在1型糖尿病患者同时进行胰腺脏移植后的长期代谢结果
Harsham Choksi1,2, Henry Pleass3,4, Paul Robertson4
1Faculty of Medicine and Health, University of Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Transplantation
|January 23, 2025
概括
同时的胰腺-脏移植为1型糖尿病和功能衰竭提供了很好的生存率. 然而,患者经历了显著的长期体重增加,这表明潜在的心血管风险需要管理.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 移植医学 移植医学
背景情况:
- 同时胰腺-脏 (SPK) 移植是1型糖尿病 (T1DM) 和末期脏疾病 (ESKD) 的治疗方法.
- 在SPK后的免疫抑制可以产生糖尿病效应,可能会否定血糖效益.
- 在SPK后的长期代谢趋势和心血管风险尚未得到充分记录.
研究的目的:
- 评估SPK移植后的长期代谢趋势和心血管风险因素.
- 为了评估患者和异种移植的存活率,体重指数 (BMI),脂质概况,胰岛素敏感性和移植后长达10年的功能.
主要方法:
- 在500名T1DM患者的回顾性分析中,他们接受了SPK移植,并进行了至少2年的随访.
- 对代谢参数 (BMI,脂质,胰岛素敏感性) 和全移植功能 (eGFR,UACR) 的纵向监测.
主要成果:
- 优秀的患者 (97%在1y,87%在10y) 和死亡审查的移植存活率 (87%在1y,80%在10y).
- 在移植后的1,3年和5年观察到显著的BMI增加.
- 10年后改善了脂质特征和胰岛素敏感性,但尽管稳定的eGFR,尿动白蛋白-肌素比率在3至10年之间增加.
结论:
- 在SPK移植中,患者和移植的生存率很高.
- 显著的长期体重增加发生在SPK后,随着脂质和胰岛素敏感性的改善.
- 观察到的代谢变化表明,在SPK接受者中,潜在的心血管负担需要临床关注.
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