The Impact of New-onset Diabetes on Arterial Stiffness after Renal Transplantation

Endocrine Journal

Toshihiko SHIRAIWA⁴  Yasuyuki KOJIMA¹  Hideaki KANETO⁴  Kaoru YAMAMOTO⁴  Ken'ya SAKAMOTO⁴  Masatsugu HORI⁴  Taka-aki MATSUOKA⁴  Ken KATO⁴  Munehide MATSUHISA⁴  Akio KURODA⁴  Shiro TAKAHARA³  Yoshimitsu YAMASAKI⁴  Naoto KATAKAMI⁴  Naotsugu ICHIMARU² 

[1] Department of Urology, Inoue Hospital;Department of Urology, Osaka University Graduate School of Medicine;Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine;Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine

关键词: New-onset diabetes after transplantation;    Renal transplantation;    PWV;    Atherosclerosis;   

DOI  :  10.1507/endocrj.K07E-138

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(36)Cited-By(8)New-onset diabetes after renal transplantation (NODAT) is known to be a potent risk factor for cardiovascular events. We therefore investigated the incidence and risk factors for NODAT, and evaluated surrogate endpoints of atherosclerosis in Japanese patients with stable renal function after renal transplantation. Seventy-nine patients were enrolled in the study, and a 75 g oral glucose tolerance test (OGTT) was performed in subjects excluding patients with known NODAT. We evaluated the risk factors for NODAT and the degree of atherosclerosis, determined by brachial-ankle pulse wave velocity (baPWV), ankle-brachial blood pressure index (ABPI) and intima-media thickness (IMT) of the carotid artery. Eleven patients diagnosed as NODAT had significantly higher fasting plasma glucose before transplantation, blood pressure, and incidence of hepatitis C virus (HCV) infection than patients without NODAT. Multivariate regression analysis revealed that the independent determinant of NODAT was fasting plasma glucose pre-transplantation, HCV infection and systolic blood pressure. The baPWV in patients with NODAT was significantly higher compared to that in patients without NODAT. In addition, the independent determinant of baPWV evaluated by multivariate regression analysis was an increase in systolic blood pressure and age, and a decrease of adiponectin levels. In conclusion, we found that high fasting plasma glucose prior to transplantation, HCV infection and high blood pressure are risk factors for NODAT in Japanese patients after renal transplantation. Since NODAT patients have advanced arterial stiffness probably due to high blood pressure, strict control of blood pressure will be important for preventing the development of cardiovascular disease in NODAT.

【 授权许可】

Unknown