Unmasking Glucose Metabolism Alterations in Stable Renal Transplant Recipients: A Multicenter Study

• Published in: Clinical journal of the American Society of Nephrology 2008-05, Vol.3 (3), p.808-813
• Main Authors: Delgado, Patricia, Diaz, Juan Manuel, Silva, Irene, Osorio, José M, Osuna, Antonio, Bayés, Beatriz, Lauzurica, Ricardo, Arellano, Edgar, Campistol, Jose Maria, Dominguez, Rosa, Gómez-Alamillo, Carlos, Ibernon, Meritxell, Moreso, Francisco, Benitez, Rocio, Lampreave, Ildefonso, Porrini, Esteban, Torres, Armando
• Format: Article
• Language: English
• Subjects: Adrenergic beta-Antagonists - adverse effects; Adult; Age Factors; Blood Glucose - metabolism; Cross-Sectional Studies; Diabetes Mellitus - blood; Diabetes Mellitus - epidemiology; Diabetes Mellitus - etiology; Fasting - blood; Female; Glucose Intolerance - blood; Glucose Intolerance - epidemiology; Glucose Intolerance - etiology; Glucose Tolerance Test; Humans; Immunosuppressive Agents - adverse effects; Kidney Transplantation - adverse effects; Kidney Transplantation - statistics & numerical data; Lipids - blood; Logistic Models; Male; Middle Aged; Odds Ratio; Prednisone - adverse effects; Prevalence; Renal Transplantation; Risk Assessment; Risk Factors; Spain - epidemiology; Time Factors
• ISSN: 1555-9041; 1555-905X
• DOI: 10.2215/CJN.04921107

Emerging information indicates that glucose metabolism alterations are common after renal transplantation and are associated with carotid atheromatosis. The aims of this study were to investigate the prevalence of different glucose metabolism alterations in stable recipients as well as the factors related to the condition. A multicenter, cross-sectional study was conducted of 374 renal transplant recipients without pre- or posttransplantation diabetes. A standard 75-g oral glucose tolerance test was performed. Glucose metabolism alterations were present in 119 (31.8%) recipients: 92 (24.6%) with an abnormal oral glucose tolerance test and 27 (7.2%) with isolated impaired fasting glucose. The most common disorder was impaired glucose tolerance (17.9%), and an abnormal oral glucose tolerance test was observed for 21.5% of recipients with a normal fasting glucose. By multivariate analysis, age, prednisone dosage, triglyceride/high-density lipoprotein cholesterol ratio, and beta blocker use were shown to be factors related to glucose metabolism alterations. Remarkably, triglyceride levels, triglyceride/high-density lipoprotein cholesterol ratio, and the proportion of recipients with impaired fasting glucose were already higher throughout the first posttransplantation year in recipients with a current glucose metabolism alteration as compared with those without the condition. Glucose metabolism alterations are common in stable renal transplant recipients, and an oral glucose tolerance test is required for its detection. They are associated with a worse metabolic profile, which is already present during the first posttransplantation year. These findings may help planning strategies for early detection and intervention.