肾移植术后糖尿病形成的危险因素

The Risk Factors Caused Renal Post-transplantation Diabetes Mellitus

目的探讨肾移植后糖尿病(post-transplantation diabetes mellitus,PTDM)发生的危险因素。方法回顾性分析自2003年1月至2006年10月在首都医科大学附属北京同仁医院移植中心101例同种异体尸体肾移植术后病人资料,将其分为PTDM组和非PTDM组,比较2组间年龄、性别、糖尿病家族史、术前体质量指数(BMI)、服用免疫抑制剂(环孢霉素A,CsA;普乐可复,FK506)情况等方面的差异。结果1)PTDM的发生率为11.9%;2)2组患者的平均年龄、糖尿病家族史及术前BMI差异有统计学意义,PTDM组患者的年龄和术前BMI均较非PTDM组偏大,且有明显的糖尿病家族史;3)2组患者性别分布、服用CsA与FK506的患者比例差异均无统计学意义。结论患者糖尿病家族史、较大的年龄及术前较高的BMI是导致PTDM发生的危险因素;性别与PTDM发生无关;与服用CsA的患者相比,服用FK506并不增加PTDM的发生。

Objective To study the risk factors of post-transplantation diabetes mellitus （PTDM）. Methods A retrospective analysis was performed in 101 cadaveric renal transplantation patients, without previously known diabetes, during the period from January 2003 to October 2006. The patients were divided into two groups： PTDM and no-PTDM. The two groups were compared for age, sex, family history of diabetes mellitus, pre-transplanting BMI （ body mass index）, baseline immunosuppressive agents. Results 1） The incidence of PTDM was about 11.9% in these 101 patients. 2） There were great differences between the two groups in terms of age, family history of diabetes mellitus, pre-transplanting BMI. The PTDM eases were prone to have older ages, higher pre-transplanting BMI and more commonly with family history of diabetes mellitus. 3） There was no difference between the two groups in terms of sex and baseline immunosuppressive agents. Conclusion This study shows that the risk factors of PTDM include： older age, family history of diabetes mellitus, higher pre-transplant BMI. Sex is not a risk factor for development of PTDM. Compared to patients on eyelosperine use, tacrolimus is not a risk factor for development of PTDM.