以前存在但不是固体器官移植后的糖尿病预测末期脏病和死亡率
Wei-Syun Hu1,2, Cheng-Li Lin3
1School of Medicine, College of Medicine, China Medical University, Taichung, 40402, Taiwan. weisyunhu@gmail.com.
Naunyn-Schmiedeberg's archives of pharmacology
|August 13, 2025
概括
在固体器官移植 (SOT) 之前的2型糖尿病 (T2DM) 会增加末期病 (ESRD) 和死亡的风险. 然而,在SOT后发展的T2DM在本研究中没有显示增加的风险.
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:
- 固体器官移植 (SOT) 是一种拯救生命的手术,但接受者面临着不良结果的风险.
- 2型糖尿病 (T2DM) 是一种常见的并发症,可能会影响移植后的结果.
- 了解T2DM在SOT接受者的预后作用对于优化患者护理至关重要.
研究的目的:
- 调查前现有和后SOT T2DM与末期脏疾病 (ESRD) 和死亡率之间的关联.
- 确定T2DM是否在接受SOT的患者中作为独立的预后因素.
主要方法:
- 对6294名在台湾医疗保健系统中接受SOT的患者进行了回顾性队列研究.
- 在非T2DM,先前存在的T2DM和后SOT T2DM组之间对结果 (ESRD,死亡率) 的比较.
- 使用单变量和多变量考克斯比例危险回归模型来评估风险因素.
主要成果:
- 与非T2DM患者相比,患有先前存在的T2DM患者的ESRD风险 (调整HR [aHR] = 2.14) 和死亡率 (aHR = 1.37) 显著增加 (调整HR [aHR] = 2.14).
- 在SOT后发展T2DM的患者没有显示ESRD (aHR = 0.95) 或死亡率 (aHR = 1.23) 的风险增加.
- 预先存在的T2DM患者中ESRD和死亡率的风险增加在肝移植小组中尤为明显.
结论:
- 移植前T2DM是ESRD和SOT接受者的全因死亡率的重要预测因素.
- 诊断T2DM的时间 (SOT前与后) 影响其预后影响.
- 密切监测和管理T2DM在前SOT患者,特别是肝移植接受者是必不可少的.
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