糖化白蛋白对肾移植受者继发移植后糖尿病的预测价值

Objective: To investigate the predictive value of glycated albumin (GA) in renal transplant recipients (RTRs) with post-transplant diabetes mellitus (PTDM). Methods:We conducted a retrospective study. We recruited patients aged ≥18 years old who had no pre-transplant diabetes and received the first renal transplantation (RT) in The First Affiliated Hospital of Xi'an Jiaotong University from January 2017 to December 2017. Patients with pre-transplant thyroid dysfunction, post-transplant impaired fasting glucose, renal graft failure, transplant nephrectomy, loss of follow-up, or death were excluded. According to the diagnostic criteria of PTDM in 2014, on the basis of the results of fasting plasma glucose (FPG) at least twice after 45 days of RT, the patients were divided into post-transplant diabetes mellitus group (PTDM group) and post-transplant normal fasting glucose group (PTNFG group). Each patient was followed up for one year. After comparison of the clinical data of the two groups, SPSS software was used for analyzing the data. Receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of GA for PTDM. Results: In this study, a total of 282 RTR were screened, and 72 patients were not qualified. We recruited 210 patients, with 21 in PTDM group and 189 in PTNFG group. The levels of body mass and body mass index (BMI) in PTDM group were higher than those in PTNFG group (P<0.05). The incidence of hypomagnesemia was higher in PTDM group than in PTNFG group (P<0.05). The two groups did not differ significantly in GA before transplantation (P>0.05). GA in PTDM group was higher than that in PTNFG group at 7 days and 14 days after RT (P<0.05). ROC curve analysis showed that the predictive value of GA was the highest at 14 days after RT, its area under ROC curve (AUC) was 0.749. GA was 14.55% at 14 days after RT. Youden index was the largest, with the sensitivity of 57.1% and the specificity of 87.3%. The positive likelihood ratio was 4.5, the negative likelihood ratio was 0.49, the positive predictive value was 57.1%, and the negative predictive value was 87.3%. Conclusion: GA can predict RTR with PTDM at 14 days after RT.