Association Between Preoperative Lipid Profiles and New-onset Diabetes After Transplantation in Chinese Kidney Transplant Recipients: a Retrospective Cohort Study

Abstract Background: This study investigated the association between the preoperative lipid profiles and new-onset diabetes after transplantation (NODAT) in Chinese kidney transplant recipients (KTRs).Methods: In this study, of 1140 KTRs registered between January 1993 and March 2018 in Zhongshan Hospital, Fudan University, 449 were enrolled. Clinical data, obtained through a chart review of the patient records in the medical record system, were evaluated, and NODAT was diagnosed based on the American Diabetes Association guidelines. Multivariate Cox regression analysis was conducted to determine whether the preoperative lipid profiles in KTRs were independently associated with NODAT incidence. The preoperative lipid profiles were analyzed as continuous variables and grouped into tertiles. Smooth curve fitting was used to confirm the linear associations.Results: During a median follow-up of 28.03 (interquartile range 12.00–84.23) months, 104 of the 449 (23.16%) participants developed NODAT. In the multivariate model analysis, after adjusting for all potential covariates, increased preoperative total cholesterol (TC) [hazard ratio (HR)=1.25; 95% confidence interval (CI):1.09–1.58, p=0.0495], low-density lipoprotein cholesterol (LDL-C, HR=1.33, 95% CI: 1.02–1.75, p=0.0352), non-high-density lipoprotein cholesterol (non-HDL-C, HR=1.41, 95% CI: 1.09–1.82, p=0.0084), TC/HDL-C(HR=1.28, 95% CI: 1.06–1.54, p=0.0109), and non-HDL-C/HDL-C(HR=1.26 , 95% CI: 1.05–1.52, p=0.0138) were associated with NODAT. The association between the preoperative triglyceride (TG), HDL-C, or TG/HDL-C and NODAT were not significant.Conclusions: Preoperative TC, LDL-C, non-HDL-C, TC/HDL-C, and non-HDL-C/HDL-C were independent risk factors for NODAT.