scholarly journals Statin use is prospectively associated with new onset diabetes after transplantation in renal transplant recipients

2020 ◽  
Author(s):  
Tamas Szili-Torok ◽  
Stephan J.L. Bakker ◽  
Uwe J.F. Tietge
Keyword(s):  
Renal Transplant ◽  
Cox Regression ◽  
Rank Test ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Prospective Longitudinal Study ◽  
Onset Diabetes ◽  
Prospective Longitudinal ◽  
Statin Use ◽  
New Onset

Objective: New onset diabetes after transplantation (NODAT) is frequent and worsens graft and patient outcomes in renal transplant recipients (RTR). In the general population statins are diabetogenic. This study investigated whether statins also increase NODAT risk in RTR. <p><br></p><p>Research design and methods: From a prospective longitudinal study of 606 RTR (functioning allograft >1 year, single academic center, follow-up: median 9.6 [6.6-10.2] years) 95 patients using statins were age- and gender-matched to RTR not on statins (all diabetes-free at inclusion) .</p> <p><br></p><p>Results: NODAT incidence was 7.2% (73.3% of these on statins). In Kaplan-Meier (log rank test, p=0.017) and COX regression analyses (HR, 3,86 [1.21-12.27], P=0.022) statins prospectively associated with incident NODAT, even independent of several relevant confounders including immunosuppressive medication and biomarkers of glucose homeostasis. </p> <p><br></p><p>Conclusions: This study demonstrates that statin use is prospectively associated with the development of NODAT in RTR independent of other recognized risk factors. </p>

scholarly journals Statin use is prospectively associated with new onset diabetes after transplantation in renal transplant recipients

2020 ◽  
Author(s):  
Tamas Szili-Torok ◽  
Stephan J.L. Bakker ◽  
Uwe J.F. Tietge
Keyword(s):  
Renal Transplant ◽  
Cox Regression ◽  
Rank Test ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Prospective Longitudinal Study ◽  
Onset Diabetes ◽  
Prospective Longitudinal ◽  
Statin Use ◽  
New Onset

Objective: New onset diabetes after transplantation (NODAT) is frequent and worsens graft and patient outcomes in renal transplant recipients (RTR). In the general population statins are diabetogenic. This study investigated whether statins also increase NODAT risk in RTR. <p><br></p><p>Research design and methods: From a prospective longitudinal study of 606 RTR (functioning allograft >1 year, single academic center, follow-up: median 9.6 [6.6-10.2] years) 95 patients using statins were age- and gender-matched to RTR not on statins (all diabetes-free at inclusion) .</p> <p><br></p><p>Results: NODAT incidence was 7.2% (73.3% of these on statins). In Kaplan-Meier (log rank test, p=0.017) and COX regression analyses (HR, 3,86 [1.21-12.27], P=0.022) statins prospectively associated with incident NODAT, even independent of several relevant confounders including immunosuppressive medication and biomarkers of glucose homeostasis. </p> <p><br></p><p>Conclusions: This study demonstrates that statin use is prospectively associated with the development of NODAT in RTR independent of other recognized risk factors. </p>

scholarly journals FC 125DIURETIC USE IS  ASSOCIATED WITH INCREASED RISK FOR POSTTRANSPLANTATION DIABETES MELLITUS IN RENAL TRANSPLANT RECIPIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Sara Sokooti Oskooei ◽  
Sok Cin Tye ◽  
Rianne M. Douwes ◽  
Hiddo Lambers Heerspink ◽  
Stephan Bakker
Keyword(s):  
Diabetes Mellitus ◽  
Renal Transplant ◽  
Cox Regression ◽  
Loop Diuretics ◽  
Renal Transplant Recipients ◽  
Regression Analyses ◽  
Transplant Recipients ◽  
Prospective Longitudinal Study ◽  
Increased Risk ◽  
Prospective Longitudinal

Abstract Background and Aims Posttransplantation diabetes Mellitus (PTDM) is one of the major medical problems in renal transplant recipients (RTRs). Diuretic-induced hyperglycemia and diabetes have been described in the general population. We aimed to investigate whether diuretics also increase PTDM risk in RTRs. Method We included 486 stable outpatient RTRs (with a functioning graft ≥1 year) without diabetes from a prospective longitudinal study (the Transplantlines Food and Nutrition Study [NCT02811835]). Participants were classified as diuretic users and non-diuretic users based on their medication use recording at baseline. PTDM was defined according the American Diabetes Association’s diagnostic criteria for diabetes. Multivariable Cox proportional-hazards regression analyses were performed to assess the prospective association between diuretic use and the risk of PTDM development. Results Median time since transplantation was 5.4 (2.0-12.2) years and 168 (35%) RTRs were taking diuretics. After 5.2 (IQR, 4.0 5.9) years of follow up, 54 (11%) RTRs developed PTDM. In Kaplan-Meier (log-rank test, p&lt;0.001) and Cox regression analyses, diuretic use was found to be associated with incident PTDM after adjustment for age, sex, fasting plasma glucose (FPG), and HbA1c (hazard ratio[HR] 3.28, 95% CI 1.84-5.83; p&lt;0.001). The association remained independent of further adjustment for potential confounders, including lifestyle, use of other medication, kidney function, transplantation-specific parameters, BMI, lipids, and blood pressure. Exploratory analyses further indicates that, in Cox regression analyses, both thiazide (n=74) and loop diuretics (n=76) as two main types of diuretics used among RTRs appeared to be associated with the development of PTDM, independent of age, sex, FPG, and HbA1c ([HR 2.70, 95% CI 1.24-5.29; p=0.012], and [HR 5.08, 95% CI 2.49-10.34; p&lt;0.001], respectively). Conclusion This study demonstrates that diuretics overall, associated with the risk of developing PTDM in RTRs, independent of established risk factors for PTDM development. The association was consistent for thiazide and loop diuretics.

scholarly journals Statin Use Is Prospectively Associated With New-Onset Diabetes After Transplantation in Renal Transplant Recipients

Diabetes Care ◽  
2020 ◽  
Vol 43 (8) ◽  
pp. 1945-1947
Author(s):  
Tamas Szili-Torok ◽  
Stephan J.L. Bakker ◽  
Uwe J.F. Tietge
Keyword(s):  
Renal Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Onset Diabetes ◽  
Statin Use ◽  
New Onset

scholarly journals Plasma Malondialdehyde and Risk of New-Onset Diabetes after Transplantation in Renal Transplant Recipients: A Prospective Cohort Study

2019 ◽  
Vol 8 (4) ◽  
pp. 453 ◽  
Author(s):  
Manuela Yepes-Calderón ◽  
Camilo Sotomayor ◽  
António Gomes-Neto ◽  
Rijk Gans ◽  
Stefan Berger ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Renal Transplant ◽  
Cox Proportional Hazards ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Dietary Antioxidants ◽  
Onset Diabetes ◽  
Plasma Malondialdehyde ◽  
New Onset

New-onset diabetes after transplantation (NODAT) is a frequent complication in renal transplant recipients (RTR). Although oxidative stress has been associated with diabetes mellitus, data regarding NODAT are limited. We aimed to prospectively investigate the long-term association between the oxidative stress biomarker malondialdehyde (measured by high-performance liquid chromatography) and NODAT in an extensively phenotyped cohort of non-diabetic RTR with a functioning graft ≥1 year. We included 516 RTR (51 ± 13 years-old, 57% male). Median plasma malondialdehyde (MDA) was 2.55 (IQR, 1.92–3.66) µmol/L. During a median follow-up of 5.3 (IQR, 4.6–6.0) years, 56 (11%) RTR developed NODAT. In Cox proportional-hazards regression analyses, MDA was inversely associated with NODAT, independent of immunosuppressive therapy, transplant-specific covariates, lifestyle, inflammation, and metabolism parameters (HR, 0.55; 95% CI, 0.36–0.83 per 1-SD increase; p < 0.01). Dietary antioxidants intake (e.g., vitamin E, α-lipoic acid, and linoleic acid) were effect-modifiers of the association between MDA and NODAT, with particularly strong inverse associations within the subgroup of RTR with relatively higher dietary antioxidants intake. In conclusion, plasma MDA concentration is inversely and independently associated with long-term risk of NODAT in RTR. Our findings support a potential underrecognized role of oxidative stress in post-transplantation glucose homeostasis.

scholarly journals HDL Cholesterol Efflux Predicts Incident New-Onset Diabetes After Transplantation (NODAT) in Renal Transplant Recipients Independent of HDL Cholesterol Levels

Diabetes ◽  
2019 ◽  
Vol 68 (10) ◽  
pp. 1915-1923 ◽  
Author(s):  
Tamas Szili-Torok ◽  
Wijtske Annema ◽  
Josephine L.C. Anderson ◽  
Stephan J.L. Bakker ◽  
Uwe J.F. Tietge
Keyword(s):  
Renal Transplant ◽  
Cholesterol Efflux ◽  
Hdl Cholesterol ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Cholesterol Levels ◽  
Onset Diabetes ◽  
New Onset

scholarly journals High Serum PCSK9 Is Associated With Increased Risk of New-Onset Diabetes After Transplantation in Renal Transplant Recipients

Diabetes Care ◽  
2017 ◽  
Vol 40 (7) ◽  
pp. 894-901 ◽  
Author(s):  
Michele F. Eisenga ◽  
Dorien M. Zelle ◽  
John H. Sloan ◽  
Carlo A.J.M. Gaillard ◽  
Stephan J.L. Bakker ◽  
...  
Keyword(s):  
Renal Transplant ◽  
High Serum ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Onset Diabetes ◽  
Increased Risk ◽  
New Onset

scholarly journals New-Onset Diabetes Mellitus Associated with Sirolimus Use in Renal Transplant Recipients

2015 ◽  
Vol 47 (3) ◽  
pp. 213-215 ◽  
Author(s):  
Vural Taner Yilmaz ◽  
Huseyin Kocak ◽  
Ayhan Dinckan ◽  
Ramazan Cetinkaya
Keyword(s):  
Diabetes Mellitus ◽  
Renal Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Onset Diabetes ◽  
New Onset Diabetes Mellitus ◽  
New Onset
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