摘要
目的探讨糖化白蛋白(glycated albumin,GA)对肾移植受者(renal transplant recipients,RTR)继发移植后糖尿病(post-transplantation diabetes mellitus,PTDM)的预测价值。方法回顾性分析西安交通大学第一附属医院2017年1月至2017年12月年龄≥18岁、移植前无糖尿病、首次肾移植患者,排除移植前甲状腺功能异常、移植后空腹血糖受损、移植肾失功、移植肾切除、失访或死亡患者。按照2014年PTDM诊断标准,根据肾移植(renal transplantation,RT)45 d后至少2次空腹血糖(FPG)结果分为移植后糖尿病组(PTDM组)及移植后空腹血糖正常组(PTNFG组),并随访1年。对两组患者临床资料进行统计分析。绘制受试者工作特征曲线(ROC),评价GA对RTR继发PTDM的预测价值。结果共筛选282例RTR,有72例不符合条件,最终210例患者纳入分析,其中PTDM组21例、PTNFG组189例。PTDM组体质量、体质量指数(BMI)均高于PTNFG组(P<0.05);低镁血症发生率PTDM组高于PTNFG组(P<0.05);术前GA两组比较无统计学差异(P>0.05);术后7、14 d,PTDM组GA均高于PTNFG组(P<0.05);其中术后14 d GA预测价值最大,ROC曲线下面积(AUC)为0.749,当术后14 d GA为14.55%时,约登指数最大,预测PTDM的敏感度为57.1%,特异度为87.3%,阳性似然比为4.5,阴性似然比为0.49,阳性预测值为57.1%,阴性预测值为87.3%。结论肾移植术后14 d GA可预测RTR继发PTDM。
Objective To investigate the predictive value of glycated albumin(GA)in renal transplant recipients(RTRs)with post-transplant diabetes mellitus(PTDM).Methods We conducted a retrospective study.We recruited patients aged≥18 years old who had no pre-transplant diabetes and received the first renal transplantation(RT)in The First Affiliated Hospital of Xi'an Jiaotong University from January 2017 to December 2017.Patients with pre-transplant thyroid dysfunction,post-transplant impaired fasting glucose,renal graft failure,transplant nephrectomy,loss of follow-up,or death were excluded.According to the diagnostic criteria of PTDM in 2014,on the basis of the results of fasting plasma glucose(FPG)at least twice after 45 days of RT,the patients were divided into post-transplant diabetes mellitus group(PTDM group)and post-transplant normal fasting glucose group(PTNFG group).Each patient was followed up for one year.After comparison of the clinical data of the two groups,SPSS software was used for analyzing the data.Receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of GA for PTDM.Results In this study,a total of 282 RTR were screened,and 72 patients were not qualified.We recruited 210 patients,with 21 in PTDM group and 189 in PTNFG group.The levels of body mass and body mass index(BMI)in PTDM group were higher than those in PTNFG group(P<0.05).The incidence of hypomagnesemia was higher in PTDM group than in PTNFG group(P<0.05).The two groups did not differ significantly in GA before transplantation(P>0.05).GA in PTDM group was higher than that in PTNFG group at 7 days and 14 days after RT(P<0.05).ROC curve analysis showed that the predictive value of GA was the highest at 14 days after RT,its area under ROC curve(AUC)was 0.749.GA was 14.55%at 14 days after RT.Youden index was the largest,with the sensitivity of 57.1%and the specificity of 87.3%.The positive likelihood ratio was 4.5,the negative likelihood ratio was 0.49,the positive predictive value was 57.1%,and the negative predictive value was 87.3%.Conclusion GA can predict RTR with PTDM at 14 days after RT.
作者
王乐
高媛
王鸽
史可薇
汪博
李亚娟
高巍
景桂霞
WANG Le;GAO Yuan;WANG Ge;SHI Ke-wei;WANG Bo;LI Ya-juan;GAO Wei;JING Gui-xia(Department of Anesthesia and Surgery,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061;No.521 Hospital of Norinco Group,Xi'an 710065,China)
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2020年第1期108-113,共6页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
国家自然科学基金面上项目(No.81771485)
陕西省青年科技新星项目(No.2019KJXX-046)
中央高校基本科研业务费(No.xjj2018262)~~
关键词
糖化白蛋白
移植后糖尿病
肾移植
氧化应激
glycated albumin
post-transplant diabetes mellitus
renal transplantation
oxidative stress
