PMID- 26586047
OWN - NLM
STAT- MEDLINE
DCOM- 20160211
LR  - 20151120
IS  - 1319-2442 (Print)
IS  - 1319-2442 (Linking)
VI  - 26
IP  - 6
DP  - 2015 Nov
TI  - Is there a genetic predisposition to new-onset diabetes after kidney 
      transplantation?
PG  - 1113-20
LID - 10.4103/1319-2442.168558 [doi]
AB  - Kidney transplant recipients may develop new-onset diabetes after transplantation 
      (NODAT) and transplant-associated hyperglycemia (TAH) (NODAT or new-onset 
      impaired glucose tolerance-IGT). We studied 251 consecutive renal transplant 
      South Asian recipients for incidence of NODAT and its risk factors between June 
      2004 and January 2009. Pre-transplant glucose tolerance test (GTT) identified 
      non-diabetics (n = 102, IGT-24, NGT-78) for analysis. Baseline immunosuppression 
      along with either cyclosporine (CsA) (n = 70) or tacrolimus (Tac) (n = 32) was 
      given. Patients underwent GTT 20 days (mean) post-transplant to identify NODAT, 
      normal (N) or IGT. TAH was observed in 40.2% of the patients (40% in CsA and 
      40.6% in Tac) (P = 0.5). NODAT developed in 13.7% of the patients (12.9% in CsA 
      and 15.6% in Tac) (P = 0.5). Overall, Hepatitis C (P = 0.007), human leukocyte 
      antigen (HLA) B52 (P = 0.03) and lack of HLA A28 (A68/69) (P = 0.03) were 
      associated with TAH. In the Tac group, higher Day 1 dosage (P <0.001), HLA A1 (P 
      = 0.04), B13 (P = 0.03) and lack of DR2 (P = 0.004) increased the risk of TAH. In 
      the CsA group, HLA A10 (P = 0.03), failure of triglyceride (P = 0.001) or 
      low-density lipoprotein (LDL) (P = 0.03) to lower or high-density lipoprotein to 
      rise (P = 0.001), and higher post-transplant LDL (P <0.001) and cholesterol 
      levels (P = 0.02) were associated with NODAT or TAH. Post-transplant fasting 
      plasma glucose on Day 1 had sensitivity-54.5%, specificity-50.1%, positive 
      predictive value-18.1% and negative predictive value-84.8% for detecting NODAT. 
      In conclusion, there is a genetic predisposition to NODAT and TAH in South Asia 
      as seen by the HLA associations, and a predisposition exists to the individual 
      diabetogenic effects of Tac and CsA based on HLA type. This could lead to more 
      careful selection of calcineurin inhibitors based on HLA types in the South Asian 
      population.
FAU - Reddy, Yogesh N V
AU  - Reddy YN
AD  - Madras Medical Mission Hospital, Chennai, India; Division of Cardiovascular 
      Disease, Mayo Clinic, Rochester, Minnesota, USA, .
FAU - Abraham, Georgi
AU  - Abraham G
FAU - Sundaram, Varun
AU  - Sundaram V
FAU - Reddy, Pooja P
AU  - Reddy PP
FAU - Mathew, Milly
AU  - Mathew M
FAU - Nagarajan, Prethivee
AU  - Nagarajan P
FAU - Mehra, Nikita
AU  - Mehra N
FAU - Ramachandran, A
AU  - Ramachandran A
FAU - Ali, Asik Ali Mohammed
AU  - Ali AA
FAU - Reddy, Yuvaram N V
AU  - Reddy YN
LA  - eng
PT  - Journal Article
PL  - Saudi Arabia
TA  - Saudi J Kidney Dis Transpl
JT  - Saudi journal of kidney diseases and transplantation : an official publication of 
      the Saudi Center for Organ Transplantation, Saudi Arabia
JID - 9436968
RN  - 0 (Calcineurin Inhibitors)
RN  - 0 (HLA Antigens)
RN  - 83HN0GTJ6D (Cyclosporine)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Adult
MH  - Calcineurin Inhibitors/therapeutic use
MH  - Cyclosporine/therapeutic use
MH  - Diabetes Mellitus/etiology/*genetics
MH  - Female
MH  - *Genetic Predisposition to Disease
MH  - Graft Rejection/prevention & control
MH  - HLA Antigens/immunology
MH  - Humans
MH  - Hyperglycemia/etiology/*genetics
MH  - Kidney Failure, Chronic/surgery
MH  - *Kidney Transplantation/adverse effects
MH  - Male
MH  - Middle Aged
MH  - Tacrolimus/therapeutic use
EDAT- 2015/11/21 06:00
MHDA- 2016/02/13 06:00
CRDT- 2015/11/21 06:00
PHST- 2015/11/21 06:00 [entrez]
PHST- 2015/11/21 06:00 [pubmed]
PHST- 2016/02/13 06:00 [medline]
AID - SaudiJKidneyDisTranspl_2015_26_6_1113_168558 [pii]
AID - 10.4103/1319-2442.168558 [doi]
PST - ppublish
SO  - Saudi J Kidney Dis Transpl. 2015 Nov;26(6):1113-20. doi: 
      10.4103/1319-2442.168558.