title: New-onset diabetes mellitus after heart transplantation in children - Incidence and risk factors.
abstract: Diabetes mellitus is a recognized complication of SOT in adults and is associated with decreased graft and patient survival. Little is known about NOD in pediatric HT recipients. We aimed to characterize the incidence and describe risk factors for development of NOD after HT in children. Children who developed diabetes after HT were identified from the OPTN database. Demographic and clinical data before and after transplant were compared between patients with and without NOD. A total of 2056 children were included, 56% were male, 54% were Caucasian, and 62% had cardiomyopathy prior to HT. NOD developed in 219 children (11%) after HT. The incidence of NOD was 2.4, 9.0, and 10.4% at one, five, and 10 yr after HT, respectively. Obesity (HR: 4.32), dialysis prior to transplant (HR: 2.38), African American race (HR: 1.86), transplant before year 2000 (HR: 1.82), female gender (HR: 1.68), and older age at transplant (HR: 1.28) were independent predictors of NOD. The major modifiable risk factor for NOD is obesity, imparting the maximum hazard. Improved surveillance for diabetes in high-risk patients and specific prevention and intervention strategies are imperative in this population.
authors.affiliation: Division of Cardiology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. ssehgal@dmc.org.
authors.forename: Swati
authors.initials: S
authors.lastname: Sehgal
authors.affiliation: Division of Cardiology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Bock
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Hannah
authors.initials: H
authors.lastname: Louks Palac
authors.affiliation: Division of Endocrinology, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Brickman
authors.affiliation: Division of Cardiology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Gossett
authors.affiliation: Division of Cardiology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Marino
authors.affiliation: Division of Cardiovascular Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Siragusa Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Carl L
authors.initials: CL
authors.lastname: Backer
authors.affiliation: Division of Cardiology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Elfriede
authors.initials: E
authors.lastname: Pahl
mesh_terms: D000293:Adolescent; D001741:Black or African American; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D048909:Diabetes Complications / Q000175:diagnosis; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D005260:Female; D006085:Graft Survival; D006333:Heart Failure / Q000150:complications / Q000208:ethnology / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D009765:Obesity / Q000150:complications; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
keywords: children; diabetes mellitus; heart transplantation; pediatric