肝移植术后生存期五年及以上患者糖尿病患病率与相关因素分析

目的 探讨肝移植术后生存期≥5年患者肝移植后糖尿病(PTDM)的患病率及危险因素.方法 收集肝移植术后生存期≥5年的102例患者病历资料进行回顾性分析,分为PTDM组与非PTDM组,比较2组基本参数的差异,采用Logistic多元回归分析进行PTDM的危险因素研究.结果 102例患者PTDM患病率为34.1％ (35/102),移植前糖尿病患病率为17.1％ (17/102),差异有统计学意义(x2=6.102,P＜0.05).PTDM组术前BMI值和肥胖、高血压、糖尿病、高TG者占比均明显高于非PTDM组,组间差异有统计学意义[BMI:(26.2±3.2) kg/m2比(23.3±2.1)kg/m2,肥胖:34.3％(12/35)比11.9％ (8/67),高血压:48.6％ (17/35)比4.5％ (3/67),糖尿病:34.3％(12/35)比7.5％ (5/67),高TG.11.4％ (4/35)比1.5％(1/67),均P＜0.05].Logistic多元回归分析结果显示,PTDM的独立风险因素有:术前BMI[比值比(OR)=1.31,95％置信区间(CI):1.085～1.585,P=0.005]和术前糖尿病(OR=1.49,95％CI=1.33 ～1.66,P=0.000).结论 PTDM患病率高于移植术前糖尿病患病率,其独立的危险因素为术前BMI和术前糖尿病.

Prevalence of post-transplant diabetes mellitus and preliminary investigation of its pathogenesis in patients being alive over five years after liver transplantation

Objective To explore the incidence and risk factors of the liver post-transplant diabetes melli- tus （PTDM） in patients surviving ≥ 5 years after liver transplantation. Methods Retrospective analysis the data of 102 cases of liver transplantation patient who were divided into PTDM group and non-PTDM group was done. The parameters between the two groups were compared. Study the risk factors of PTDM by Logistic regression analysis. Results The incidence of PTDM was 17. 1% （17/102）, the incidence of PTDM was 34. 1% （35/102）. The difference was statistically significant （X2 = 6. 102, P 〈 0.05）. The PTDM group was statistically different from the non-diabetic group regarding preoperative body mass index （BMI）, obesity, hypertension, diabetes, high triglycer- ide（TG） [BMI： （26.2 ±3.2）kg/m： vs （23.3 ±2.1）kg/m2, obesity： 34.3% （12/35） vs 11.9% （8/67）, hy- pertension： 48.6% （ 17/35 ） vs 4.5% （3/67）, diabetes： 34.3% （ 12/35 ） vs 7.5% （5/67）, high TG： 11.4% （4/35） vs 1.5% （ 1/67）, all P 〈 0.05 ]. The result of Logistic regression analysis showed that the independent risk factors of the PTDM were preoperative BMI [ odds ratio（OR） = 1.31,95% confidence interval （CI） ： 1. 085 - 1.585, P=0.005] and preoperative diabetes （0R=1.49,95%CI： 1.33-1.66, P=0.000）. Conclusions The incidence of PTDM is higher than the incidence of diabetes before transplantation. The preoperative BMI and preop- erative diabetes are independent risk factors.