肾移植术后糖尿病的危险因素与易感基因多态性分析-analysis of risk factors and susceptibility gene polymorphism of diabetes after renal transplantation.docxVIP

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肾移植术后糖尿病的危险因素与易感基因多态性分析-analysis of risk factors and susceptibility gene polymorphism of diabetes after renal transplantation.docx

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肾移植术后糖尿病的危险因素与易感基因多态性分析-analysis of risk factors and susceptibility gene polymorphism of diabetes after renal transplantation

华中科技大学博士学位论文华中科技大学博士学位论文 PAGE PAGE 5 Studies on the risk factors and susceptibility gene of posttransplantation diabetes mellitus Abstract Post transplantation diabetes mellitus (PTDM) is a well-recognized complication of solid-organ transplantation. The incidence of PTDM ranges from 2% to 53%. PTDM contributes to the risk for cardiovascular disease and infection, reducing graft and patient survival. Some factors, such as older age, obesity, and ethnicity, family history of diabetes, cadaver donor, and immunosuppressive regimen are risk markers for the development of PTDM. Recent studies have shown that Calpain10 gene, transcription factor 7-like 2 (TCF7L2) gene and zinc transporter solute carrier family 30 member 8 gene (SLC30A8) polymorphisms are associated with PTDM. However, whether the genetic polymorphisms are associated with PTDM in Chinese renal allograft recipients still remains unknown and needs further extensive investigation. The goals of this study was to investigate the incidence of PTDM, identify the risk factors and the susceptibility genes for its development in Chinese renal allograft recipients, and discover treatment strategies that lead to improved patient outcomes. In the present study, a total of 567 unrelated renal allograft recipients were recruited in this retrospective study to evaluate the incidence, risk factors of PTDM and the effect of different immunosuppressive agents such as cyclosporine (CsA) and tacrolimus (FK506) on the development of PTDM. In addition, 137 patients with PTDM were enrolled to observer the clinical effect and safety of oral glucose-lowering mediations and insulin therapy. Seven single nucleotide polymorphisms ( adiponectin gene SNP-45、SNP-276，CAPN10 gene SNP-19、 SNP-3、SNP-63，TCF7L2 rs290487 and SLC30A8 r were genotyped in the cohort, which consisted of 97 renal allograft recipients with PTDM (PTDM group) and 301 renal allograft recipients without PTDM (control group). The genotypes of poly