Risk for diabetes can be detected prior to liver transplants

[Guest guest]

Risk for diabetes can be detected prior

to liver transplants

Liver Transplant January 2007

New-onset diabetes mellitus after liver transplantation is

related to risk factors that can be detected prior to the graft, reports

January's Liver Transplantation.

New-onset diabetes mellitus

remains a common complication of liver transplantation.

Dr Faouzi Saliba and colleagues from France studied incidence and risk factors in 211 patients who had

undergone a primary liver transplantation between 6 and 24 months previously.

The research team conducted a

cross-sectional and retrospective multicenter study. Demographic details, immunosuppressive

regimens, familial and personal histories, hepatitis status, and cardiovascular

risk were analyzed.

The researchers collected on

consecutive patients at a single routine post-liver transplantation

consultation

The team assessed those with

newly developed diabetes, according to American Diabetes Association/World

Health Organization criteria.

The researchers found that the

overall incidence of new-onset diabetes mellitus was 23%.

The incidence in tacrolimus-treated patients was 24%, and 17% in

cyclosporine-treated patients.

A total of 81% of the cases

were diagnosed within 3 months of liver transplantation.

Among Hepatitis C

virus-infected patients, new-onset diabetes mellitus incidence was 42%.

However, the team observed that

among those patients negative for Hepatitis C virus, the incidence was only

19%.

With tacrolimus,

the incidence of new-onset diabetes mellitus in the Hepatitis C virus positive

patients was higher than in the Hepatitis C virus negative patients.

Only 17% of the Hepatitis C

virus positive patients developed new-onset diabetes mellitus on cyclosporine.

The researchers found that

impaired fasting glucose were independent pretransplantation

risk factors for new-onset diabetes mellitus.

A maximum lifetime body-mass

index over 25 kg/m2 was an independent pretransplantation risk factor for new-onset diabetes

mellitus.

Dr Saliba's

team concludes, “Emergence of new-onset diabetes mellitus after liver

transplantation is related to risk factors that can be detected prior to the

graft.”

“These risk factors

include maximum lifetime body-mass index, impaired fasting glucose, and

Hepatitis C virus status.”

“Tacrolimus

induced a higher incidence of new-onset diabetes mellitus in the Hepatitis C

virus positive compared to the Hepatitis C virus negative patients.”

“The treatment should be

tailored to the patient's risk especially in case of Hepatitis C virus

infection.”

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