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J Diabetes:复旦大学附属中山医院于明香教授团队研究:HCV感染使肾移植患者糖尿病风险增加3倍

2018-10-02 国际糖尿病编辑部 国际糖尿病

日前,复旦大学附属中山医院内分泌科于明香教授团队在Diabetes杂志发表的研究结果显示,术前丙型肝炎(HCV)感染的成人在接受肾移植后患糖尿病的风险比乙型肝炎(HBV)感染和无感染的成人增加3倍以上。

日前,复旦大学附属中山医院内分泌科于明香教授团队在Diabetes杂志发表的研究结果显示,术前丙型肝炎(HCV)感染的成人在接受肾移植后患糖尿病的风险比乙型肝炎(HBV)感染和无感染的成人增加3倍以上。

于明香教授等对1993~2004年在复旦大学附属中山医院接受肾移植的557例患者进行了一项回顾性队列研究。将患者分为四组:移植前HCV感染组(n=34)、HBV组(n=46)、HBV合并HCV感染组(n=7)、无感染组(n=470)。肾移植后所有受试者在门诊监测,每月一次,一年后每2~3个月一次。肾移植手术3个月后才进行糖尿病诊断,以避免术后不良反应带来的潜在混杂因素。

557例受试者中,120例在观察期间被诊断糖尿病,从肾移植到诊断糖尿病的中位时间为7.53年。研究人员发现,与其他组相比,HCV感染组糖尿病患病人数最多(55.88%)(P<0.001),HBV和HCV合并感染组糖尿病患病率更高(71.43%)。

此外,多因素分析显示,感染HCV的移植受体患糖尿病的可能性比HBV感染组和未感染组高3倍以上(aHR=3.03,95%CI:1.77~5.18),HBV感染者的糖尿病发生风险增加1.8倍,但并未达统计学意义。

研究人员指出,HCV感染与移植后新发糖尿病风险增加相关的机制尚未完全阐明,胰岛素抵抗增加和胰岛素分泌减少均牵涉其中。而胰岛素抵抗通过几种途径在HCV感染与移植后新发糖尿病的联系中起着重要作用,所有这些途径都会导致胰岛素受体底物的降解或下调,从而中断对胰岛素的代谢反应。

总之,这项研究显示,在中国肾移植患者,术前HCV感染与移植后新发糖尿病风险之间有很强的关联,且与各种混杂因素无关。HBV感染以及HBV和HCV合并感染不会独立增加移植后新发糖尿病的风险。对既往感染HCV的肾移植受者需严格监测和筛查,有效诊断,及时干预,有助于改善其长期生存状况。

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07:35:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618981, encodeId=3bc7161898192, content=<a href='/topic/show?id=5f1785e9d5' target=_blank style='color:#2F92EE;'>#HCV感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8579, encryptionId=5f1785e9d5, topicName=HCV感染)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9cb419968800, createdName=12498e5fm18(暂无昵称), createdTime=Thu Oct 04 07:35:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347683, encodeId=72dc34e68377, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4mzqK7XHyH86ToibWNdzamnZozW6yiceXFib4QHq1lCOia34v7bgwXUIH1Rdnoqia2y6ibLX156v1xmicZw/0, createdBy=15891613430, createdName=xuexin53, createdTime=Tue Oct 02 20:35:32 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347676, encodeId=391f34e676b8, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue Oct 02 19:56:48 CST 2018, time=2018-10-02, status=1, ipAttribution=)]
    2018-10-04 kafei

    了解一下谢谢

    0

  5. 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    2018-10-04 ymljack
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07:35:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618981, encodeId=3bc7161898192, content=<a href='/topic/show?id=5f1785e9d5' target=_blank style='color:#2F92EE;'>#HCV感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8579, encryptionId=5f1785e9d5, topicName=HCV感染)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9cb419968800, createdName=12498e5fm18(暂无昵称), createdTime=Thu Oct 04 07:35:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347683, encodeId=72dc34e68377, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4mzqK7XHyH86ToibWNdzamnZozW6yiceXFib4QHq1lCOia34v7bgwXUIH1Rdnoqia2y6ibLX156v1xmicZw/0, createdBy=15891613430, createdName=xuexin53, createdTime=Tue Oct 02 20:35:32 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347676, encodeId=391f34e676b8, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue Oct 02 19:56:48 CST 2018, time=2018-10-02, status=1, ipAttribution=)]
    2018-10-04 saikp
  8. 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  9. 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07:35:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618981, encodeId=3bc7161898192, content=<a href='/topic/show?id=5f1785e9d5' target=_blank style='color:#2F92EE;'>#HCV感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8579, encryptionId=5f1785e9d5, topicName=HCV感染)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9cb419968800, createdName=12498e5fm18(暂无昵称), createdTime=Thu Oct 04 07:35:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347683, encodeId=72dc34e68377, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4mzqK7XHyH86ToibWNdzamnZozW6yiceXFib4QHq1lCOia34v7bgwXUIH1Rdnoqia2y6ibLX156v1xmicZw/0, createdBy=15891613430, createdName=xuexin53, createdTime=Tue Oct 02 20:35:32 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347676, encodeId=391f34e676b8, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue Oct 02 19:56:48 CST 2018, time=2018-10-02, status=1, ipAttribution=)]
    2018-10-02 xuexin53

    学习

    0

  10. 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07:35:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618981, encodeId=3bc7161898192, content=<a href='/topic/show?id=5f1785e9d5' target=_blank style='color:#2F92EE;'>#HCV感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8579, encryptionId=5f1785e9d5, topicName=HCV感染)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9cb419968800, createdName=12498e5fm18(暂无昵称), createdTime=Thu Oct 04 07:35:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347683, encodeId=72dc34e68377, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4mzqK7XHyH86ToibWNdzamnZozW6yiceXFib4QHq1lCOia34v7bgwXUIH1Rdnoqia2y6ibLX156v1xmicZw/0, createdBy=15891613430, createdName=xuexin53, createdTime=Tue Oct 02 20:35:32 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347676, encodeId=391f34e676b8, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue Oct 02 19:56:48 CST 2018, time=2018-10-02, status=1, ipAttribution=)]
    2018-10-02 天地飞扬

    了解一下,谢谢分享!

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