Inflammation on the Waiting List Is a Risk Factor for New-Onset Prediabetes and Post-Transplant Diabetes Mellitus: A...

Area of Science:

• Nephrology
• Endocrinology
• Immunology

Background:

• Inflammation is a known risk factor for diabetes in the general population.
• The relationship between inflammation and prediabetes or post-transplant diabetes mellitus (PTDM) is not well-established.
• Understanding these links is crucial for managing glucose metabolism in renal transplant candidates.

Purpose of the Study:

• To investigate the association between pre-transplant inflammatory markers and the development of prediabetes or PTDM.
• To identify risk factors for glucose metabolism disorders in patients awaiting kidney transplantation.

Main Methods:

• A prospective study analyzed 110 non-diabetic kidney transplant candidates.
• Pre-transplant serum cytokines (TNFα, IL6, IL1β, CRP, MCP1) and Body Mass Index (BMI) were measured.
• Patients were assessed for prediabetes and PTDM using oral glucose tolerance tests (OGTT) at baseline and 12 months post-transplantation.

Main Results:

• Overall, pre-transplant inflammation was not significantly associated with prediabetes or PTDM, likely due to the high prevalence of obesity and pre-existing glucose issues.
• In a sub-analysis of patients without prediabetes or occult diabetes at baseline, elevated pre-transplant Tumor Necrosis Factor-alpha (TNFα) levels and higher BMI were independently associated with the onset of prediabetes or PTDM one year post-transplant.
• The study identified 36 patients with prediabetes or occult diabetes at baseline and 57 patients who developed prediabetes or PTDM post-transplant.

Conclusions:

• Pre-transplant inflammation, specifically TNFα, and BMI are significant risk factors for developing prediabetes or PTDM in kidney transplant candidates with normal glucose metabolism prior to transplantation.
• These findings suggest targeted interventions focusing on inflammation and weight management may help prevent glucose dysregulation in this vulnerable population.