体质量指数与接受成人脂肪肝供体的肝移植术后 糖尿病关系探讨.

To explore the correlation between different body mass index (BMI) and new-onset diabetes (NODAT) after steatotic liver transplantation in adults. Methods The clinical data of 181 patients who underwent steatotic liver transplantation were retrospectively analyzed. Patients were divided into four groups including 5 patients in the thin group (BMI＜18.5 kg/m² ), 82 patients in the normal group (18.5 kg/m² ≤BMI＜24 kg/m² ), 65 patients in the overweight group (24 kg/m2 ≤BMI＜28 kg/m2 ) and 29 patients in the obese group (BMI≥28 kg/m² ). Clinical data, incidence of complications and accumulated survival rates were compared between 4 groups. Binary Logistic regression were used to assess the risk factors of diabetes after steatotic liver transplantation, and the Kaplan-Meier survival curves were drawn to analyze the 1- year,3-year and 5-year cumulative survival rates of patients. Results The serum albumin level was significantly lower in the obese group than that of the normal group and overweight group (P＜0.05). Compared with the normal group, the incidence of NODAT was significantly increased in the overweight group and obese group (P＜0.01). The incidence of NODAT was significantly higher in the obese group than that of the overweight group (P＜0.01). The incidence of NODAT was significantly higher in the obese group than that of the thin group (P＜0.05). Logistic analysis showed that the over weight (OR=3.423,95%CI:1.410-8.310) and obesity (OR=16.808,95%CI:6.023-46.907) were independent risk factors in the development of NODAT in steatotic liver transplantation (OR=1.363，95% CI：1.214-1.530). Survival curves revealed that the survival rate of the obese group was observably lower than that of the other 3 groups (Log-rank χ² =44.998，P＜0.01). Conclusion Overweight and obesity are independent risk factor for the occurrence of NODAT after steatotic liver transplantation, and rational control of BMI before surgery can significantly improve the prognosis. [ABSTRACT FROM AUTHOR]