1. Unmasking Glucose Metabolism Alterations in Stable Renal Transplant Recipients
- Author
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Edgar Arellano, Patricia Delgado, Jose Manule Osorio, Ildefonso Lampreave, Rosa Domínguez, Campistol Jm, Francisco Moreso, Rocio Benitez, Meritxell Ibernon, Beatriz Bayés, Antonio Osuna, Carlos Gómez-Alamillo, Juan Manuel Diaz, Armando Torres, Esteban Porrini, Irene Silva, and Ricardo Lauzurica
- Subjects
Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,Time Factors ,Epidemiology ,Adrenergic beta-Antagonists ,Carbohydrate metabolism ,Critical Care and Intensive Care Medicine ,Risk Assessment ,Atheromatosis ,Impaired glucose tolerance ,chemistry.chemical_compound ,Abnormal oral glucose tolerance ,Risk Factors ,Internal medicine ,Diabetes mellitus ,Glucose Intolerance ,Renal Transplantation ,Diabetes Mellitus ,Odds Ratio ,Prevalence ,Humans ,Medicine ,Transplantation ,Glucose tolerance test ,medicine.diagnostic_test ,Triglyceride ,business.industry ,Age Factors ,Fasting ,Glucose Tolerance Test ,Middle Aged ,medicine.disease ,Impaired fasting glucose ,Kidney Transplantation ,Lipids ,Cross-Sectional Studies ,Logistic Models ,Endocrinology ,chemistry ,Spain ,Nephrology ,Prednisone ,Female ,business ,Immunosuppressive Agents - Abstract
Background and objectives: Emerging information indicates that glucose metabolism alterations are common after renal transplantation and are associated with carotid atheromatosis. The aims of this study were to investigate the prevalence of different glucose metabolism alterations in stable recipients as well as the factors related to the condition. Design, setting, participants, & measurements: A multicenter, cross-sectional study was conducted of 374 renal transplant recipients without pre- or posttransplantation diabetes. A standard 75-g oral glucose tolerance test was performed. Results: Glucose metabolism alterations were present in 119 (31.8%) recipients: 92 (24.6%) with an abnormal oral glucose tolerance test and 27 (7.2%) with isolated impaired fasting glucose. The most common disorder was impaired glucose tolerance (17.9%), and an abnormal oral glucose tolerance test was observed for 21.5% of recipients with a normal fasting glucose. By multivariate analysis, age, prednisone dosage, triglyceride/high-density lipoprotein cholesterol ratio, and β blocker use were shown to be factors related to glucose metabolism alterations. Remarkably, triglyceride levels, triglyceride/high-density lipoprotein cholesterol ratio, and the proportion of recipients with impaired fasting glucose were already higher throughout the first posttransplantation year in recipients with a current glucose metabolism alteration as compared with those without the condition. Conclusions: Glucose metabolism alterations are common in stable renal transplant recipients, and an oral glucose tolerance test is required for its detection. They are associated with a worse metabolic profile, which is already present during the first posttransplantation year. These findings may help planning strategies for early detection and intervention.
- Published
- 2008