| Objective:To explore the related influence factors affecting the reversal of posttransplantation diabetes mellitus(PTDM)after liver transplantation,in order to provide clinical basis for the prevention and early treatment of PTDM.Methods:We collected clinical and follow-up data from 509 patients who underwent liver transplantation in the Department of liver transplantation at the First Hospital of Jilin University between January 2016 and March 2021.Of all these patients,81 were found to meet the criteria for PTDM complications.Patients were divided into two group named transient PTDM(T-PTDM)or persistent PTDM(P-PTDM),based on the disappearance or continued presence of symptoms in PTDM.Out of 81 PTDM patients in our center,25 cases were identified as T-PTDM,while the remaining 56 cases were classified as P-PTDM.The follow-up data included:(1)basic patient information before surgery,such as age and gender;(2)patient medical history,including smoking and alcohol consumption;(3)the patient’s primary disease and clinical grading,such as MELD score and ChildPugh classification;(4)preoperative laboratory tests,such as fasting blood glucose and total cholesterol levels;(5)liver transplant donor-related information,such as liver quality and degree of fat degeneration;(6)postoperative immunosuppressive drug,such as types and blood drug concentrations;(7)postoperative follow-up information,such as whether the reversal of PTDM occurred and the time of the reversal.Data was analyzed using SPSS 25.0.Normally distributed metric data were expressed as ?± ,and intergroup comparisons were made using t-tests.Skewed metric data were expressed as M(Q1,Q3)or M(range),and intergroup comparisons were made using Mann-Whitney U tests.Count data were expressed as absolute numbers(rates),and intergroup comparisons were made using chi-square tests.P < 0.05 was considered to be statistically significant.Variables with P < 0.1 were included in multivariate Logistic regression analysis to find the independent influencing factors of diabetes reversal after liver transplantation in our center.Result:Among the 509 liver transplant patients,81 were diagnosed with PTDM,of which25 were in the group of T-PTDM,and 56 were in the group of P-PTDM.It was concluded that the incidence of PTDM complications after liver transplantation in our center was 15.9%(81/509),with the incidence of transient PTDM accounting for 30.9%(25/81)of all PTDM patients.Univariate analysis showed that HCV infection(6.2% VS 1.8%,P=0.014)and Creatinine(Cr)(62.3(53.8,73.05)VS 63.1(57.18,76.2),P=0.043)were correlated with the reversal of PTDM after liver transplantation.Multivariate Logistic regression analysis suggested that: Preoperative triglyceride content(OR 3.242,95%CI 1.244-8.445,P=0.016),creatinine level(OR 1.045,95%CI 1.004-1.088,P=0.033),HCV infection(OR 34.087,95%CI 2.060-564.102,P=0.014)was an independent risk factor for persistent PTDM after liver transplantation.The area under the curve(AUC)of persistent PTDM predicted by triglyceride,creatinine and HCV infection was 77.1%.According to the Norman chart,it was observed that the preoperative levels of triglycerides(TG)and Cr,the presence of HCV infection were identified as significant predictors of increased risk of PTDM following liver transplantation.Conclusion:(1)Preoperative content of TG,Cr and HCV infection were independent influence factors for the reversal of PTDM after liver transplantation;(2)The three indexes of triglyceride content,creatinine level and HCV infection could predict the probability of the reversal of PTDM patients with PTDM after liver transplantation,and the accuracy was 77.1%. |
PDF Full Text Request