诱导免疫抑制和移植后糖尿病:一种倾向匹配的队列研究
Suruchi K Gupta1,2,3, Elizabeth Mostofsky1, Shweta R Motiwala3,4
1Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Frontiers in endocrinology
|November 6, 2023
概括
移植后糖尿病 (PTDM) 是心脏移植后的一个常见问题. 这项研究发现,在移植期间使用的诱导性免疫抑制药物不会增加患PTDM的风险.
科学领域:
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
- 移植医学 移植医学
背景情况:
- 移植后糖尿病 (PTDM) 是心脏移植接受者的常见并发症,与不良结果有关.
- 虽然维持性免疫抑制剂是已知的PTDM风险因素,但诱导性免疫抑制的影响尚不清楚.
研究的目的:
- 调查移植前诱导免疫抑制与成人心脏移植接受者中PTDM的发展之间的关联.
- 评估特定的诱导药物,包括IL-2受体对抗剂,多克隆抗淋巴细胞抗体和Alemtuzumab.
主要方法:
- 使用移植受体科学注册数据库 (2008-2018) 的回顾性队列研究.
- 包括17,142名成年心脏移植接受者,不包括先前移植或先前存在的糖尿病患者.
- 分析了倾向匹配的队列 (n=7,412),使用考克斯的比例危险模型来评估PTDM风险.
主要成果:
- 在倾向匹配的队列中,3706名接受者接受了诱导性免疫抑制.
- 在26,710个人年中观察到867例PTDM事件.
- 在诱导免疫抑制和PTDM (HR=1.04,95%CI:0.91-1.19) 之间没有发现显著的关联,也没有特定的诱导剂类.
结论:
- 在心脏移植中,当代诱导免疫抑制方案与患心脏移植后糖尿病风险的增加无关.
- 这些发现表明,诱导性免疫抑制可以安全地使用,而不会显著增加PTDM风险.
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