Post-Renal Transplant Diabetes Mellitus in Korean Subjects: Superimposition of Transplant-Related Immunosuppressant Factors on Genetic and Type 2 Diabetic Risk Factors.
10.4093/dmj.2012.36.3.199
- Author:
Hyun Chul LEE
1
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. endohclee@yuhs.ac
- Publication Type:Review
- Keywords:
Diabetes mellitus;
Immunosuppressive agents;
Polymorphism, genetic;
Risk factors;
Transplantation
- MeSH:
Calcineurin;
Diabetes Mellitus;
Genetic Variation;
Hepatitis C;
Humans;
Immunosuppressive Agents;
Insulin;
Insulin Resistance;
Obesity;
Organ Transplantation;
Polymorphism, Genetic;
Risk Factors;
Transplantation, Homologous;
Transplants
- From:Diabetes & Metabolism Journal
2012;36(3):199-206
- CountryRepublic of Korea
- Language:English
-
Abstract:
Postrenal transplantation diabetes mellitus (PTDM), or new-onset diabetes after organ transplantation, is an important chronic transplant-associated complication. Similar to type 2 diabetes, decreased insulin secretion and increased insulin resistance are important to the pathophysiologic mechanism behind the development of PTDM. However, beta-cell dysfunction rather than insulin resistance seems to be a greater contributing factor in the development of PTDM. Increased age, family history of diabetes, ethnicity, genetic variation, obesity, and hepatitis C are partially accountable for an increased underlying risk of PTDM in renal allograft recipients. In addition, the use of and kinds of immunosuppressive agents are key transplant-associated risk factors. Recently, a number of genetic variants or polymorphisms susceptible to immunosuppressants have been reported to be associated with calcineurin inhibition-induced beta-cell dysfunction. The identification of high risk factors of PTDM would help prevent PTDM and improve long-term patient outcomes by allowing for personalized immunosuppressant regimens and by managing cardiovascular risk factors.
