Is there a link between hepatitis C virus and new onset of diabetes mellitus after liver transplantation?

✍ Scribed by Paul J. Thuluvath

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 65 KB
• Volume: 13
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.21024

✦ Synopsis

New-onset diabetes mellitus (NODM) is seen in 10-30% of renal and 9-21% of liver transplant recipients. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Older age, black race, obesity, hepatitis C virus (HCV) infection, family history of diabetes mellitus (DM), and use of tacrolimus or corticosteroids are important risk factors that predict the development of NODM in transplant recipients. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] There is wide variation (5-15%) in the incidence rates of NODM after liver transplantation in published studies. [4][5][6][7][8][9][10][11][12][13][14] Potential factors that may explain the differences in the incidence rates of NODM may include reporting bias, sample size, definition of NODM, transient nature of DM, immunosuppressive regimens, and confounding factors such as age, race, family history of DM, and body mass index. It is also probable that many of these patients had occult DM that was masked by severe liver disease before transplantation, and alternatively, preexisting DM may disappear after liver transplantation in some patients. 9 In this issue, Saliba et al. 15 report NODM, defined as fasting blood glucose Ͼ126 mg/dL on 2 separate occasions or the use of oral antidiabetic agents or insulin, in 48 (22.7%) of 211 liver transplant recipients who were randomly selected from 10 centers in France. In addition, 12.4% of patients who had normal pretransplantation glucose developed impaired fasting glucose, defined as 2 fasting measurements of blood glucose between 110 and 126 mg/dL. Overall, 35.1% of patients had evidence of either NODM or impaired fasting glucose. It is important to note that only patients who were not overtly diabetic before liver transplantation were selected for this study, but 26 patients (12.3%) had impaired fasting glucose before transplantation.