An Analysis of the Risk Factors for New-Onset Diabetes Mellitus After Liver Transplantation

Figures & data

Table 1 Clinical Parameters of Liver Transplant Recipients with Diagnosis of NODM and without NODM

	NO-NODM	NODM	P
Age(years)	39.27±11.49	52.15±8.47	<0.001
Gender			0.221
Male	22	14
Female	22	6
Donor type			0.053
DCD	24	5
LDLT	20	15
Etiology
HBV cirrhosis	21	14	<0.001
HCV cirrhosis	3	3
Cancer	14	2
Other	6	1
MELD score	19.3±7.68	16.9±8.45	0.287
Child-Pugh grade			0.139
A	5	5
B	19	4
C	20	11
Hypertension	4	5	0.191
Alcohol consumption	12	4	0.756
Smoking history	13	6	1
Previous surgery	12	8	0.467
BMI(kg/m^2)	20.4±3.40	25.8±4.99	<0.001
Immunosuppression			0.268
TAC	30	17
CsA	14	3
Hospitalization,(days)	32.9±10.8	34.4±16.8	0.706
Follow-up time,(days)	1296±761	1034±566	0.573
TC(mmol/L)	2.20±1.34	2.26±0.624	0.806
Triglycerides(mmol/L)	1.12±0.68	0.874±0.493	0.115
HDL-C(mmol/L)	0.684±0.522	1.12±2.03	0.359
LDL-C(mmol/L)	1.42±0.84	1.24±0.53	0.308
AST(U/L)	89.5±110	172±334	0.145
ALT(U/L)	85.8±181	175±479	0.283
DB(umol/L)	75.9±97.3	88.7±91.9	0.622
IB(umol/L)	69.4±84.4	82.0±75.0	0.571
TBIL(umol/L)	145±166	169±158	0.593
ALB(g/L)	30.6±8.80	29.1±6.52	0.513
FBG(mmol/L)	5.86±2.32	8.01±4.32	0.047
PCT(ng/L)	1.22±1.94	8.10±21.9	0.177
IL-6(pg/mL)	12.8±9.67	43.4±57.9	0.029
CRP(mg/L)	4.99±8.19	7.17±7.50	0.301
Urea(mmol/L)	5.69±4.47	4.63±2.02	0.194
CRE(umol/L)	65.0±31.3	60.8±20.2	0.531
CIT(h)	2.49±1.42	3.00±1.60	0.227
WIT(min)	4.5±3.05	7.5±4.30	0.009
Surgery time(h)	10.7±3.17	10.6±2.05	0.876
Anhepatic stage time(h)	1.61±0.76	1.45±0.57	0.348
Blood loss(mL)	2655±1741	2325±1105	0.365

Abbreviations: LDLT, living donor liver transplantation; DCD, donation after circulatory death; HBV, hepatitis B virus; HCV, hepatitis C virus; BMI, body mass index; TAC, tacrolimus; TC, total cholesterol; AST, aspartate aminotransferase; ALT, alanine aminotransferase; DB, direct bilirubin; IB, indirect bilirubin; TBIL, total bilirubin; ALB, albumin; FBG, fast blood glucose; PCT, Procalcitonin; IL-6, interleukin-6; CRP, C-reactive protein; CRE, creatinine; CIT, cold ischemia time; WIT, warm ischemia time.

Table 2 Clinical and Preoperative Laboratory Test Parameters of DCD & LDLT Donor

	NO-NODM	NODM	P
DCD
Gender			0.018
Male	10	14
Female	10	1
Age(years)	36.2±4.87	37.9±3.61	0.792
BMI(kg/m^2)	21.8±1.40	23.4±1.39	0.003
Hepatic steatosis	20	15	0.005
Cause of death
Cerebral hemorrhage	11	15	0.011
Cranial trauma	8	0
Other	1	0
Use of vasopressor agents			0.089
Norepinephrine	16	7
Norepinephrine+Dopamine	4	8
ICU stay(days)	16.9±5.95	17.5±5.38	0.77
Infection	20	15	0.669
AST(U/L)	31.2±11.1	49.7±15.4	0.001
ALT(U/L)	26.6±11.3	43.2±13.3	0.001
TBIL (umol/L)	14.5±2.76	17.5±3.91	0.018
Na+(mmol/L)	144±6.56	143±6.94	0.797
IL-6(pg/mL)	7.55±3.06	8.28±2.72	0.471
LDLT
Gender			1
Male	17	4
Female	7	1
Age(years)	38.8±6.74	38±5.24	0.792
BMI(kg/m^2)	23.1±1.42	24.7±1.48	0.003
Hepatic steatosis	24	5	0.572
IL-6(pg/mL)	2.02±1.50	2.07±1.58	0.942

Abbreviations: BMI, body mass index; AST, aspartate aminotransferase; ALT, alanine aminotransferase; TBIL, total bilirubin; IL-6, interleukin-6.

Table 3 Risk Factors of NODM in Multivariate Logistic Regression Analysis

	OR	95% CI	P
Age(years)	1.089	0.0211–0.1495	0.003
BMI(kg/m^2)	1.235	0.0284–0.3931	0.248
HBV cirrhosis	2.376	0.1116–1.6197	0.251
FBG(mmol/L)	1.287	0.0087–0.4953	0.300
IL-6(pg/mL)	1.122	0.0619–0.1677	0.029
WIT(min)	1.171	0.1037–0.21209	0.731

Abbreviations: BMI, body mass index; FBG, fast blood glucose; IL-6, interleukin-6; WIT, warm ischemia time.

Figure 1 Constructed Logistic regression model was used to predict the test set and construct the ROC chart. It can be seen from the figure that AUC=0.868, 95% CI: 0.745, 0.992, indicating that the prediction effect of the model is excellent.

Figure 2 (A) The IL-6 levels of NO-NODM group in NODM combination after liver transplantation, the inner lines represent the median, the bars represent the 25% and 75% confidence intervals, and the error bars represent the 5% and 95% confidence intervals. (B) The PCT levels of NO-NODM group in NODM combination after liver transplantation, the inner lines represent the median, the bars represent the 25% and 75% confidence intervals, and the error bars represent the 5% and 95% confidence intervals. (C) The CRP levels of NO-NODM group in NODM combination after liver transplantation, the inner lines represent the median, the bars represent the 25% and 75% confidence intervals, and the error bars represent the 5% and 95% confidence intervals.

Figure 3 The TAC plasma concentration of NO-NODM group in NODM combination after liver transplantation, the inner lines represent the median, the bars represent the 25% and 75% confidence intervals, and the error bars represent the 5% and 95% confidence intervals.

Figure 4 The FBG levels of NO-NODM group in NODM combination after liver transplantation, the inner lines represent the median, the bars represent the 25% and 75% confidence intervals, and the error bars represent the 5% and 95% confidence intervals.

Figure 5 Kaplan-Meier survival curve analysis of 2 group.