Can Pre-Transplant Psychometric Testing Predict Tacrolimus Intrapatient Variability After Living Kidney Transplantation?

IF 1.8 4区医学 Q3 PSYCHIATRY

Psychiatry Investigation Pub Date : 2024-07-25 DOI:10.30773/pi.2024.0058

Ah Rah Lee, Sang Min Lee, Won Sub Kang, A. Cho, Jong Woo Kim, Jin Kyung Park

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引用次数: 0

Abstract

Objective Tacrolimus intrapatient variability (Tac IPV) has been considered a marker for post-graft risk. We investigated pre-transplant psychometric testing to predict Tac IPV after living kidney transplantation.Methods Minnesota Multiphasic Personality Inventory-2 (MMPI-2) examined during pre-transplant evaluation by 102 recipients were analyzed. Subjects were divided into two groups, low IPV (L-IPV) and high IPV (H-IPV), by cutoffs of Tac IPV: median of 24 and value of 30. T-scores of MMPI-2 scales were used to analyze difference between L-IPV and H-IPV using independent t-tests. Stepwise multiple logistic regression was used to test whether MMPI-2 scales affected Tac IPV. Confusion matrix of logistic regression was used to explain statistical power. Cutoff values of significant scales for H-IPV were analyzed by constructing receiver operating characteristic curves.Results Hysteria (Hy) and depression (D) scale scores and Tac IPV were associated in IPV 24 (odds ratio [OR]: 1.08, p<0.01 for Hy; OR: 0.93, p<0.01 for D) and IPV 30 models (OR: 1.09, p<0.01 for Hy; OR: 0.92, p<0.01 for D). Paranoia (Pa) scale scores were associated with Tac IPV in IPV 24 model (OR=1.10, p<0.01) and were significantly higher in H-IPV 24 (p<0.01). F1 scores of confusion matrix in IPV 24 and 30 models were 0.70 and 0.71, respectively. Cutoffs of Hy, D, and Pa scales were 51, 57, and 47, respectively.Conclusion MMPI-2 profile is suggested as a predictor for high Tac IPV after living kidney transplantation.

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移植前心理测试能否预测活体肾移植后他克莫司在患者体内的变异性？

目的他克莫司患者间变异性（Tac IPV）一直被认为是移植后风险的标志。我们对移植前心理测试进行了研究，以预测活体肾移植后的 Tac IPV。受试者被分为两组，即低 IPV（L-IPV）组和高 IPV（H-IPV）组，Tac IPV 的临界值分别为中位数 24 和数值 30。采用独立 t 检验法对 MMPI-2 量表的 T 值分析 L-IPV 和 H-IPV 之间的差异。逐步多元逻辑回归用于检验 MMPI-2 量表是否会影响 Tac IPV。逻辑回归的混淆矩阵用于解释统计能力。结果在 IPV 24 模型中，癔症（Hy）和抑郁（D）量表得分与 Tac IPV 相关（几率比[OR]：Hy：1.08，p<0.01；D：0.93，p<0.01），在 IPV 30 模型中，癔症（Hy）和抑郁（D）量表得分与 Tac IPV 相关（几率比[OR]：Hy：1.09，p<0.01；D：0.92，p<0.01）。在 IPV 24 模型中，妄想症（Pa）量表得分与 Tac IPV 相关（OR=1.10，p<0.01），在 H-IPV 24 模型中显著较高（p<0.01）。IPV 24 和 30 模型混淆矩阵的 F1 分数分别为 0.70 和 0.71。结论 MMPI-2 资料可作为活体肾移植后高 Tac IPV 的预测指标。

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来源期刊

Psychiatry Investigation PSYCHIATRY-

CiteScore

4.10

自引率

3.70%

发文量

105

审稿时长

6-12 weeks

期刊介绍： The Psychiatry Investigation is published on the 25th day of every month in English by the Korean Neuropsychiatric Association (KNPA). The Journal covers the whole range of psychiatry and neuroscience. Both basic and clinical contributions are encouraged from all disciplines and research areas relevant to the pathophysiology and management of neuropsychiatric disorders and symptoms, as well as researches related to cross cultural psychiatry and ethnic issues in psychiatry. The Journal publishes editorials, review articles, original articles, brief reports, viewpoints and correspondences. All research articles are peer reviewed. Contributions are accepted for publication on the condition that their substance has not been published or submitted for publication elsewhere. Authors submitting papers to the Journal (serially or otherwise) with a common theme or using data derived from the same sample (or a subset thereof) must send details of all relevant previous publications and simultaneous submissions. The Journal is not responsible for statements made by contributors. Material in the Journal does not necessarily reflect the views of the Editor or of the KNPA. Manuscripts accepted for publication are copy-edited to improve readability and to ensure conformity with house style.