title: Vitamin D deficiency is an independent risk factor for PTDM after kidney transplantation.
abstract: An association between 25 hydroxyvitamin D [25(OH)D] deficiency and type 2 diabetes was observed in the general population. Such association was not investigated in kidney transplant recipients. We prospectively evaluated 444 patients following primary kidney transplantation between 2000 and 2010. The 25(OH)D level at transplantation was classified into three grades: deficiency (< 10 ng/ml), insufficiency (≥ 10 and < 30 ng/ml), and normal range (≥ 30 ng/ml). Time to Post-Transplant Diabetes Mellitus (PTDM) was defined according to the day of first prescription of hypoglycemic treatment. The 25(OH)D level at transplantation was deficient in 88 patients, insufficient in 264 patients, and normal in 92 patients. At 1 year post-transplantation, cumulative incidence of PTDM was 13.2%. Cox multivariate analysis indicated that 25(OH)D deficiency (≤ 10 ng/ml) at the time of transplantation was an independent risk factor for PTDM within the first year post-transplantation (HR = 2.41, 95% CI 1.01-5.75, P = 0.048), whereas insufficiency tended to increase this risk, although not significantly. 25(OH)D deficiency is a new independent risk factor for PTDM within the first year after kidney transplantation. Our study suggests that 25(OH)D may be a marker of general health in kidney transplant recipients and could alert clinicians for PTDM risk.
authors.affiliation: Institute of Transplantation, Urology and Nephrology (ITUN), Nantes University Hospital, Nantes, France.|INSERM UMR 1064, Nantes University Hospital, Nantes, France.
authors.forename: Awena
authors.initials: A
authors.lastname: Le Fur
authors.affiliation: INSERM UMR 1064, Nantes University Hospital, Nantes, France.|EA 4275 - SPHERE Biostatistics, Pharmacoepidemiology, and Human Sciences Research, Nantes University Hospital, Nantes, France.
authors.forename: Marie-Cécile
authors.initials: MC
authors.lastname: Fournier
authors.affiliation: Institute of Transplantation, Urology and Nephrology (ITUN), Nantes University Hospital, Nantes, France.|INSERM UMR 1064, Nantes University Hospital, Nantes, France.|EA 4275 - SPHERE Biostatistics, Pharmacoepidemiology, and Human Sciences Research, Nantes University Hospital, Nantes, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Gillaizeau
authors.affiliation: Biochemistry Laboratory, Nantes, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Masson
authors.affiliation: Institute of Transplantation, Urology and Nephrology (ITUN), Nantes University Hospital, Nantes, France.|INSERM UMR 1064, Nantes University Hospital, Nantes, France.|EA 4275 - SPHERE Biostatistics, Pharmacoepidemiology, and Human Sciences Research, Nantes University Hospital, Nantes, France.
authors.forename: Magali
authors.initials: M
authors.lastname: Giral
authors.affiliation: Endocrinology Clinic, Nantes University Hospital, Nantes, France.|INSERM UMR 1087, CNRS UMR 6291, Thorax Institute, Nantes University Hospital, Nantes, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Cariou
authors.affiliation: Institute of Transplantation, Urology and Nephrology (ITUN), Nantes University Hospital, Nantes, France.|INSERM UMR 1064, Nantes University Hospital, Nantes, France.
authors.forename: Diego
authors.initials: D
authors.lastname: Cantarovich
authors.affiliation: Institute of Transplantation, Urology and Nephrology (ITUN), Nantes University Hospital, Nantes, France.|INSERM UMR 1064, Nantes University Hospital, Nantes, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Dantal
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: kidney transplantation; post-transplant diabetes mellitus; vitamin D