Role of sex in post-transplant diabetes mellitus development: Are men and women equal?

Abstract

Introduction: Sex differences are defined as biology-linked differences between women and men that occur through the sex chromosomes and their effects on organ systems.

Material and methods: The objective of this prospective study was to determine risk factors for post-transplant diabetes mellitus (PTDM) in men and women.

Results: A total of 417 patients (271 men and 146 women) were included in the monitored group. Age at the time of kidney transplantation (KT) >60 years and hypovitaminosis D at the time of KT (<20 μg/l) were identified as independent risk factors for PTDM in both men and women. It was further confirmed as an independent risk factor for men a waist circumference at the time of KT >94 cm, C-peptide at the time of KT >5 ng/ml, HOMA-IR >2 and triacylglycerols at the time of KT >1.7 mmol/l. In case of women, the dominant factor was BMI at the time of KT >30 kg/m2 and menopause at the time of KT. A significant decrease in C-peptide was recorded in women with PTDM.

Conclusion: It was confirmed that there are gender differences with regard to the development of PTDM after KT. Women show pancreas β cell dysfunction, whereas insulin resistance and metabolic syndrome are dominant in men.

Keywords: C-peptide; Insuline resistance; Kidney transplantation; Post-transplant diabetes mellitus; Sex differences.