HbA1c changes in the first year post-kidney transplant and associated risk factors in a Saudi cohort.

IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Therapeutic Advances in Endocrinology and Metabolism Pub Date : 2024-11-30 eCollection Date: 2024-01-01 DOI:10.1177/20420188241301940
Ziad Arabi, Hazim S Alghamdi, Tarek Arabi, Areez Shafqat, Badr Elwy, Belal Sabbah
{"title":"HbA1c changes in the first year post-kidney transplant and associated risk factors in a Saudi cohort.","authors":"Ziad Arabi, Hazim S Alghamdi, Tarek Arabi, Areez Shafqat, Badr Elwy, Belal Sabbah","doi":"10.1177/20420188241301940","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There is limited data about the risk factors of clinically significant glycosylated hemoglobin (HbA1c) change and post-transplant diabetes mellitus (PTDM) in the first year post-kidney transplantation (KT), especially in the Middle East.</p><p><strong>Objectives: </strong>To determine the trends of HbA1c levels, the risk factors associated with HbA1c increases, and predictors of clinically significant HbA1c change and PTDM in the first year post-KT.</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Methods: </strong>We included all KT recipients (KTRs) at our center from 2017 until 2020. The study focused on reviewing the patients' demographic information, cardiovascular risk factors, and HbA1c values at baseline, 6 months, and 12 months.</p><p><strong>Results: </strong>A total of 203 KTRs were included. The mean age of the participants was 44.7 ± 15.5 years, 59.1% were men, and 80.3% received living donors. Eighty-two (40.4%) KTRs had pre-KT diabetes. At 12 months post-KT, the total HbA1c change was 0.87 ± 1.6. In total, 130 (64.04%) KTRs demonstrated clinically significant HbA1c change, and 19 (15.7%) nondiabetics developed PTDM. Pre-KT diabetics suffered greater increases than their nondiabetic counterparts (0.8 vs 0.6, <i>p</i> = 0.043). Increased age (adjusted odds ratio (aOR) = 1.053), weight change (aOR = 1.055), pre-KT hypertension (aOR = 3.015), and lower baseline HbA1c (aOR = 0.453) were independently associated with clinically significant HbA1c change. PTDM patients were older (<i>p</i> = 0.007) and had higher HbA1c levels at baseline (<i>p</i> = 0.033), 6 months (<i>p</i> = 0.002), and 1-year post-KT (<i>p</i> = 0.001). Gender, type of KT, dialysis, and cardiovascular risk factors were not different between PTDM and non-PTDM patients. Abnormal perfusion tests (<i>p</i> < 0.001) and coronary artery disease on coronary angiogram (<i>p</i> = 0.046) were more common in PTDM patients. Only age was independently associated with the presence of PTDM at 1-year post-KT (aOR = 1.044).</p><p><strong>Conclusion: </strong>The incidence rate of PTDM in Saudi KT patients is similar to that of other populations. Several risk factors, including low baseline HbA1c and pre-KT hypertension, predict a clinically significant change in HbA1c. Patients with these risk factors may require stricter monitoring and control of HbA1c.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"15 ","pages":"20420188241301940"},"PeriodicalIF":3.9000,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607771/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Endocrinology and Metabolism","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/20420188241301940","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0

Abstract

Background: There is limited data about the risk factors of clinically significant glycosylated hemoglobin (HbA1c) change and post-transplant diabetes mellitus (PTDM) in the first year post-kidney transplantation (KT), especially in the Middle East.

Objectives: To determine the trends of HbA1c levels, the risk factors associated with HbA1c increases, and predictors of clinically significant HbA1c change and PTDM in the first year post-KT.

Design: Retrospective chart review.

Methods: We included all KT recipients (KTRs) at our center from 2017 until 2020. The study focused on reviewing the patients' demographic information, cardiovascular risk factors, and HbA1c values at baseline, 6 months, and 12 months.

Results: A total of 203 KTRs were included. The mean age of the participants was 44.7 ± 15.5 years, 59.1% were men, and 80.3% received living donors. Eighty-two (40.4%) KTRs had pre-KT diabetes. At 12 months post-KT, the total HbA1c change was 0.87 ± 1.6. In total, 130 (64.04%) KTRs demonstrated clinically significant HbA1c change, and 19 (15.7%) nondiabetics developed PTDM. Pre-KT diabetics suffered greater increases than their nondiabetic counterparts (0.8 vs 0.6, p = 0.043). Increased age (adjusted odds ratio (aOR) = 1.053), weight change (aOR = 1.055), pre-KT hypertension (aOR = 3.015), and lower baseline HbA1c (aOR = 0.453) were independently associated with clinically significant HbA1c change. PTDM patients were older (p = 0.007) and had higher HbA1c levels at baseline (p = 0.033), 6 months (p = 0.002), and 1-year post-KT (p = 0.001). Gender, type of KT, dialysis, and cardiovascular risk factors were not different between PTDM and non-PTDM patients. Abnormal perfusion tests (p < 0.001) and coronary artery disease on coronary angiogram (p = 0.046) were more common in PTDM patients. Only age was independently associated with the presence of PTDM at 1-year post-KT (aOR = 1.044).

Conclusion: The incidence rate of PTDM in Saudi KT patients is similar to that of other populations. Several risk factors, including low baseline HbA1c and pre-KT hypertension, predict a clinically significant change in HbA1c. Patients with these risk factors may require stricter monitoring and control of HbA1c.

沙特队列患者肾移植后第一年HbA1c变化及相关危险因素
背景:关于肾移植(KT)后第一年临床显著的糖化血红蛋白(HbA1c)变化和移植后糖尿病(PTDM)的危险因素的数据有限,特别是在中东地区。目的:确定kt术后一年内HbA1c水平的变化趋势,与HbA1c升高相关的危险因素,以及临床显著HbA1c变化和PTDM的预测因素。设计:回顾性图表回顾。方法:我们纳入了2017年至2020年在我们中心的所有KT接受者(ktr)。该研究的重点是回顾患者在基线、6个月和12个月的人口统计信息、心血管危险因素和HbA1c值。结果:共纳入203例ktr。参与者的平均年龄为44.7±15.5岁,男性占59.1%,80.3%接受活体供体。82例(40.4%)ktr患者有kt前期糖尿病。kt后12个月,总HbA1c变化为0.87±1.6。总共有130例(64.04%)KTRs表现出临床显著的HbA1c变化,19例(15.7%)非糖尿病患者发生了PTDM。kt前糖尿病患者比非糖尿病患者增加更多(0.8 vs 0.6, p = 0.043)。年龄增加(调整优势比(aOR) = 1.053)、体重变化(aOR = 1.055)、kt前高血压(aOR = 3.015)和基线HbA1c降低(aOR = 0.453)与临床显著HbA1c变化独立相关。PTDM患者年龄较大(p = 0.007),基线HbA1c水平较高(p = 0.033), kt后6个月(p = 0.002)和1年(p = 0.001)。PTDM和非PTDM患者的性别、KT类型、透析和心血管危险因素无差异。灌注试验异常(p = 0.046)在PTDM患者中更为常见。只有年龄与kt后1年PTDM的存在独立相关(aOR = 1.044)。结论:沙特KT患者PTDM发病率与其他人群相似。几个危险因素,包括低基线HbA1c和kt前高血压,预测HbA1c的临床显著变化。有这些危险因素的患者可能需要更严格的监测和控制HbA1c。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Therapeutic Advances in Endocrinology and Metabolism
Therapeutic Advances in Endocrinology and Metabolism Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
7.70
自引率
2.60%
发文量
42
审稿时长
8 weeks
期刊介绍: Therapeutic Advances in Endocrinology and Metabolism delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of endocrinology and metabolism.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信