title: Effect of interleukin-2 receptor antagonists on new-onset diabetes after liver transplantation: A retrospective cohort study.
abstract: BACKGROUND
  The aim of the present retrospective observational study was to examine the effect of interleukin-2 receptor antagonists (IL-2Ra) on new-onset diabetes after transplantation (NODAT) in liver transplant recipients.
  
  
  METHODS
  Pre- and postoperative clinical data of 781 patients undergoing liver transplantation between April 2001 and December 2014 at Zhongshan Hospital, Fudan University, were analyzed. Patients were divided into two groups depending on the use of IL-2Ra (IL-2Ra and non-IL-2Ra). The cumulative incidence of NODAT was compared between the IL-2Ra and non-IL-2Ra groups and the effect of IL-2Ra on the incidence of NODAT in liver transplant recipients was evaluated.
  
  
  RESULTS
  Of the 781 patients in the study, 451 received IL-2Ra. During follow-up, 138 (41.8%) and 137 (30.4%) patients in the non-IL-2Ra and IL-2Ra groups, respectively, developed NODAT (P = 0.001). The cumulative incidence of NODAT at 1, 3, 5, and 8 years after transplantation in the IL-2Ra group was 30%, 38%, 45%, and 54%, respectively; these values were substantially lower than corresponding values for the non-IL-2Ra group (P < 0.05). Cox regression analyses showed that IL-2Ra was a protective factor against NODAT development (odds ratio 0.685; 95% confidence interval 0.473-0.991; P = 0.044). This was independent of age, sex, donor type, hepatitis virus infection, body mass index, history of hypertension, preoperative liver function, preoperative fasting plasma glucose, total cholesterol, and total triglyceride levels, severity of liver cirrhosis, acute rejection, initial immunosuppressant regimen type, and postoperative immunosuppressant levels.
  
  
  CONCLUSIONS
  In conclusion, IL-2Ra reduces the risk of NODAT in liver transplant recipients.
authors.affiliation: Department of Endocrinology and Metabolism, Zhongshan Hospital, Shanghai, China.
authors.forename: Mengjuan
authors.initials: M
authors.lastname: Xue
authors.affiliation: Department of Endocrinology and Metabolism, Zhongshan Hospital, Shanghai, China.
authors.forename: Chaoyang
authors.initials: C
authors.lastname: Lv
authors.affiliation: Department of Endocrinology and Metabolism, Zhongshan Hospital, Shanghai, China.|Department of Endocrinology and Metabolism, Hainan Provincial Nong Ken Hospital, Hainan, China.
authors.forename: Xianying
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Liver Surgery, Zhongshan Hospital, Shanghai, China.
authors.forename: Xiaowu
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Liver Surgery, Zhongshan Hospital, Shanghai, China.
authors.forename: Qiman
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Department of Liver Surgery, Zhongshan Hospital, Shanghai, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Endocrinology and Metabolism, Zhongshan Hospital, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Liang
authors.affiliation: Department of Endocrinology and Metabolism, Zhongshan Hospital, Shanghai, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology and Metabolism, Zhongshan Hospital, Shanghai, China.
authors.forename: Shunmei
authors.initials: S
authors.lastname: He
authors.affiliation: Center of Clinical Epidemiology and Evidence-Based Medicine, Fudan University, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Gao
authors.affiliation: Department of Liver Surgery, Zhongshan Hospital, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Endocrinology and Metabolism, Zhongshan Hospital, Shanghai, China.
authors.forename: Mingxiang
authors.initials: M
authors.lastname: Yu
authors.affiliation: Department of Liver Surgery, Zhongshan Hospital, Shanghai, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Fan
authors.affiliation: Department of Endocrinology and Metabolism, Zhongshan Hospital, Shanghai, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Gao
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000276:immunology / Q000627:therapeutic use; D000077552:Basiliximab; D016572:Cyclosporine / Q000627:therapeutic use; D000077561:Daclizumab; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000276:immunology / Q000627:therapeutic use*; D053645:Interleukin-2 Receptor alpha Subunit / Q000037:antagonists & inhibitors* / Q000276:immunology; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D011993:Recombinant Fusion Proteins / Q000276:immunology / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D053645:Interleukin-2 Receptor alpha Subunit; D011993:Recombinant Fusion Proteins; D016572:Cyclosporine; D000077552:Basiliximab; D000077561:Daclizumab
keywords: interleukin-2; liver transplantation; new-onset diabetes after transplantation; receptor antagonists; 受体拮抗剂; 白细胞介素2; 移植后新发糖尿病; 肝移植