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Postoperative fasting plasma glucose and family history diabetes mellitus can predict post-transplantation diabetes mellitus in kidney transplant recipients

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Abstract

Purpose

To explore whether glycated albumin (GA) or fasting plasma glucose (FPG), both routinely monitored during patients’ hospital stay, can be used to predict post-transplantation diabetes mellitus (PTDM).

Methods

All kidney transplantation recipients (KTRs) from January 2017 to December 2018 were followed-up for 1 year. PTDM was diagnosed from day 45 post-operation to 1 year. When the completeness was above 80%, FPG or GA data on the day was selected, analyzed, and presented as range parameters and standard deviation (SD) and compared between PTDM and non-PTDM groups in fluctuation and stable periods. The predictive cut-off values were determined via receiver operating characteristic (ROC) analysis. The PTDM combined predictive mode, formed by the independent risk factors derived from logistic regression analyses, was compared with each independent risk factor with the independent ROC curve test.

Results

Among 536 KTRs, 38 patients developed PTDM up to 1 year post-operatively. The family history diabetes mellitus (OR, 3.21; P = 0.035), the FPG SD in fluctuation period >2.09 mmol/L (OR, 3.06; P = 0.002), and the FPG maximum in stable period >5.08 mmol/L (OR, 6.85; P < 0.001) were the PTDM independent risk factors. The discrimination of the combined mode (area under the curve = 0.81, sensitivity = 73.68%, and specificity = 76.31%) was higher than each prediction (P < 0.05).

Conclusions

The FPG standard deviation during the fluctuation period, FPG maximum during the stable period, and family history diabetes mellitus predicted PTDM with good discrimination and potential routine clinical use.

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Funding

This study was supported by the National Nature Science Foundation of China (No. 81771485 and 81971290), the Key Research and Development Program of Shaanxi Province (No. 2020SF-136), the Program for New Scientific and Technological Star of Shaanxi Province (No. 2019KJXX-046), Young Talent Support Plan of Shaanxi Province, the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University, China (No. XJTU1AF2021CRF-012).

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Author notes

  1. These authors contributed equally: Le Wang, Jin Huang

Authors and Affiliations

  1. Department of Anesthesiology & Center for Brain Science & Center for Translational Medicine, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    Le Wang, Jin Huang, Yajuan Li, Kewei Shi, Sai Gao, Wangcheng Zhao, Shanshan Zhang & Wei Gao

  2. Department of Kidney Transplantation, Nephropathy Hospital, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    Chenguang Ding

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  1. Le Wang
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Contributions

LW and WG: study design and drafting of the manuscript. JH, YL, KS, SG, WZ, SZ, and CD: data acquisition and analysis and study supervision. LW, YL, and WG: statistical analysis. WG: obtained funding support. All authors have approved the final version and agreed to publish the manuscript.

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Correspondence to Wei Gao.

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Wang, L., Huang, J., Li, Y. et al. Postoperative fasting plasma glucose and family history diabetes mellitus can predict post-transplantation diabetes mellitus in kidney transplant recipients. Endocrine 81, 58–66 (2023). https://doi.org/10.1007/s12020-023-03374-y

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