title: Waist circumference as an independent risk factor for NODAT.
abstract: BACKGROUND
  New-onset diabetes mellitus after transplantation (NODAT) is a serious and frequent complication of solid organ transplantations. NODAT leads to 2-3 times higher cardiovascular morbidity and mortality. Visceral obesity is a key factor for diabetes mellitus type 2 and metabolic syndrome development, and is an independent risk factor for cardiovascular diseases.
  
  
  METHODS
  The series consisted of 167 patients after primary kidney transplantation from a dead donor (64 patients had developed NODAT), average age of the series was 46.1±11.6 years. We retrospectively examined waist circumference, body mass index, and weight gain in the 12th month after transplantation. We examined average level of triglycerides, cholesterol, and immunosuppression throughout the 12 monitored months.
  
  
  RESULTS
  Patients with NODAT were significantly older (P=0.004) and had greater waist circumference (P<0.0001) and higher average sirolimus level (P=0.0262). We identified the following independent risk factors for NODAT by using multivariate analysis: age at the time of transplantation above 50 years (HR=2.5038, [95% CI: 1.7179 to 3.6492], P<0.0001), waist circumference in men greater than 94 cm (HR=1.9492, [95% CI: 1.1697 to 3.2480], P=0.0104) and in women greater than 80 cm (HR=4.5018, [95% CI: 1.8669 to 10.8553], P=0.009). By using correlation coefficient we have proved that greater waist circumference was related to higher incidence of NODAT (r=0.1935, [95% CI: 0.01156 to 0.3630], P=0.0374). Graft survival (death censored) 12 months after kidney transplantation was 97.1% in the control group and 95.3% in the NODAT group (P=0.5381). Patient survival 12 months after kidney transplantation in the control group was 98.1% and in the NODAT group it was 96.9% (P=0.6113).
  
  
  CONCLUSIONS
  We identified waist circumference as an independent risk factor for NODAT in our analysis.
authors: Surgery Clinic and Transplant Center, University Hospital Martin and Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.
authors: Ivana
authors: I
authors: Dedinská
authors: Surgery Clinic and Transplant Center, University Hospital Martin and Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.
authors: Ľudovít
authors: Ľ
authors: Laca
authors: Surgery Clinic and Transplant Center, University Hospital Martin and Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.
authors: Juraj
authors: J
authors: Miklušica
authors: Transplant Center, University Hospital of L. Pasteur, Košice, Slovakia.
authors: Jaroslav
authors: J
authors: Rosenberger
authors: Urological Clinic and Center for Kidney Transplantation, University Hospital Bratislava and Faculty of Medicine, Comenius University, Martin, Slovakia.
authors: Zuzana
authors: Z
authors: Žilinská
authors: Clinic of Internal Medicine I, University Hospital Martin and Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.
authors: Peter
authors: P
authors: Galajda
authors: Clinic of Internal Medicine I, University Hospital Martin and Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.
authors: Marián
authors: M
authors: Mokáň
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology* / Q000401:mortality; D005260:Female; D006084:Graft Rejection / Q000401:mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016559:Tacrolimus / Q000627:therapeutic use; D055105:Waist Circumference
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus