title: New onset diabetes and impaired fasting glucose after liver transplant: risk analysis and the impact of tacrolimus dose.
abstract: OBJECTIVE
  New onset diabetes mellitus after transplant is one of the major metabolic complications after liver transplant. Development of impaired fasting glucose after liver transplant is thought to be associated with increased risk of cardiovascular mortality and has not been well studied before. The aim of this study was to evaluate incidence and risk factors of new onset diabetes mellitus after transplant and impaired fasting glucose in liver transplant patients.
  
  
  METHODS
  In a cross-sectional study, all adult patients (aged≥18 years) who were transplanted because of chronic liver diseases from June 2002 to September 2010 at Shiraz Liver Transplant Center were evaluated for developing diabetes and impaired fasting glucose.
  
  
  RESULTS
  Totally, 86 patients (18.81%) were found to have diabetes after liver transplant. Forty patients (27 men and 13 women; 8.75%) developed new onset diabetes mellitus after transplant and 36 patients (7.87%) developed impaired fasting glucose after liver transplant. The mean age of patients with new onset diabetes mellitus after transplant was higher than that of nondiabetic patients (P = .001). Mean fasting plasma glucose before liver transplant was significantly higher in diabetic patients compared with nondiabetic patients (P = .002) (5.20±0.93 mmol/L vs 4.44±0.56 mmol/L) (93.86±16.80 mg/dL vs 80±10.14 mg/dL). Patients with new onset diabetes mellitus after transplant received higher doses of tacrolimus as immunosuppressive medication than nondiabetic patients (P = .001).
  
  
  CONCLUSIONS
  Fasting plasma glucose before transplant can predict development of new onset diabetes mellitus after transplant. Age and tacrolimus dosage are independent risk factors for new onset diabetes mellitus after transplant in our patients.
authors.affiliation: Health Policy Research Center, Namazi Hospital, Shiraz University of Medical Science, Shiraz, Iran.
authors.forename: Kamran Bagheri
authors.initials: KB
authors.lastname: Lankarani
authors.forename: Ahad
authors.initials: A
authors.lastname: Eshraghian
authors.forename: Saman
authors.initials: S
authors.lastname: Nikeghbalian
authors.forename: Parisa
authors.initials: P
authors.lastname: Janghorban
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Malek-Hosseini
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007166:Immunosuppressive Agents; D016559:Tacrolimus