World journal of nephrology · 2025
Relationship between vitamin D and post-transplant diabetes mellitus in kidney transplant recipients.
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Singh Dhiraj, Sangha Sukhwinder S, Yadav Raj K, Subbiah Arun K, Yadav Sushma, Kumar Asheesh, Khadgawat Rajesh, Chaturvedi Pradeep K, Agarwal Sanjay K, Mahajan Sandeep, Pahuja Taruna, Bhowmik Dipankar
Аннотация
BACKGROUND: Post-transplant diabetes mellitus (PTDM) adversely affects graft survival and is an independent predictor of adverse cardiovascular events. Observational studies in the general population as well as the post-transplant setting suggest an association between the plasma 25-hydroxyvitamin D [25(OH)D] level and onset of type 2 diabetes mellitus. Literature is very limited in the context of PTDM.
AIM: To study the relationship between vitamin D deficiency at the time of kidney transplant and PTDM in the post-transplant period.
METHODS: In this single center study, 72 patients who underwent kidney transplant were included. Blood samples for serum vitamin D level were collected on the day of transplant and analyzed at the end of study. The LIAISON® 25(OH)D assay was used for quantitative estimation of total 25(OH)D in the serum. PTDM was diagnosed by either fasting plasma glucose (> 126 mg/dL), 2-h post prandial plasma glucose (> 200 mg/dL), or 2-h oral glucose tolerance test after 45 days post-transplant. Hemoglobin A1c was not used to diagnose PTDM. Vitamin D levels were labeled as sufficient (≥ 30.0 ng/mL), insufficient (20.0-29.9 ng/mL), and deficient (< 20.0 ng/mL). Patients were reviewed at 45 days and 1 year post transplant for the occurrence of PTDM.
RESULTS: In our study cohort 72 patients completed the study. Overall, 32 (43.8%) patients developed PTDM during the follow up of 1 year, 44 (61.1%) patients had deficient (< 20 ng/mL) 25(OH)D levels. Twenty-six (81.2%) patients with PTDM had deficient vitamin D levels as compared with 18 (45.0%) patients without PTDM (P = 0.007). This association was also significant when univariable [odds ratio (OR) = 5.3, 95% confidence interval (CI): 1.79-15.67, P = 0.003)] and multivariable (OR = 8.21, 95%CI: 2.19-30.75, P = 0.002) regression analysis was performed. A higher proportion of subjects having PTDM (15.6%) had a positive family history of diabetes mellitus than the controls (2.5%) (P = 0.045). However, this association did not persist in the multivariable regression analysis (OR = 12.6, 95%CI: 0.86-185.4, P = 0.065).
CONCLUSION: Deficient vitamin D levels (< 20 ng/mL) were significantly associated with PTDM in the post kidney transplant setting. Further studies are needed to see the effect of vitamin D replacement on PTDM.
AIM: To study the relationship between vitamin D deficiency at the time of kidney transplant and PTDM in the post-transplant period.
METHODS: In this single center study, 72 patients who underwent kidney transplant were included. Blood samples for serum vitamin D level were collected on the day of transplant and analyzed at the end of study. The LIAISON® 25(OH)D assay was used for quantitative estimation of total 25(OH)D in the serum. PTDM was diagnosed by either fasting plasma glucose (> 126 mg/dL), 2-h post prandial plasma glucose (> 200 mg/dL), or 2-h oral glucose tolerance test after 45 days post-transplant. Hemoglobin A1c was not used to diagnose PTDM. Vitamin D levels were labeled as sufficient (≥ 30.0 ng/mL), insufficient (20.0-29.9 ng/mL), and deficient (< 20.0 ng/mL). Patients were reviewed at 45 days and 1 year post transplant for the occurrence of PTDM.
RESULTS: In our study cohort 72 patients completed the study. Overall, 32 (43.8%) patients developed PTDM during the follow up of 1 year, 44 (61.1%) patients had deficient (< 20 ng/mL) 25(OH)D levels. Twenty-six (81.2%) patients with PTDM had deficient vitamin D levels as compared with 18 (45.0%) patients without PTDM (P = 0.007). This association was also significant when univariable [odds ratio (OR) = 5.3, 95% confidence interval (CI): 1.79-15.67, P = 0.003)] and multivariable (OR = 8.21, 95%CI: 2.19-30.75, P = 0.002) regression analysis was performed. A higher proportion of subjects having PTDM (15.6%) had a positive family history of diabetes mellitus than the controls (2.5%) (P = 0.045). However, this association did not persist in the multivariable regression analysis (OR = 12.6, 95%CI: 0.86-185.4, P = 0.065).
CONCLUSION: Deficient vitamin D levels (< 20 ng/mL) were significantly associated with PTDM in the post kidney transplant setting. Further studies are needed to see the effect of vitamin D replacement on PTDM.