Prevalence and predictors of “New-onset diabetes after transplantation” (NODAT) in renal transplant recipients: An observational study
Objective: New-onset diabetes after transplantation (NODAT) develops frequently after renal transplant. The study aims at the prevalence of NODAT , predictors for developing it and therapeutic glycemic responses in NODAT. Materials and Methods: Consecutive renal transplant recipients excluding Diabe...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2019-01-01
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| Series: | Indian Journal of Endocrinology and Metabolism |
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| Online Access: | http://www.ijem.in/article.asp?issn=2230-8210;year=2019;volume=23;issue=3;spage=273;epage=277;aulast=Choudhury |
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| author | Partha Sarathi Choudhury Pradip Mukhopadhyay Arpita Roychowdhary Subhankar Chowdhury Sujoy Ghosh |
| author_facet | Partha Sarathi Choudhury Pradip Mukhopadhyay Arpita Roychowdhary Subhankar Chowdhury Sujoy Ghosh |
| author_sort | Partha Sarathi Choudhury |
| collection | DOAJ |
| description | Objective: New-onset diabetes after transplantation (NODAT) develops frequently after renal transplant. The study aims at the prevalence of NODAT , predictors for developing it and therapeutic glycemic responses in NODAT. Materials and Methods: Consecutive renal transplant recipients excluding Diabetic Kidney Disease (DKD) or pretransplant diabetes were evaluated. Forty-three out of 250 persons were found to have NODAT. Ninety age-matched transplant recipients from the rest were recruited as control. Fasting blood sugar (FBS), HbA1c, lipid profile, and trough tacrolimus level (T0) were examined in all. HOMA IR C-peptide and HOMA-beta C-peptide were calculated. Results: Prevalence of NODAT in renal transplant recipients was 17.2% (43/250). Twenty-four (55.8%) developed early NODAT (<1 year) and 19 (44.2%) developed late NODAT (>1 year). Significantly higher pretransplant body mass index (BMI) (kg/m2) (P < 0.001), waist circumference (WC) (cm) (P < 0.001), pretransplant cholesterol (mg%) (P = 0.04), triglyceride (mg%) (P < 0.001), and FBS (mg%) (P < 0.001) were found in NODAT compared with non-NODAT. Trough tacrolimus (ng/mL) was found to be higher in NODAT (10.2 vs. 5.37, P < 0.001). Though HOMA IR was not found to be different between groups, HOMA-beta C-peptide was low in NODAT compared with non-NODAT (P = 0.03). Predictors of NODAT were WC [odds ratio (OR) = 01.15] and trough tacrolimus level (OR = 1.316). Best cut-off of WC for predicting NODAT was 87.5 cm for male and 83.5 cm for female. Best cut-off of T0 was 8.5 ng/mL. In NODAT, 9.3% were treated by lifestyle modification, 67.4% by oral hypoglycemic agents, 11.6% by insulin, and 11.6% by combined insulin and oral antidiabetic agents with HbA1c <7%. Conclusion: NODAT in renal transplant recipients is more common in those with higher pretransplant BMI, WC, pretransplant total cholesterol, triglyceride, and FBS. Beta-cell secretory defect is more relevant as etiological factor rather than insulin resistance. Higher WC and trough tacrolimus level above 8.5 ng/mL may be important factors for predicting NODAT. |
| first_indexed | 2024-12-21T08:41:26Z |
| format | Article |
| id | doaj.art-f6aa16280f8145a19492b442e7ee4490 |
| institution | Directory Open Access Journal |
| issn | 2230-8210 |
| language | English |
| last_indexed | 2024-12-21T08:41:26Z |
| publishDate | 2019-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj.art-f6aa16280f8145a19492b442e7ee44902022-12-21T19:09:56ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102019-01-0123327327710.4103/ijem.IJEM_178_19Prevalence and predictors of “New-onset diabetes after transplantation” (NODAT) in renal transplant recipients: An observational studyPartha Sarathi ChoudhuryPradip MukhopadhyayArpita RoychowdharySubhankar ChowdhurySujoy GhoshObjective: New-onset diabetes after transplantation (NODAT) develops frequently after renal transplant. The study aims at the prevalence of NODAT , predictors for developing it and therapeutic glycemic responses in NODAT. Materials and Methods: Consecutive renal transplant recipients excluding Diabetic Kidney Disease (DKD) or pretransplant diabetes were evaluated. Forty-three out of 250 persons were found to have NODAT. Ninety age-matched transplant recipients from the rest were recruited as control. Fasting blood sugar (FBS), HbA1c, lipid profile, and trough tacrolimus level (T0) were examined in all. HOMA IR C-peptide and HOMA-beta C-peptide were calculated. Results: Prevalence of NODAT in renal transplant recipients was 17.2% (43/250). Twenty-four (55.8%) developed early NODAT (<1 year) and 19 (44.2%) developed late NODAT (>1 year). Significantly higher pretransplant body mass index (BMI) (kg/m2) (P < 0.001), waist circumference (WC) (cm) (P < 0.001), pretransplant cholesterol (mg%) (P = 0.04), triglyceride (mg%) (P < 0.001), and FBS (mg%) (P < 0.001) were found in NODAT compared with non-NODAT. Trough tacrolimus (ng/mL) was found to be higher in NODAT (10.2 vs. 5.37, P < 0.001). Though HOMA IR was not found to be different between groups, HOMA-beta C-peptide was low in NODAT compared with non-NODAT (P = 0.03). Predictors of NODAT were WC [odds ratio (OR) = 01.15] and trough tacrolimus level (OR = 1.316). Best cut-off of WC for predicting NODAT was 87.5 cm for male and 83.5 cm for female. Best cut-off of T0 was 8.5 ng/mL. In NODAT, 9.3% were treated by lifestyle modification, 67.4% by oral hypoglycemic agents, 11.6% by insulin, and 11.6% by combined insulin and oral antidiabetic agents with HbA1c <7%. Conclusion: NODAT in renal transplant recipients is more common in those with higher pretransplant BMI, WC, pretransplant total cholesterol, triglyceride, and FBS. Beta-cell secretory defect is more relevant as etiological factor rather than insulin resistance. Higher WC and trough tacrolimus level above 8.5 ng/mL may be important factors for predicting NODAT.http://www.ijem.in/article.asp?issn=2230-8210;year=2019;volume=23;issue=3;spage=273;epage=277;aulast=ChoudhuryHOMA-beta C-peptidenew-onset diabetes after transplantationrenal transplanttacrolimus |
| spellingShingle | Partha Sarathi Choudhury Pradip Mukhopadhyay Arpita Roychowdhary Subhankar Chowdhury Sujoy Ghosh Prevalence and predictors of “New-onset diabetes after transplantation” (NODAT) in renal transplant recipients: An observational study Indian Journal of Endocrinology and Metabolism HOMA-beta C-peptide new-onset diabetes after transplantation renal transplant tacrolimus |
| title | Prevalence and predictors of “New-onset diabetes after transplantation” (NODAT) in renal transplant recipients: An observational study |
| title_full | Prevalence and predictors of “New-onset diabetes after transplantation” (NODAT) in renal transplant recipients: An observational study |
| title_fullStr | Prevalence and predictors of “New-onset diabetes after transplantation” (NODAT) in renal transplant recipients: An observational study |
| title_full_unstemmed | Prevalence and predictors of “New-onset diabetes after transplantation” (NODAT) in renal transplant recipients: An observational study |
| title_short | Prevalence and predictors of “New-onset diabetes after transplantation” (NODAT) in renal transplant recipients: An observational study |
| title_sort | prevalence and predictors of new onset diabetes after transplantation nodat in renal transplant recipients an observational study |
| topic | HOMA-beta C-peptide new-onset diabetes after transplantation renal transplant tacrolimus |
| url | http://www.ijem.in/article.asp?issn=2230-8210;year=2019;volume=23;issue=3;spage=273;epage=277;aulast=Choudhury |
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