Lower magnesium level associated with new-onset diabetes and pre-diabetes after kidney transplantation

Springer Science and Business Media LLC - Tập 27 - Trang 339-344 - 2014
Neetika Garg1, Janice Weinberg2, Sandeep Ghai3, Gitana Bradauskaite3, Matthew Nuhn4, Amitabh Gautam4, Nilay Kumar5, Jean Francis3, Joline L. T. Chen3
1Department of Internal Medicine, Boston University Medical Center, Boston, USA
2Department of Biostatistics, Boston University School of Public Health, Boston, USA
3Renal Section, Department of Medicine, Boston University, Boston, USA
4Department of Transplant Surgery, Boston University Medical Center, Boston, USA
5Department of Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, USA

Tóm tắt

Hypomagnesemia is associated with increased peripheral insulin resistance in the general population. It is frequently seen after renal transplantation. We examined its role as a risk factor for new-onset diabetes after transplantation (NODAT) and new-onset pre-diabetes after transplantation (NOPDAT). A retrospective analysis of 138 previously non-diabetic renal transplant recipients was conducted. Cox and logistic regression analyses were performed to examine the associations between 1-month post-transplant serum magnesium level and subsequent diagnoses of NODAT/NOPDAT. NODAT was diagnosed in 34 (24.6 %) and NOPDAT in 12 (8.7 %) patients. Median time to diagnosis of NODAT/NOPDAT was 20.4 months (interquartile range [IQR] 6.8–34.8). Median follow up for the entire group was 3.5 years (IQR 2.3–5.6). Mean magnesium level at 1 month after transplantation was significantly lower in patients subsequently diagnosed with NODAT/NOPDAT (1.60 ± 0.27 vs. 1.76 ± 0.29 mg/dl, p = 0.002). Cox regression analysis identified a trend towards developing NODAT/NOPDAT with lower baseline magnesium levels (hazard ratio 0.89 per 0.1 mg/dl increment in magnesium level, 95 % confidence interval [CI] = 0.78–1.01, p = 0.07); a stronger relationship between the two variables was seen at logistic regression analysis (odds ratio 0.81 per 0.1 mg/dl increment in serum magnesium (95 % CI 0.67–0.98, p = 0.03). A lower magnesium level at 1 month after transplantation may be predictive of a subsequent diagnosis of glucose intolerance or diabetes in renal transplant recipients. Whether replenishing magnesium stores can prevent development of these disorders requires further investigation.

Tài liệu tham khảo

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