title: Insulin resistance as a risk factor for new-onset diabetes after kidney transplantation.
abstract: BACKGROUND
  New-onset diabetes after transplantation (NODAT) is a serious and common complication after kidney transplantation. Insulin resistance, together with β-cell dysfunction, plays an essential role in the development of diabetes. Homeostasis model assessment of insulin resistance (HOMA-IR), which is calculated as [fasting plasma glucose (mmol/L) × fasting insulin (mU/L)]/22.5, is widely used as an index of insulin resistance. However, the correlation between pretransplant HOMA-IR and the development of NODAT has not been fully established.
  
  
  METHODS
  We performed a retrospective study of 44 nondiabetic patients who underwent living donor kidney transplantation in our hospital from July 2006 to October 2009. We compared the HOMA-IR and demographic variables of patients who developed NODAT with those who did not.
  
  
  RESULTS
  Five patients (11.4%) developed NODAT within 3 years after transplantation. There were no differences in demographic variables between patients who developed NODAT and those who did not. Logistic regression analysis revealed that HOMA-IR was a predictive factor of NODAT (odds ratio, 2.88; 95% CI, 1.11-9.59; P < .05).
  
  
  CONCLUSIONS
  Our results indicate that high HOMA-IR might be an important predictive factor for NODAT. These findings underline the importance of routine pretransplant measurements of fasting plasma glucose and serum insulin for evaluating HOMA-IR.
authors.affiliation: Department of Surgery, Sendai Shakaihoken Hospital, Miyagi, Japan. Electronic address: tsu7ka5so8mi@yahoo.co.jp.
authors.forename: K
authors.initials: K
authors.lastname: Tokodai
authors.affiliation: Department of Surgery, Sendai Shakaihoken Hospital, Miyagi, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Amada
authors.affiliation: Department of Surgery, Sendai Shakaihoken Hospital, Miyagi, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Haga
authors.affiliation: Department of Surgery, Sendai Shakaihoken Hospital, Miyagi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Takayama
authors.affiliation: Department of Surgery, Sendai Shakaihoken Hospital, Miyagi, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Nakamura
authors.affiliation: Department of Surgery, Sendai Shakaihoken Hospital, Miyagi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kashiwadate
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors