HLA-B27 is a Potential Risk Factor for Posttransplantation Diabetes Mellitus in Autosomal Dominant Polycystic Kidney Disease Patients

Pietrzak-Nowacka, Maria; Safranow, Krzysztof; Nowosiad, M.; Dębska‐Ślizień, Alicja; Dziewanowski, Krzysztof; Głyda, Maciej; Jankowska, Magdalena; Rutkowski, Bolesław; Ciechanowski, Kazimierz

doi:10.1016/j.transproceed.2010.08.046

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…[3][4][5] Estudos sobre associação entre antígenos HLA e susceptibilidade a DMPT, apesar de já terem sido realizados em várias populações, não revelaram, até o momento, resultados consistentes. [6][7][8][9][10][11] A recomendação inicial na abordagem da intolerância à glicose e DMPT é baseada na identificação precoce de pacientes com risco de desenvolver hiperglicemia pós-transplante, bem como na atuação sobre os fatores de risco modificáveis com mudanças de estilo de vida, seguida de rápida intervenção terapêutica medicamentosa. [12][13][14] O presente estudo teve como objetivo verificar a prevalência de DMPT e sua relação com fatores genéticos representados por antígenos HLA numa coorte de pacientes transplantados renais, avaliados ao longo dos três primeiros anos, em um centro único.…”

Section: Resultsunclassified

“…É importante ressaltar que nenhuma das associações encontradas em nosso trabalho foram relatadas previamente em nenhuma das várias populações estudadas por outros autores e que também não há uniformidade de achados entre os trabalhos publicados. [6][7][8][9][10][11] Estes fatos vão contra a hipótese de haver associação entre genes HLA e susceptibilidade ou resistência ao desenvolvimento de DMPT. Por outro lado, considerando os achados do presente trabalho, assim como os trabalhos da literatura que analisaram antígenos HLA-DR, é possível afirmar que os genes HLA-DR que estão associados à susceptibilidade ao diabetes mellitus (HLA-DR3 e HLA-DR4) não se associam com DMPT.…”

Section: Métodosunclassified

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ANTíGENOS HLA ESTÃO ASSOCIADOS a RISCO DE DIABETES MELLITUS Pós-Transplante?

Lucena

Marco

Sá

et al. 2021

bjt

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Introdução: Diabetes mellitus pós-transplante (DMPT) tem impacto na morbidade e na mortalidade em receptores de transplante renal, uma vez que aumenta o risco de complicações cardiovasculares e de perda do enxerto renal. Os fatores de risco para DMPT podem ser divididos em modificáveis e não modificáveis. Ainda há controversas sobre a influência do sistema de antígenos leucocitários humanos (Human Leukocyte Antigens ou HLA) no risco de DMPT. Objetivo: Verificar prevalência para DMPT e sua relação com fatores genéticos. Métodos: Foram avaliados 450 pacientes submetidos ao transplante renal e realizada a investigação quanto à associação entre antígenos HLA-A, -B e -DR e DMPT. As frequências dos antígenos HLA-A, -B e -DR foram comparadas entre receptores com e sem diagnóstico de DMPT, ao longo de três anos após o transplante. Resultados: Na população de estudo, 60% eram do sexo masculino, 47,2% eram negros e 57,8% receberam rim de doador falecido. DMPT foi diagnosticado em 61 pacientes (13,5%), 315 (70%) permaneceram com níveis glicêmicos normais e 74 (16,5%) desenvolveram glicemia de jejum alterada. Associações positivas de DMPT foram observadas em relação aos antígenos HLA-A23 (18% vs 8,7%, P=0,024) e HLA-A29 (13,1% vs 5,1%, P=0,017) e associação negativa com o antígeno HLA-A68 (4,9% vs 14,1%, P=0,046). Conclusão: Encontramos relação estatística entre DMPT e HLA- A23, HLA-A29 e HLA-A68, porém, estudos com maior número de indivíduos são necessários para comprovar definitivamente a associação entre antígenos HLA e o risco de DMPT.

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Section: Resultsunclassified

Section: Métodosunclassified

ANTíGENOS HLA ESTÃO ASSOCIADOS a RISCO DE DIABETES MELLITUS Pós-Transplante?

Lucena

Marco

Sá

et al. 2021

bjt

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“…In recent clinical studies and reviews, it was suggested that the incidence of glucose metabolic disorders after kidney transplantation in patients with ADPKD is higher than in those with other kidney diseases. 22 Some authors even proposed potential mechanisms 23 24 to explain this finding.…”

Section: Discussionmentioning

confidence: 98%

New onset diabetes after kidney transplantation in patients with autosomal dominant polycystic kidney disease: systematic review protocol

et al. 2015

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IntroductionAutosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disorder with numerous cysts developing in bilateral kidneys. Meanwhile, ADPKD can also be regarded as a systemic disease because the cystic and non-cystic abnormalities could be identified in multiple organs in patients with ADPKD. Several lines of evidence suggest the risk of post-transplant diabetes mellitus or new-onset diabetes after transplantation (NODAT) is higher in patients with ADPKD compared with non-ADPKD renal recipients, but the available results are conflicting. We describe the protocol of a systematic review and meta-analysis for investigating the risk of NODAT in patients with ADPKD.Methods and analysisPubMed, EMBASE and The Cochrane Library will be searched. Cohort studies irrespective of language and publication status, comparing the incidence of NODAT in renal recipients with ADPKD and other kidney disease will be eligible. We will assess heterogeneity among studies. Along with 95% CIs, dichotomous data will be summarised as risk ratios; numbers needed to treat/harm and continuous data will be given as standard mean differences. Excluding outliers and testing small sample size studies if our results are robust, sensitivity analysis will be carried out.Ethics and disseminationEthical approval is not required because this study includes no confidential personal data or patient interventions. The review findings will be helpful in designing and implementing future studies and will be of interest to a wide range of readers, including healthcare professionals, researchers, health service managers and policymakers. The systematic review will be published in a peer-reviewed journal and disseminated electronically and in print.Trial registration numberThe study protocol has been registered in PROSPERO (http://www.crd.york.ac.uk/PROSPERO/) under registration number CRD42014009677.

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“…2 In addition, the distributions of ethnicity are variable and reflect the diverse prevalence of HLA alleles. For example, previous studies were conducted in diverse cohorts including Norwegian, 11 south Asian, 10 Puerto Rican, 12 United States (majority African-American), 13 United States (majority White), 14 Brazilian, 15 Polish, 16 Saudi Arabian, 17 Singaporean, 18 and Swiss 19 kidney transplant recipients. Because of such heterogeneous data, the original international consensus guidelines from 2003 22 dismissed the reliability of HLA alleles as specific risk factors for PTDM.…”

Section: Discussionmentioning

confidence: 99%

HLA Alleles Cw12 and DQ4 in Kidney Transplant Recipients Are Independent Risk Factors for the Development of Posttransplantation Diabetes

Phagura

Hussain

Culliford

et al. 2021

Transplantation Direct

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Background. The association between specific HLA alleles and risk for posttransplantation diabetes (PTDM) in a contemporary and multiethnic kidney transplant recipient cohort is not clear. Methods. In this single-center analysis, data were retrospectively analyzed for 1560 nondiabetic kidney transplant recipients at a single center between 2007 and 2018, with median follow-up of 33 mo (interquartile range 8-73). HLA typing methodology was by DNA analysis and reported at the resolution required for the national allocation scheme. Diagnosis of PTDM was aligned with International Consensus recommendations. Results. PTDM developed in 231 kidney transplant recipients. Exploring 99 HLA alleles, the presence of Cw12, B52, B38, B58, DQ4, A80, and DR13 and the absence of DQ3 and DR04 were associated with significant increases in PTDM risk. In a multivariable Cox regression model, adjusting for other clinical risk factors for PTDM, the presence of Cw12 (hazard ratio [HR], 1.57; 95% CI, 1.08-2.27; P = 0.017) and DQ4 (HR, 1.78; 95% CI, 1.07-2.96; P = 0.026) were found to be independent risk factors for PTDM. There was also evidence that the presence of B58 increases PTDM risk within the subgroup of recipients of White ethnicity (HR, 5.01; 95% CI,; P < 0.001). Conclusion. Our data suggest that specific HLA alleles can be associated with PTDM risk, which can be used pretransplantation for PTDM risk stratification. However, association is not causality, and this work requires replication and further investigation to understand underlying biological mechanisms.

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HLA-B27 is a Potential Risk Factor for Posttransplantation Diabetes Mellitus in Autosomal Dominant Polycystic Kidney Disease Patients

Cited by 5 publications

References 13 publications

ANTíGENOS HLA ESTÃO ASSOCIADOS a RISCO DE DIABETES MELLITUS Pós-Transplante?

ANTíGENOS HLA ESTÃO ASSOCIADOS a RISCO DE DIABETES MELLITUS Pós-Transplante?

New onset diabetes after kidney transplantation in patients with autosomal dominant polycystic kidney disease: systematic review protocol

HLA Alleles Cw12 and DQ4 in Kidney Transplant Recipients Are Independent Risk Factors for the Development of Posttransplantation Diabetes

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