International journal of endocrinology and metabolism · 2026
Pre-diabetes and Diabetes in Heart Transplant Recipients: Epidemiological Insights from a Decade-Long Study.
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Soleimani Sanaz, Kazemi Hasnijeh Fatemeh, Vasheghani Maryam, Naghashzadeh Farah, Ahmadi Zargham Hossein, Sharif Kashani Babak, Nouri Fatemeh, Alizadeh Kolahdozi Niloufar, Shafaghi Shadi
Аннотация
BACKGROUND: Post-transplant diabetes mellitus (PTDM) is a serious complication after heart transplantation, with reported incidence rates ranging from 2% to 53% among solid organ transplant recipients. Comprehensive epidemiological data on prediabetes (Pre-DM) and diabetes mellitus (DM) in heart transplant populations remain limited, particularly in Middle Eastern populations.
OBJECTIVES: This decade-long study investigated the prevalence of DM and Pre-DM among heart transplant recipients and evaluated selected intraoperative risk factors.
METHODS: This retrospective cohort study included 250 heart transplant recipients who received post-transplant care at Dr. Masih Daneshvari Hospital, Tehran, Iran, between 2010 and 2020. Overall, 244 patients were included in the final analysis. Data included anthropometric measurements, cardiovascular parameters, and metabolic profiles. Pre-DM and DM were diagnosed according to the American Diabetes Association criteria. Statistical analyses were performed using SPSS version 26.
RESULTS: The study population comprised 192 males (78.7%) and 52 females (21.3%), with a mean age of 38.46 ± 12.69 years. At transplantation, 36.5% of recipients had established DM, 29.1% had Pre-DM, and 34.4% had normal glucose metabolism. Among patients with DM, 58.4% (52 of 89) were unaware of their diagnosis before transplantation. New-onset PTDM occurred in 6.8% of previously normoglycemic patients by 6 months. The prevalence of hypertension differed markedly by glucose status (P < 0.001): 100% of the normal group had normal blood pressure, 97.2% of patients with Pre-DM had stage 1 hypertension, and 87.6% of patients with DM had stage 2 hypertension. Dyslipidemia, particularly low high-density lipoprotein (HDL), was present in all groups. Pre-transplant hyperglycemia was associated with a numerically higher, but nonsignificant, mortality risk (hazard ratio [HR] = 1.371; 95% CI, 0.891 - 2.132; P = 0.162), which reversed after age adjustment (HR = 0.676; P = 0.083), consistent with negative confounding.
CONCLUSIONS: Pre-transplant metabolic dysfunction was highly prevalent, and 58.4% of diabetic recipients were unaware of their diagnosis. Although the association with mortality was nonsignificant and reversed after adjustment for age, these findings underscore the need for systematic pre-transplant metabolic screening, post-transplant glucose monitoring, and multidisciplinary care in heart transplant recipients.
OBJECTIVES: This decade-long study investigated the prevalence of DM and Pre-DM among heart transplant recipients and evaluated selected intraoperative risk factors.
METHODS: This retrospective cohort study included 250 heart transplant recipients who received post-transplant care at Dr. Masih Daneshvari Hospital, Tehran, Iran, between 2010 and 2020. Overall, 244 patients were included in the final analysis. Data included anthropometric measurements, cardiovascular parameters, and metabolic profiles. Pre-DM and DM were diagnosed according to the American Diabetes Association criteria. Statistical analyses were performed using SPSS version 26.
RESULTS: The study population comprised 192 males (78.7%) and 52 females (21.3%), with a mean age of 38.46 ± 12.69 years. At transplantation, 36.5% of recipients had established DM, 29.1% had Pre-DM, and 34.4% had normal glucose metabolism. Among patients with DM, 58.4% (52 of 89) were unaware of their diagnosis before transplantation. New-onset PTDM occurred in 6.8% of previously normoglycemic patients by 6 months. The prevalence of hypertension differed markedly by glucose status (P < 0.001): 100% of the normal group had normal blood pressure, 97.2% of patients with Pre-DM had stage 1 hypertension, and 87.6% of patients with DM had stage 2 hypertension. Dyslipidemia, particularly low high-density lipoprotein (HDL), was present in all groups. Pre-transplant hyperglycemia was associated with a numerically higher, but nonsignificant, mortality risk (hazard ratio [HR] = 1.371; 95% CI, 0.891 - 2.132; P = 0.162), which reversed after age adjustment (HR = 0.676; P = 0.083), consistent with negative confounding.
CONCLUSIONS: Pre-transplant metabolic dysfunction was highly prevalent, and 58.4% of diabetic recipients were unaware of their diagnosis. Although the association with mortality was nonsignificant and reversed after adjustment for age, these findings underscore the need for systematic pre-transplant metabolic screening, post-transplant glucose monitoring, and multidisciplinary care in heart transplant recipients.