Plasma Malondialdehyde and Risk of New-Onset Diabetes after Transplantation in Renal Transplant Recipients: A Prospective Cohort Study.
腎移植患者移植后血漿MDA與新發(fā)糖尿病風(fēng)險: 一項(xiàng)前瞻性隊(duì)列研究。
IF：5.6880? ?Doi：10.3390/jcm8040453? ? ?
New-onset diabetes after transplantation (NODAT) is a frequent complication in renal transplant recipients (RTR). Although oxidative stress has been associated with diabetes mellitus, data regarding NODAT are limited. We aimed to prospectively investigate the long-term association between the oxidative stress biomarker malondialdehyde (measured by high-performance liquid chromatography) and NODAT in an extensively phenotyped cohort of non-diabetic RTR with a functioning graft ≥1 year. We included 516 RTR (51 ± 13 years-old, 57% male). Median plasma malondialdehyde (MDA) was 2.55 (IQR, 1.92-3.66) μmol/L. During a median follow-up of 5.3 (IQR, 4.6-6.0) years, 56 (11%) RTR developed NODAT. In Cox proportional-hazards regression analyses, MDA was inversely associated with NODAT, independent of immunosuppressive therapy, transplant-specific covariates, lifestyle, inflammation, and metabolism parameters (HR, 0.55; 95% CI, 0.36-0.83 per 1-SD increase; p < 0.01). Dietary antioxidants intake (e.g., vitamin E, α-lipoic acid, and linoleic acid) were effect-modifiers of the association between MDA and NODAT, with particularly strong inverse associations within the subgroup of RTR with relatively higher dietary antioxidants intake. In conclusion, plasma MDA concentration is inversely and independently associated with long-term risk of NODAT in RTR. Our findings support a potential underrecognized role of oxidative stress in post-transplantation glucose homeostasis.
移植后新發(fā)糖尿病 (NODAT) 是腎移植受體 (RTR) 的常見并發(fā)癥宵睦。盡管氧化應(yīng)激與糖尿病有關(guān)交惯，但關(guān)于 NODAT 的數(shù)據(jù)有限。我們的目的是前瞻性地研究氧化應(yīng)激生物標(biāo)記物 mda (通過高效液相色譜法測量) 之間的長期關(guān)聯(lián) NODAT 在一個功能移植物 ≥ 1 年的非糖尿病 RTR 的廣泛表型隊(duì)列中变秦。我們包括 516 RTR (51 ± 13 歲成榜，57% 男性)。血漿 MDA 中位數(shù)為 2.55 (IQR蹦玫，1.92-3.66) mol/L赎婚。在 5.3 (IQR刘绣，4.6-6.0) 年的中位隨訪中，56 (11%) RTR 發(fā)展為 NODAT挣输。在 Cox 比例風(fēng)險回歸分析中纬凤，獨(dú)立于免疫抑制治療、移植特異性協(xié)變量撩嚼、生活方式停士、炎癥和代謝參數(shù)，MDA 與 NODAT 呈負(fù)相關(guān) (HR完丽，0.55; 95% 每 1-sd 增加 0.36-0.83; p <0.01)恋技。膳食抗氧化劑攝入量 (如維生素E 、 α-硫辛酸）是 MDA 和 NODAT 之間關(guān)聯(lián)的效應(yīng)修飾劑, RTR 亞組中具有特別強(qiáng)的反向關(guān)聯(lián)舰涌，飲食抗氧化劑攝入量相對較高猖任。總之瓷耙，血漿 MDA 濃度與 RTR 中 NODAT 的長期風(fēng)險成反比且獨(dú)立相關(guān)朱躺。我們的發(fā)現(xiàn)支持了氧化應(yīng)激在移植后葡萄糖穩(wěn)態(tài)中的潛在作用。
