Pretransplant evaluation and the risk of glucose metabolic alterations after renal transplantation: a prospective study

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dc.contributor.authorFarina-Hernandez, Arminda
dc.contributor.authorMarrero-Miranda, Domingo
dc.contributor.authorPerez-Carreno, Estefania
dc.contributor.authorDe Vera-Gonzalez, Antonia
dc.contributor.authorGonzalez, Alejandra
dc.contributor.authorAcosta-Sorensen, Cristian
dc.contributor.authorRodriguez-Rodriguez, Ana Elena
dc.contributor.authorCollantes, Tatiana
dc.contributor.authorGarcia, Maria Del Pino
dc.contributor.authorRodriguez-Munoz, Ana-Isabel
dc.contributor.authorRodriguez-Alvarez, Carla
dc.contributor.authorRivero, Antonio
dc.contributor.authorMacia, Manuel
dc.contributor.authorTeran, Elena
dc.contributor.authorSanchez-Dorta, Nuria, V
dc.contributor.authorPerez-Tamajon, Lourdes
dc.contributor.authorAlvarez-Gonzalez, Alejandra
dc.contributor.authorGonzalez-Rinne, Ana
dc.contributor.authorRodriguez-Hernandez, Aurelio
dc.contributor.authorDe Bonis-Redondo, Eduardo
dc.contributor.authorRodriguez-Adanero, Concepcion
dc.contributor.authorHernandez, Domingo
dc.contributor.authorPorrini, Esteban
dc.contributor.authorTorres, Armando
dc.date.accessioned2025-01-20T20:20:59Z
dc.date.available2025-01-20T20:20:59Z
dc.date.issued2023
dc.description.abstractBackground Post-transplant prediabetes (PreDM) and diabetes (PTDM) are common and have an impact on cardiovascular events. We sought to investigate the pathogenesis and best approach for prediction. Methods We prospectively studied 115 waitlisted patients from a single center without manifest diabetes. An oral glucose tolerance test (OGTT) was performed yearly until transplantation and 12 months later. Insulin secretion, insulin sensitivity (IS) and disposition index (DI) were derived from the OGTT. Results PreDM and PTDM were observed in 27% and 28.6% of patients, respectively. Pretransplant age, body mass index (BMI), 120 min glucose, IS, DI, and prediabetes or undiagnosed diabetes were significantly associated with these alterations. In multivariate analysis, pretransplant age [odds ratio (OR) 1.5; 95% confidence interval (CI) 1.04-2.1], BMI (OR 1.16; 95% CI 1.04-1.3) and cumulative steroids (OR 1.5; 95% CI 1.02-2.2) were predictors of PreDM or PTDM. Receiver operating characteristic curve analysis showed that pretransplant BMI and 120 min glucose had the highest area under the curve (0.72; 95% CI 0.62-0.8; and 0.69; 95% CI 0.59-0.79, respectively). The highest discrimination cut-off for BMI (>= 28.5 kg/m(2)) and 120 min glucose (>= 123.5 mg/dL) yielded a similar number needed to diagnose (2.5). Conclusions PreDM or PTDM develops in waitlisted patients with an ineffective insulin secretion and BMI shows a similar diagnostic capacity to OGTT. Pretransplant interventions may reduce post-transplant glucose alterations.
dc.description.funderInstituto de Salud Carlos III
dc.fuente.origenWOS
dc.identifier.doi10.1093/ndt/gfac256
dc.identifier.eissn1460-2385
dc.identifier.issn0931-0509
dc.identifier.urihttps://doi.org/10.1093/ndt/gfac256
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/92607
dc.identifier.wosidWOS:000859751300001
dc.issue.numero3
dc.language.isoen
dc.pagina.final786
dc.pagina.inicio778
dc.revistaNephrology dialysis transplantation
dc.rightsacceso restringido
dc.subjectinsulin resistance
dc.subjectinsulin secretion
dc.subjectobesity
dc.subjectpost-transplant diabetes mellitus
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titlePretransplant evaluation and the risk of glucose metabolic alterations after renal transplantation: a prospective study
dc.typeartículo
dc.volumen38
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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