title: Hepatitis C infection increases the risk of new-onset diabetes after transplantation in liver allograft recipients.
abstract: BACKGROUND
  Recent evidence suggests that new-onset diabetes after transplant (NODAT) adversely affects orthotopic liver transplant (OLTX) patient and graft survival. The objective of this study is to evaluate the effect of hepatitis C infection on the natural history of NODAT.
  
  
  METHODS
  A retrospective review of 492 OLTX recipients at a single center was conducted from January 1993 to January 2003. Patients were followed for a minimum of 12 months (range 12 months-10 years). The study population consisted of 444 OLTX recipients who were either HCV positive (n = 206) or HCV negative (n = 238). NODAT was defined by the need for antidiabetic medication for at least 7 days starting anytime after OLTX. Statistical analysis was performed by using the Student t test, Kaplan-Meier survival, and chi-square tests.
  
  
  RESULTS
  The overall incidence of NODAT was 33% (146/444). There was a significant difference in the development of NODAT between the HCV-positive group (82/206, 40%) and the HCV-negative group (64/238, 27%) (P < .001). Other independent risk factors for development of NODAT were male gender and age >50 years.
  
  
  CONCLUSIONS
  Hepatitis C infection contributes to the development of diabetes mellitus in OLTX recipients. The mechanisms behind HCV infection and associated NODAT in HCV-positive OLTX recipients warrant further investigation.
authors.affiliation: Department of Surgery, Division of Liver/Pancreas Transplantation, Oregon Health and Science University, 8131 SW Sam Jackson Park Road, L590, Portland, OR 97239, USA.
authors.forename: Jordana L
authors.initials: JL
authors.lastname: Soule
authors.forename: Ali J
authors.initials: AJ
authors.lastname: Olyaei
authors.forename: Tobin A
authors.initials: TA
authors.lastname: Boslaugh
authors.forename: Ann M H
authors.initials: AM
authors.lastname: Busch
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Schwartz
authors.forename: Samuel H
authors.initials: SH
authors.lastname: Morehouse
authors.forename: John M
authors.initials: JM
authors.lastname: Ham
authors.forename: Susan L
authors.initials: SL
authors.lastname: Orloff
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors