Abstract
Aims
To evaluate the predictive power of the 5-time point oral glucose tolerance test (OGTT)
for new-onset diabetes after kidney transplantation (NODAT).
Methods
We performed a retrospective study of 145 patients without diabetes who received kidney
transplantations at our hospital. The 5-time point OGTT was performed before transplantation.
The area under a receiver-operating characteristic curve (aROC) was used for evaluating
the predictive power of 5-time point OGTT values.
Results
Seventeen patients developed NODAT within 1 year after transplantation. All postload
plasma glucose (PPG) levels were higher in patients who developed NODAT than in those
who did not; fasting plasma glucose levels were not different. The aROC for the area
under the glucose concentration-time curve was significantly greater than that for
fasting plasma glucose. Univariate and multivariate analyses showed that each PPG
level was an independent risk factor for NODAT. Furthermore, patients with normal
glucose tolerance (NGT) or impaired glucose tolerance (IGT) could be stratified with
a 1-h plasma glucose (1h-PG) cut-off point of 8.4 mmol/L. The incidences of NODAT were 23.5%, 16.7%, 9.1%, and 0% for patients with
IGT + 1h-PG ≥8.4 mmol/L,IGT + 1h-PG <8.4 mmol/L, NGT + 1h-PG ≥ 8.4 mmol/L, and NGT + 1h-PG < 8.4 mmol/L, respectively.
Conclusions
The area under the glucose concentration-time curve and each PPG concentration during
the 5-time point OGTT are strong predictors of NODAT. A 1h-PG cut-off point of 8.4 mmol/L plus NGT/IGT can be used to identify patients at intermediate and high risk
of developing NODAT.
Keywords
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Article info
Publication history
Published online: January 27, 2014
Accepted:
December 29,
2013
Received in revised form:
July 10,
2013
Received:
May 7,
2013
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
