Pre-transplant HbA1c level as an early marker for new-onset diabetes after renal transplantation.
BACKGROUND
New-onset diabetes after transplantation (NODAT) is a common complication in renal transplant (RT) patients. The clinical significance of pre-transplant HbA1c level remains unclear in RT patients. Thus, we investigated the predictive role of pre-transplant HbA1c levels for the NODAT diagnosed in 1 year after renal transplantation.


METHODS
Two hundred and four RT patients older than 18 years were analyzed. NODAT diagnosis during the 1-year follow-up after RT was based on the 2003 modified criteria of the ADA. HbA1c level was measured at pre-transplantation period and every 3 months after RT.


RESULTS
Mean age was 39.3 ± 10.7 (20-73) years and 36 % were female. Mean pre-transplant HbA1c level was 4.9 ± 0.5 % (4.0-6.4 %). Pre-transplant HbA1c level was positively correlated with age, pre-transplant body mass index (BMI) and cholesterol level. Fifty-four patients (25.9 %) developed NODAT and 33.8 % had impaired fasting blood glucose levels. Patients with NODAT were significantly older and had higher pre-transplant BMI and HbA1c than those without. Use of Tacrolimus was also higher in patients with NODAT. In stepwise logistic regression analysis, pre-transplant HbA1c level was an independent predictor for the development on NODAT (OR = 4.63, 95 % CI: 2.09-10.2, p < 0.001) together with age, Tacrolimus-based regimen and pre-transplant fasting blood glucose level.


CONCLUSIONS
Assessment of pre-transplant HbA1c levels may be a valuable tool for early diagnosis of NODAT in RT recipients.
Division of Nephrology, Ege University School of Medicine, 35100, Bornova, Izmir, Turkey. etatar@hotmail.com
Erhan
E
Tatar
Fatih
F
Kircelli
Meltem Sezis
MS
Demirci
Mehmet Nuri
MN
Turan
Ozkan
O
Gungor
Gulay
G
Asci
Mehmet
M
Ozkahya
Ercan
E
Ok
Cuneyt
C
Hoscoskun
Huseyin
H
Toz
D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D057234:Preoperative Period; D012372:ROC Curve; D016559:Tacrolimus / Q000009:adverse effects; D055815:Young Adult
D015415:Biomarkers; D006442:Glycated Hemoglobin; D007166:Immunosuppressive Agents; D016559:Tacrolimus; C517652:hemoglobin A1c protein, human