title: Risk factors associated with the onset and progression of posttransplantation diabetes in renal allograft recipients.
abstract: OBJECTIVE
  The aim of this study was to assess the incidence of posttransplantation diabetes mellitus (PTDM) in renal allograft recipients and to investigate factors contributing to the onset and progression of PTDM and its underlying pathogenic mechanism(s).
  
  
  METHODS
  A total of 77 patients with normal glucose tolerance (NGT) were enrolled in this study. An oral glucose tolerance test was performed 1 week before transplantation and repeated at 1 and 7 years after transplantation.
  
  
  RESULTS
  The overall incidence of PTDM was 39% at 1 year and 35.1% at 7 years posttransplantation. The incidence for each category of PTDM was as follows: persistent PTDM (P-PTDM) (patients who developed diabetes mellitus within 1 year of transplantation and remained diabetic during 7 years), 23.4%; transient PTDM (T-PTDM) (patients who developed diabetes mellitus during the 1st year after transplantation but eventually recovered to have NGT), 15.6%; late PTDM (L-PTDM) (patients who developed diabetes mellitus later than 1 year after transplantation), 11.7%; and non-PTDM during 7 years (N-PTDM7) (patients who did not develop diabetes mellitus during 7 years), 49.3%. Older age (> or = 40 years) at transplantation was a higher risk factor for P-PTDM, whereas a high BMI (> or = 25 kg/m2) and impaired fasting glucose (IFG) at 1 year posttransplantation were higher risk factors for L-PTDM. Impaired insulin secretion rather than insulin resistance was significantly associated with the development of P- and L-PTDM.
  
  
  CONCLUSIONS
  Impaired insulin secretion may be the main mechanism for the development of PTDM. Older age at transplantation seems to be associated with P-PTDM, whereas a high BMI and IFG at 1 year after transplantation were associated with L-PTDM.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-Dong Seodaemun-Gu, Seoul, 120-752, Korea.
authors.forename: Kyu Yeon
authors.initials: KY
authors.lastname: Hur
authors.forename: Myoung Soo
authors.initials: MS
authors.lastname: Kim
authors.forename: Yu Seun
authors.initials: YS
authors.lastname: Kim
authors.forename: Eun Seok
authors.initials: ES
authors.lastname: Kang
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Nam
authors.forename: So Hun
authors.initials: SH
authors.lastname: Kim
authors.forename: Chung Mo
authors.initials: CM
authors.lastname: Nam
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Ahn
authors.forename: Bong Soo
authors.initials: BS
authors.lastname: Cha
authors.forename: Soon Il
authors.initials: SI
authors.lastname: Kim
authors.forename: Hyun Chul
authors.initials: HC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000235:genetics; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000378:metabolism*; D000078790:Insulin Secretion; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors; D014184:Transplantation, Homologous / Q000009:adverse effects
chemical_list: D001786:Blood Glucose; D007328:Insulin