التفاصيل البيبلوغرافية
| العنوان: |
Influence of Immunosuppression and Effect of Hepatitis C Virus on New Onset of Diabetes Mellitus in Liver Transplant Recipients |
| المؤلفون: |
Sánchez-Pérez, B.1 cirbelinda@telefonica.net, Aranda Narváez, J.M.1, Santoyo Santoyo, J.1, Fernández-Aguilar, J.L.1, Suárez Muñoz, M.A.1, González-Sánchez, A.J.1, Pérez Daga, J.A.1, Ramírez Plaza, C.P.1, Carrasco Campos, J.1, Jiménez Mazure, C., Becerra Ortíz, R. |
| المصدر: |
Transplantation Proceedings. Nov2008, Vol. 40 Issue 9, p2994-2996. 3p. |
| مصطلحات موضوعية: |
*IMMUNOSUPPRESSIVE agents, *HEPATITIS C virus, *LIVER transplantation, *DIABETES, *MORTALITY, *DISEASE incidence, *OBESITY, *PATIENTS |
| مستخلص: |
Abstract: Introduction: New-onset posttransplantation diabetes mellitus (PTDM), with an incidence of 10% to 30%, increased graft and patient morbidity and mortality. Such causal factors as age, obesity, therapy, immunosuppression, and hepatitis C virus (HCV) contribute to this disease. Objective: We sought to determine the incidence of PTDM and impaired fasting glucose (IFG) concentration in transplant recipients to define the causal variables. Material and Methods: The study included 127 patients. Patients with pretransplantation diabetes and those with less than 6 months of follow-up were excluded. A descriptive observational study to assess the association between PTDM and IFG and the immunosuppression therapy used was performed by monitoring the potential confounding variables of age, obesity, and HCV. Results: During mean follow-up of 73.7 months (range, 7–120 mo), 93 patients received cyclosporine A (CyA) and 34 received tacrolimus (Tac) therapy. Thirty patients (23.6%) developed PTDM or IFG including 15 (16%; PTDM, six IFG, nine) in the CyA group and 15 (PTDM, seven; IFG, eight) in the Tacrolimus group (P = .001; odds ratio [OR], 4.1). They were homogeneous with respect to confounding variables except for HCV (P = .01). Of the 55 patients with HCV infection, 12 developed PTDM or IFG, including three in the CyA group and nine in the tacrolimus group (P = .03; OR, 7.7), whereas in the 72 patients without HCV infection, the CyA or tacrolimus association with PTDM or IFG was significant (P = .05), Mantel-Haenszel test; OR, 4.9). The interaction between HCV and immunosuppression therapy was primarily produced in the IFG group (HCV-positive; P = .008; OR, 8). Conclusion: We observed an association between the use of tacrolimus and the development of PTDM or IFG. There is greater risk in HCV-positive patients, in particular in relation to IFG. The choice of immunosuppressive treatment might be decided on the basis of the patient''s pretransplantation status. [Copyright &y& Elsevier] |
| قاعدة البيانات: |
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