Pancreatic steatosis is an independent risk factor for post-transplant diabetes mellitus in kidney transplant patients

Clin Transplant. 2024 Jan;38(1):e15204. doi: 10.1111/ctr.15204. Epub 2023 Dec 1.

Abstract

Background and aim: Post-transplant diabetes mellitus (PTDM) is associated with an increased risk of post-transplant cardiovascular diseases, and several risk factors of PTDM have been shown in the literature. Yet, the relationship between hepatic and pancreatic steatosis with post-transplant diabetes mellitus remains vague. We aimed to evaluate pancreatic steatosis, a novel component of metabolic syndrome, and hepatic steatosis association with post-transplant diabetes mellitus in a single-center retrospective cohort study conducted on kidney transplant recipients.

Method: We have performed a single-center retrospective cohort study involving all kidney transplant recipients. We have utilized pretransplant Fibrosis-4, nonalcoholic fatty liver disease fibrosis score, and abdominal computed tomography for the assessment of visceral steatosis status.

Results: We have included 373 kidney transplant recipients with a mean follow-up period of 32 months in our final analysis. Post-transplant diabetes mellitus risk is associated with older age (p < .001), higher body-mass index (p < .001), nonalcoholic fatty liver disease-fibrosis score (p = .002), hepatic (p < .001) or pancreatic (p < .001) steatosis on imaging and higher pre-transplant serum triglyceride (p = .003) and glucose levels (p = .001) after multivariate analysis.

Conclusion: Our study illustrates that recipients' pancreatic steatosis is an independent predictive factor for post-transplant diabetes mellitus including in kidney transplant patients.

Keywords: kidney transplantation; non-alcoholic fatty liver; pancreatic steatosis; post-transplant diabetes mellitus.

MeSH terms

  • Diabetes Mellitus* / etiology
  • Fibrosis
  • Humans
  • Kidney Transplantation* / adverse effects
  • Non-alcoholic Fatty Liver Disease* / etiology
  • Retrospective Studies
  • Risk Factors