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Published on: January 12, 2024
Interleukin-2 receptor antagonists: Protective factors against new-onset diabetes after renal transplantation
Mengjuan Xue1,2, Chenhe Zhao1, Chaoyang Lv1,3
1Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China.
Background:
The aim of the present study was to examine the association between interleukin-2 receptor antagonists (IL-2Ra) and new-onset diabetes after transplantation (NODAT) among renal transplant recipients (RTRs).
Methods:
Between January 1993 and March 2014, 915 patients underwent renal transplantation at Zhongshan Hospital. In all, 557 RTRs were included in the present retrospective cohort study. The incidence of NODAT in this cohort was determined and multivariate Cox regression analysis was used to evaluate the risk factors for NODAT and to show the association between IL-2Ra use and NODAT development among RTRs. The cumulative incidence of NODAT was compared between groups treated with or without IL-2Ra.
Results:
The mean ±SD postoperative follow-up was 5.08 ±3.17 years. The incidence of NODAT at the end of follow-up was 20.3%. After adjusting for potential confounders in the multivariate logistic regression (i.e. age, sex, body mass index, history of smoking, family history of diabetes, duration of dialysis, type of dialysis, donor type, recovery of graft function, acute rejection, hepatitis B or C or cytomegalovirus infection, fasting plasma glucose levels before and 1 week after transplantation, preoperative total cholesterol and triglyceride levels, daily dose of glucocorticoid, immunosuppressive regimen type, and immunosuppressant concentration after transplantation), IL-2Ra use was found to be related to a reduced incidence of NODAT.
Conclusions:
Use of IL-2Ra is associated with protection against the development of NODAT in RTRs.
Insights
Interleukin-2 receptor antagonists (IL-2Ra) may reduce the risk of new-onset diabetes after transplantation (NODAT) in renal transplant recipients (RTRs). This study found IL-2Ra use was associated with a lower incidence of NODAT.
Area of Science:
- Nephrology
- Immunology
- Endocrinology
Background:
- New-onset diabetes after transplantation (NODAT) is a significant complication in renal transplant recipients (RTRs).
- Interleukin-2 receptor antagonists (IL-2Ra) are used as immunosuppressants in RTRs, but their effect on NODAT is not fully understood.
Purpose of the Study:
- To investigate the association between the use of IL-2Ra and the development of NODAT in RTRs.
- To identify risk factors for NODAT in a cohort of RTRs.
Main Methods:
- Retrospective cohort study of 557 RTRs from January 1993 to March 2014.
- Multivariate Cox regression analysis to assess risk factors and the association between IL-2Ra and NODAT.
- Comparison of cumulative NODAT incidence between groups with and without IL-2Ra treatment.
Main Results:
- The incidence of NODAT was 20.3% over a mean follow-up of 5.08 years.
- After adjusting for multiple confounders, IL-2Ra use was significantly associated with a reduced incidence of NODAT.
- Confounders included age, BMI, diabetes history, dialysis details, donor type, graft function, rejection, infections, glucose levels, lipid profiles, and immunosuppression regimen.
Conclusions:
- IL-2Ra use is linked to a protective effect against NODAT development in RTRs.
- Further research may explore the mechanisms behind this protective association.
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