title: Body mass index and the development of new-onset diabetes mellitus or the worsening of pre-existing diabetes mellitus in adult kidney transplant patients.
abstract: OBJECTIVE
  The purpose of this study was to determine the relationship between body mass index (BMI) and the development of new-onset diabetes after transplant (NODAT) as well as the worsening of pre-existing diabetes mellitus (DM) in adults after kidney transplantation.
  
  
  METHODS
  A medical record review was conducted using the records of 204 adult patients who underwent a first renal transplant between September 2009 and February 2011 at a single transplant center. Patients who received simultaneous transplantation of another organ, who were immunosuppressed for nontransplant reasons, or those who were less than 18 years of age were excluded.
  
  
  METHODS
  Outcome data collected at the time of hospital discharge and at 3, 6, and 12 months after kidney transplantation included the development of NODAT and the components of DM treatment regimens.
  
  
  RESULTS
  The cumulative incidence of NODAT at discharge and 3, 6, and 12 months post-transplantation was 14.2%, 19.4%, 20.1%, and 19.4%, respectively. The odds of developing NODAT by discharge or 3 or 6 months post-transplantation increased by a factor of 1.11 (95% confidence interval [CI]: 1.0-1.23), 1.13 (95% CI: 1.03-1.24), and 1.15 (95% CI: 1.05-1.27), respectively, per unit increase in pretransplantation BMI. The need for more aggressive DM treatment (suggesting a worsening of DM status) was most usually seen between discharge and 3 months; 50% of patients with preexisting DM required more aggressive DM treatment post-transplantation (X3(2) = 13.25; P = .001).
  
  
  CONCLUSIONS
  The odds of developing NODAT at discharge and 3 and 6 months post-transplantation increased per unit of pretransplantation BMI. The most common time for NODAT to develop or for preexisting DM to worsen was within 3 months of kidney transplantation.
authors.affiliation: Graduate Programs in Human Nutrition, Oregon Health & Science University, Portland, Oregon.
authors.forename: Tysen J
authors.initials: TJ
authors.lastname: Cullen
authors.affiliation: Food and Nutrition Services, Oregon Health & Science University, Portland, Oregon.
authors.forename: Maureen P
authors.initials: MP
authors.lastname: McCarthy
authors.affiliation: Center for Research on Occupational and Environmental Toxicology, Oregon Health & Science University, Portland, Oregon.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Lasarev
authors.affiliation: Division of Abdominal Organ Transplantation, Oregon Health & Science University, Portland, Oregon.
authors.forename: John M
authors.initials: JM
authors.lastname: Barry
authors.affiliation: Graduate Programs in Human Nutrition and Division of Health Promotion & Sports Medicine, Oregon Health & Science University, Portland, Oregon. Electronic address: stadlerd@ohsu.edu.
authors.forename: Diane D
authors.initials: DD
authors.lastname: Stadler
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents