Yıl: 2022 Cilt: 26 Sayı: 3 Sayfa Aralığı: 136 - 140 Metin Dili: İngilizce DOI: 10.5152/tjem.2022.22053 İndeks Tarihi: 25-09-2022

Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus

Öz:
Objective: We aimed to identify the risk factors for the development of diabetes mellitus after transplantation in liver recipients. Methods: Two hundred twenty-seven patients with a follow-up period >8 months after liver trans plantation were included in the study. The clinical and laboratory data of patients with post-liver transplantation diabetes mellitus and without post-liver transplantation diabetes mellitus were compared. Results: Of the 227 patients, 61 patients were diagnosed with diabetes mellitus in the pretransplanta tion period. Twelve percent of the patients (20 patients) were diagnosed with post-liver transplanta tion diabetes mellitus and 146 patients were not diagnosed with diabetes mellitus. We found that post-liver transplantation diabetes mellitus was associated with advanced age (95% CI: 1.002-1.142). Male liver recipients were diagnosed with a higher rate of post-liver transplantation diabetes mellitus than female recipients (15.5% and 5.4%, respectively; P = .045). Pretransplantation fasting plasma glucose levels were higher in patients with post-liver transplantation diabetes mellitus than without post-liver transplantation diabetes mellitus, which was not statistically significant (P = .097). While 22.2% of patients with post-liver transplantation diabetes mellitus had complications after transplan tation, 14.2% of the patients without post-liver transplantation diabetes mellitus had complications after transplantation (P = .370). Conclusion: As post-liver transplantation diabetes mellitus is associated with graft failure and increased mortality and morbididy, candidates for liver transplantation should be screened for risk factors of diabetes, and blood work for diabetes mellitus should be done regularly in these patients. Since patients with advanced age, male gender, and higher fasting plasma glucose levels in the pre transplantation period have higher risk for the development of post-liver transplantation diabetes mellitus, these cases should be screened more carefully.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. European Association for the Study of the Liver. Electronic address: easlo ffice@easloffice.eu. EASL clinical practice guidelines: liver transplanta tion. J Hepatol. 2016;64(2):433-485. [CrossRef]
  • 2. Adam R, Karam V, Delvart V, et al. Evolution of indications and results of liver transplantation in Europe. A report from the European Liver Trans plant Registry (ELTR). J Hepatol. 2012;57(3):675-688. [CrossRef]
  • 3. Agopian VG, Petrowsky H, Kaldas FM, et al. The evolution of liver trans plantation during 3 decades: analysis of 5347 consecutive liver trans plants at a single center. Ann Surg. 2013;258(3):409-421. [CrossRef]
  • 4. Li P, Fan H, He Q. Pretransplant diabetes mellitus predicts worse out comes of liver transplantation: evidence from meta-analysis. J Endocrinol Invest. 2018;41(2):211-221. [CrossRef]
  • 5. Barritt AS, Dellon ES, Kozlowski T, Gerber DA, Hayashi PH. The influence of nonalcoholic fatty liver disease and its associated comorbidities on liver transplant outcomes. J Clin Gastroenterol. 2011;45(4):372-378. [CrossRef]
  • 6. Tsai MS, Wang YC, Wang HH, Lee PH, Jeng LB, Kao CH. Pre-existing diabetes and risks of morbidity and mortality after liver transplantation: a nationwide database study in an Asian population. Eur J Intern Med. 2015;26(6):433-438. [CrossRef]
  • 7. Hoehn RS, Singhal A, Wima K, et al. Effect of pretransplant diabetes on short-term outcomes after liver transplantation: a national cohort study. Liver Int. 2015;35(7):1902-1909. [CrossRef]
  • 8. Honda M, Asonuma K, Hayashida S, et al. Incidence and risk factors for new-onset diabetes in living-donor liver transplant recipients. Clin Trans plant. 2013;27(3):426-435. [CrossRef]
  • 9. Kuo HT, Sampaio MS, Ye X, Reddy P, Martin P, Bunnapradist S. Risk factors for new-onset diabetes mellitus in adult liver transplant recipients, an analysis of the Organ Procurement and Transplant Network/United Net work for Organ Sharing database. Transplantation. 2010;89(9):1134- 1140. [CrossRef]
  • 10. Lv C, Zhang Y, Chen X, et al. New-onset diabetes after liver transplanta tion and its impact on complications and patient survival. J Diabetes. 2015;7(6):881-890. [CrossRef]
  • 11. Yoo HY, Thuluvath PJ. The effect of insulin dependent diabetes mellitus on outcome of liver transplantation. Transplantation. 2002; 74(7): 1007- 1012. [CrossRef]
  • 12. Tueche SG. Diabetes mellitus after liver transplant new etiologic clues and cornerstones for understanding. Transplant Proc. 2003; 35(4): 1466- 1468. [CrossRef]
  • 13. Baid S, Cosimi AB, Farrell ML, et al. Posttransplant diabetes mellitus in liver transplant recipients: risk factors, temporal relationship with hepa titis C virus allograft hepatitis, and impact on mortality. Transplantation. 2001;72(6):1066-1072. [CrossRef]
  • 14. Steinmüller TH, Stockmann M, Bechstein WO, Settmacher U, Jonas S, Neuhaus P. Liver transplantation and diabetes mellitus. Exp Clin Endo crinol Diabetes. 2000;108(6):401-405. [CrossRef]
  • 15. Marchetti P. New onset diabetes after liver transplantation: from patho genesis to management. Liver Transpl. 2005;11(6):612-620. [CrossRef]
  • 16. Ahmed A, Keeffe EB. Hepatitis C virus and liver transplantation. Clin Liver Dis. 2001;5(4):1073-1090. [CrossRef]
  • 17. Fransson L, Rosengren V, Saha TK, et al. Mitogen-activated protein kinases and protein phosphatase 5 mediate glucocorticoid-induced cytotoxicity in pancreatic islets and β-cells. Mol Cell Endocrinol. 2014; 383(1-2):126-136. [CrossRef]
  • 18. Colvin ES, Ma HY, Chen YC, Hernandez AM, Fueger PT. Glucocorticoid induced suppression of β-cell proliferation is mediated by Mig6. Endo crinology. 2013;154(3):1039-1046. [CrossRef]
  • 19. Rooney DP, Neely RD, Cullen C, et al. The effect of cortisol on glucose/gl ucose-6-phosphate cycle activity and insulin action. J Clin Endocrinol Metab. 1993;77(5):1180-1183. [CrossRef]
  • 20. Peláez-Jaramillo MJ, Cárdenas-Mojica AA, Gaete PV, Mendivil CO. Post liver transplantation diabetes mellitus: a review of relevance and approach to treatment. Diabetes Ther. 2018;9(2):521-543. [CrossRef]
  • 21. Navasa M, Bustamante J, Marroni C, et al. Diabetes mellitus after liver transplantation: prevalence and predictive factors. J Hepatol. 1996;25(1): 64-71. [CrossRef]
  • 22. Li DW, Lu TF, Hua XW, et al. Risk factors for new onset diabetes mellitus after liver transplantation: a meta-analysis. World J Gastroenterol. 2015;21(20):6329-6340. [CrossRef]
  • 23. Botta F, Giannini E, Romagnoli P, et al. MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study. Gut. 2003;52(1):134-139. [CrossRef]
  • 24. American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2021. Diabetes Care. 2021;44(Suppl 1):S15-S33. [CrossRef]
  • 25. Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mel litus [Internet]. Available at: https://apps.who.int/iris/bitstream/han dle/10665/70523/WHO_NMH_CHP_CPM_11.1_eng.pdf.
  • 26. Inzucchi SE, Lupsa B. Clinical presentation, diagnosis, and initial evalua tion of diabetes mellitus in adults [internet]. Uptodate. Search. Available at: https://www.uptodate.com/contents/clinical-presentation-diagno sis-and-initial-evaluation-of-diabetes-mellitus-in-adults? search=Clini cal%20presentation,%20diagnosis,%20and%20initial%20evalua tion%20of%20diabetes%20mellitus%20in%20adults&source=search_ result&selectedTitle=1~150&usage_type=default&display_rank=1.
  • 27. Yadav AD, Chang YH, Aqel BA, et al. New onset diabetes mellitus in living donor versus deceased donor liver transplant recipients: analysis of the UNOS/OPTN database. J Transplant. 2013;2013:269096. [CrossRef]
  • 28. Ling Q, Xu X, Xie H, et al. New-onset diabetes after liver transplantation: a national report from China liver transplant registry. Liver Int. 2016;36(5):705-712. [CrossRef]
  • 29. White DL, Ratziu V, El-Serag HB. Hepatitis C infection and risk of diabetes: a systematic review and meta-analysis. J Hepatol. 2008;49(5):831-844. [CrossRef]
  • 30. Heisel O, Heisel R, Balshaw R, Keown P. New onset diabetes mellitus in patients receiving calcineurin inhibitors: a systematic review and meta analysis. Am J Transplant. 2004;4(4):583-595. [CrossRef]
  • 31. Moon JI, Barbeito R, Faradji RN, Gaynor JJ, Tzakis AG. Negative impact of new-onset diabetes mellitus on patient and graft survival after liver transplantation: long-term follow up. Transplantation. 2006;82(12):1625- 1628. [CrossRef]
APA aydoğan ünsal y, Oz Gul O, GÖKTUĞ M, Cander S, Ersoy C, Aydemir E, ATEŞ C, Ünsal O, KIYICI M, Erturk E (2022). Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus. , 136 - 140. 10.5152/tjem.2022.22053
Chicago aydoğan ünsal yasemin,Oz Gul Ozen,GÖKTUĞ MEHMET REFİK,Cander Soner,Ersoy Canan,Aydemir Ensar,ATEŞ COŞKUN,Ünsal Oktay,KIYICI Murat,Erturk Erdinc Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus. (2022): 136 - 140. 10.5152/tjem.2022.22053
MLA aydoğan ünsal yasemin,Oz Gul Ozen,GÖKTUĞ MEHMET REFİK,Cander Soner,Ersoy Canan,Aydemir Ensar,ATEŞ COŞKUN,Ünsal Oktay,KIYICI Murat,Erturk Erdinc Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus. , 2022, ss.136 - 140. 10.5152/tjem.2022.22053
AMA aydoğan ünsal y,Oz Gul O,GÖKTUĞ M,Cander S,Ersoy C,Aydemir E,ATEŞ C,Ünsal O,KIYICI M,Erturk E Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus. . 2022; 136 - 140. 10.5152/tjem.2022.22053
Vancouver aydoğan ünsal y,Oz Gul O,GÖKTUĞ M,Cander S,Ersoy C,Aydemir E,ATEŞ C,Ünsal O,KIYICI M,Erturk E Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus. . 2022; 136 - 140. 10.5152/tjem.2022.22053
IEEE aydoğan ünsal y,Oz Gul O,GÖKTUĞ M,Cander S,Ersoy C,Aydemir E,ATEŞ C,Ünsal O,KIYICI M,Erturk E "Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus." , ss.136 - 140, 2022. 10.5152/tjem.2022.22053
ISNAD aydoğan ünsal, yasemin vd. "Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus". (2022), 136-140. https://doi.org/10.5152/tjem.2022.22053
APA aydoğan ünsal y, Oz Gul O, GÖKTUĞ M, Cander S, Ersoy C, Aydemir E, ATEŞ C, Ünsal O, KIYICI M, Erturk E (2022). Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus. Turkish Journal of Endocrinology and Metabolism, 26(3), 136 - 140. 10.5152/tjem.2022.22053
Chicago aydoğan ünsal yasemin,Oz Gul Ozen,GÖKTUĞ MEHMET REFİK,Cander Soner,Ersoy Canan,Aydemir Ensar,ATEŞ COŞKUN,Ünsal Oktay,KIYICI Murat,Erturk Erdinc Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus. Turkish Journal of Endocrinology and Metabolism 26, no.3 (2022): 136 - 140. 10.5152/tjem.2022.22053
MLA aydoğan ünsal yasemin,Oz Gul Ozen,GÖKTUĞ MEHMET REFİK,Cander Soner,Ersoy Canan,Aydemir Ensar,ATEŞ COŞKUN,Ünsal Oktay,KIYICI Murat,Erturk Erdinc Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus. Turkish Journal of Endocrinology and Metabolism, vol.26, no.3, 2022, ss.136 - 140. 10.5152/tjem.2022.22053
AMA aydoğan ünsal y,Oz Gul O,GÖKTUĞ M,Cander S,Ersoy C,Aydemir E,ATEŞ C,Ünsal O,KIYICI M,Erturk E Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus. Turkish Journal of Endocrinology and Metabolism. 2022; 26(3): 136 - 140. 10.5152/tjem.2022.22053
Vancouver aydoğan ünsal y,Oz Gul O,GÖKTUĞ M,Cander S,Ersoy C,Aydemir E,ATEŞ C,Ünsal O,KIYICI M,Erturk E Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus. Turkish Journal of Endocrinology and Metabolism. 2022; 26(3): 136 - 140. 10.5152/tjem.2022.22053
IEEE aydoğan ünsal y,Oz Gul O,GÖKTUĞ M,Cander S,Ersoy C,Aydemir E,ATEŞ C,Ünsal O,KIYICI M,Erturk E "Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus." Turkish Journal of Endocrinology and Metabolism, 26, ss.136 - 140, 2022. 10.5152/tjem.2022.22053
ISNAD aydoğan ünsal, yasemin vd. "Risk Factors and Outcomes of the Post-Liver Transplantation Diabetes Mellitus". Turkish Journal of Endocrinology and Metabolism 26/3 (2022), 136-140. https://doi.org/10.5152/tjem.2022.22053