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Risk Factors Associated With the Onset and Progression of Posttransplantation Diabetes in Renal Allograft Recipients

 Kyu Yeon Hur  ;  Myoung Soo Kim  ;  Hyun Chul Lee  ;  Soon Il Kim  ;  Bong Soo Cha  ;  Chul Woo Ahn  ;  Chung Mo Nam  ;  So Hun Kim  ;  Jae Hyun Nam  ;  Eun Seok Kang  ;  Yu Seun Kim 
 DIABETES CARE, Vol.30 : 609-615, 2007 
Journal Title
Issue Date
Adult ; Age Factors ; Blood Glucose/metabolism* ; Diabetes Mellitus/epidemiology* ; Diabetes Mellitus/genetics ; Female ; Glucose Tolerance Test ; Humans ; Incidence ; Insulin/metabolism* ; Insulin Secretion ; Kidney Transplantation/adverse effects* ; Living Donors/statistics & numerical data ; Male ; Middle Aged ; Risk Factors ; Time Factors ; Transplantation, Homologous/adverse effects
OBJECTIVE: The aim of this study was to assess the incidence of posttransplantation diabetes mellitus (PTDM) in renal allograft recipients and to investigate factors contributing to the onset and progression of PTDM and its underlying pathogenic mechanism(s). RESEARCH DESIGN AND METHODS: A total of 77 patients with normal glucose tolerance (NGT) were enrolled in this study. An oral glucose tolerance test was performed 1 week before transplantation and repeated at 1 and 7 years after transplantation. RESULTS: The overall incidence of PTDM was 39% at 1 year and 35.1% at 7 years posttransplantation. The incidence for each category of PTDM was as follows: persistent PTDM (P-PTDM) (patients who developed diabetes mellitus within 1 year of transplantation and remained diabetic during 7 years), 23.4%; transient PTDM (T-PTDM) (patients who developed diabetes mellitus during the 1st year after transplantation but eventually recovered to have NGT), 15.6%; late PTDM (L-PTDM) (patients who developed diabetes mellitus later than 1 year after transplantation), 11.7%; and non-PTDM during 7 years (N-PTDM7) (patients who did not develop diabetes mellitus during 7 years), 49.3%. Older age (> or = 40 years) at transplantation was a higher risk factor for P-PTDM, whereas a high BMI (> or = 25 kg/m2) and impaired fasting glucose (IFG) at 1 year posttransplantation were higher risk factors for L-PTDM. Impaired insulin secretion rather than insulin resistance was significantly associated with the development of P- and L-PTDM. CONCLUSIONS: Impaired insulin secretion may be the main mechanism for the development of PTDM. Older age at transplantation seems to be associated with P-PTDM, whereas a high BMI and IFG at 1 year after transplantation were associated with L-PTDM.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kim, Myoung Soo(김명수)
Kim, So Hun(김소헌)
Kim, Soon Il(김순일) ORCID logo https://orcid.org/0000-0002-0783-7538
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Nam, Jae Hyun(남재현)
Nam, Jung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Ahn, Chul Woo(안철우) ORCID logo https://orcid.org/0000-0003-3733-7486
Lee, Hyun Chul(이현철)
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
Hur, Kyu Yeon(허규연)
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