specific Mortality: A Population-Based Study
Li, S., Wang, J., Zhang, B., Li, X., & Liu, Y. (2019) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2018.0060 · Cited by 292 · see citing works
Self-citationGuidelines for the treatment and management of new‐onset diabetes after transplantation1
Wilkinson, A. H., Davidson, J. A., Dotta, F., Home, P., Keown, P. A., KIBERD, B. A., Jardine, A. G., Levitt, N. S., Marchetti, P., MARKELL, M. S., et al. (2005) · Clinical Transplantation · doi:10.1111/j.1399-0012.2005.00359.x · Cited by 240 · see citing works
Development of Diabetes Mellitus Following Kidney Transplantation: A Canadian Experience
Diekmann, F., Gourishankar, S., Jhangri, G. S., Tonelli, M. A., Wales, L. H., & Cockfield, S. M. (2004) · American Journal of Transplantation · doi:10.1111/j.1600-6143.2004.00591.x · Cited by 128 · see citing works
Kuo, H., Sampaio, M. S., Vincenti, F. G., & Bunnapradist, S. (2010) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2010.06.027 · Cited by 125 · see citing works
Pharmacokinetics of tacrolimus-based combination therapies
Undre, N. A. (2003) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfg1029 · Cited by 112 · see citing works
Cardiovascular Consequences of New-Onset Hyperglycemia After Kidney Transplantation
Wauters, R. P., Cosio, F. G., Fernández, M., Kudva, Y. C., Shah, P. R., & Torres, V. E. (2012) · Transplantation · doi:10.1097/tp.0b013e3182584831 · Cited by 106 · see citing works
Emerging treatments for post-transplantation diabetes mellitus
Jenssen, T., & Hartmann, A. (2015) · Nature Reviews Nephrology · doi:10.1038/nrneph.2015.59 · Cited by 90 · see citing works
Tacrolimus and Sirolimus Cause Insulin Resistance in Normal Sprague Dawley Rats
Larsen, J. L., Bennett, R. G., Burkman, T. W., Ramirez, A. L., Yamamoto, S., Gulizia, J. M., Radio, S. J., & Hamel, F. G. (2006) · Transplantation · doi:10.1097/01.tp.0000229384.22217.15 · Cited by 81 · see citing works
Eide, I. A., Halden, T. A. S., Hartmann, A., Åsberg, A., Dahle, D. O., Reisæter, A. V., & Jenssen, T. G. (2016) · Transplant International · doi:10.1111/tri.12757 · Cited by 60 · see citing works
Immunosuppression and Post-transplant Hyperglycemia
Montero, N., & Pascual, J. (2015) · Current Diabetes Reviews · doi:10.2174/1573399811666150331160846 · Cited by 52 · see citing works
Pascual, J., del Castillo, D., Cabello, M., et al. (2010) · Transplantation · doi:10.1097/tp.0b013e3181ccd7f2 · Cited by 51 · see citing works
Lv, C., Chen, M., Xu, M., Xu, G., Zhang, Y., He, S., Xue, M., Gao, J., Yu, M., Gao, X., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0099406 · Cited by 45 · see citing works
Veroux, M., Tallarita, T., Corona, D., Sinagra, N., Giaquinta, A., Zerbo, D., Guerrieri, C., D’Assoro, A. B., Cimino, S., & Veroux, P. (2013) · Clinical and Developmental Immunology · doi:10.1155/2013/496974 · Cited by 44 · see citing works
Sinangil, A., Çelik, V., Barlas, İ. S., Koç, Y., Baştürk, T., Şakacı, T., Akın, E. B., & Ecder, T. (2017) · Nefrología · doi:10.1016/j.nefro.2016.11.022 · Cited by 37 · see citing works
Okumi, M., Unagami, K., Hirai, T., Shimizu, T., Ishida, H., & Tanabe, K. (2016) · International Journal of Urology · doi:10.1111/iju.13253 · Cited by 25 · see citing works
Baron, P. W., Infante, S., Peters, R., Tilahun, J., Weissman, J., Delgado, L., Kore, A., Beeson, W. L., & de Vera, M. E. (2017) · Annals of Transplantation · doi:10.12659/aot.903079 · Cited by 25 · see citing works
Park, S.-C., Yoon, Y.-D., Jung, H., Kim, K.-H., Choi, J., Park, S.-H., Kim, C.-D., Kim, Y.-L., Kim, H.-K., Huh, S., et al. (2015) · Transplantation Proceedings · doi:10.1016/j.transproceed.2014.11.053 · Cited by 23 · see citing works
Paek, J. H., Kang, S. S., Park, W. Y., Jin, K., Park, S. B., Han, S., Kim, C., Ro, H., Lee, S., Jung, C. W., et al. (2019) · Transplantation Proceedings · doi:10.1016/j.transproceed.2019.02.054 · Cited by 22 · see citing works
Xu, J., Xu, L., Wei, X., Li, X., & Cai, M. (2018) · Transplantation Proceedings · doi:10.1016/j.transproceed.2018.08.007 · Cited by 19 · see citing works
Genetic factors in pathogenesis of diabetes mellitus after kidney transplantation
Tarnowski, M., Słuczanowska-Głąbowska, S., Pawlik, A., Mazurek−Mochol, M., & Dembowska, E. (2017) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s129327 · Cited by 16 · see citing works
Risk factors and long-term consequences of new-onset diabetes after renal transplantation
Tomkins, M., Tudor, R. M., Cronin, K., O’Kelly, P., Williams, Y., Little, D. M., de Freitas, D. G., Denton, M., O’Seaghdha, C. M., Conlon, P. J., et al. (2019) · Irish Journal of Medical Science (1971 -) · doi:10.1007/s11845-019-02112-6 · Cited by 13 · see citing works
Alsheikh, R., & Gabardi, S. (2018) · Progress in Transplantation · doi:10.1177/1526924818800039 · Cited by 7 · see citing works
Post–Kidney-Transplant Diabetes: Evaluation of Risk Factors
de Sá, D. C., Santos, L., Rodrigues, L., Romãozinho, C., Marques, M. G., Macario, F. J. G. R. M., Bastos, M. D. L., Baptista, C. F., Alves, R., & Figueiredo, A. (2019) · Transplantation Proceedings · doi:10.1016/j.transproceed.2019.02.021 · Cited by 6 · see citing works
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2. Classification and Diagnosis of Diabetes: <i>Standards of Medical Care in Diabetes—2022</i>
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American Diabetes Association Professional Practice Committee, ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Gaglia, J. L., Hilliard, M. E., Johnson, E. L., et al. (2024) · Diabetes Care · doi:10.2337/dc24-s002 · Cited by 2,086 · see citing works
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American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Ebekozien, O., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s002 · Cited by 1,393 · see citing works
- Authors
- Cheng, C.-Y., Chen, C.-H., Wu, M.-F., Wu, M.-J., Chen, J.-P., Liu, Y.-M., Hou, Y.-C., & Wang, H.-Y.
- Affiliations
- China Medical University (TW)
- Tunghai University (TW)
- Department of Pharmacy, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- National Chung Hsing University (TW)
- Biostatistics Task Force, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- Chi Mei Medical Center (TW)
- Corresponding author
- Wang, Hue-Yu
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2020-06-25
- Volume
- 17
- Issue
- 12
- Pages
- 4581
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC7345656
- OpenAlex
- W3037835005
- Cited by
- 18
- References
- 34
- Citations by year
- 2025: 7 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 4
- FWCI
- 1.70
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
- Keywords
- post-transplant diabetes mellitus, kidney transplantation, risk factors, long-term survival, graft survival, body mass index, donor age, deceased donor, calcineurin inhibitors, tacrolimus, mTOR inhibitors, immunosuppressive therapy
- MeSH terms
- Aged, Diabetes Mellitus, Female, Graft Survival, Humans, Immunosuppressive Agents, Male, Middle Aged, Postoperative Complications, Retrospective Studies, Risk Factors, Taiwan, Organ Transplantation
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