Risk Factors for New-Onset Diabetes Mellitus after Heart Transplantation in Chinese Patients: A Single Center Experience.

ABSTRACT

BACKGROUND: New-onset diabetes after transplantation -(NODAT) is a frequent complication after heart transplantation (HT) and is associated with graft loss and patient survival. OBJECTIVES: The aim of this study was to identify the incidence and associated factors contributing to NODAT in Chinese heart transplant recipients. METHODS: Adult patients without diabetes mellitus before HT were enrolled in this study. NODAT was diagnosed according to the criteria recommended by the American Diabetes Association. The cumulative incidence was determined at 3, 6, and 12 months, respectively. The risk factors of NODAT were estimated by logistic regression analysis. RESULTS: A total of 154 adults who first received HT were included. Among them, 50 (32.5%) recipients were diagnosed with NODAT after a median follow-up time of 611 days. The cumulative incidence of NODAT was 27.3% at 3 months, 29.9% at 6 months, and 30.5% at 12 months, respectively. Independent risk factors for NODAT included age ≥45 years (OR 3.82, 95% CI 1.57-9.31; p = 0.003), hypertension (OR 3.28, 95% CI 1.17-9.20; p= 0.024), and transient hyperglycemia (OR 12.13, 95% CI 3.35-43.92; p < 0.001). Moreover, recipients treated with both acarbose and insulin for transient hyperglycemia had a significantly higher prevalence of NODAT than those without any anti-diabetic agents (OR 5.35, 95% CI 1.21-23.64; p = 0.027). CONCLUSIONS: Age ≥45 years, hypertension, transient hyperglycemia, and associated treatment strategies are imperative to identify recipients at high risk of developing -NODAT.