Interleukin-2 receptor antagonists: Protective factors against new-onset diabetes after renal transplantation

J Diabetes. 2018 Nov;10(11):857-865. doi: 10.1111/1753-0407.12663. Epub 2018 Apr 19.

Abstract

Background: The aim of the present study was to examine the association between interleukin-2 receptor antagonists (IL-2Ra) and new-onset diabetes after transplantation (NODAT) among renal transplant recipients (RTRs).

Methods: Between January 1993 and March 2014, 915 patients underwent renal transplantation at Zhongshan Hospital. In all, 557 RTRs were included in the present retrospective cohort study. The incidence of NODAT in this cohort was determined and multivariate Cox regression analysis was used to evaluate the risk factors for NODAT and to show the association between IL-2Ra use and NODAT development among RTRs. The cumulative incidence of NODAT was compared between groups treated with or without IL-2Ra.

Results: The mean ±SD postoperative follow-up was 5.08 ±3.17 years. The incidence of NODAT at the end of follow-up was 20.3%. After adjusting for potential confounders in the multivariate logistic regression (i.e. age, sex, body mass index, history of smoking, family history of diabetes, duration of dialysis, type of dialysis, donor type, recovery of graft function, acute rejection, hepatitis B or C or cytomegalovirus infection, fasting plasma glucose levels before and 1 week after transplantation, preoperative total cholesterol and triglyceride levels, daily dose of glucocorticoid, immunosuppressive regimen type, and immunosuppressant concentration after transplantation), IL-2Ra use was found to be related to a reduced incidence of NODAT.

Conclusions: Use of IL-2Ra is associated with protection against the development of NODAT in RTRs.

Keywords: interleukin-2; kidney transplantation; new-onset diabetes after transplantation; receptor antagonists; 受体拮抗剂; 白细胞介素2; 移植后新发糖尿病; 肾移植.

MeSH terms

  • Adult
  • China / epidemiology
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / metabolism
  • Diabetes Mellitus / prevention & control*
  • Female
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Protective Factors
  • Receptors, Interleukin-2 / antagonists & inhibitors*
  • Receptors, Interleukin-2 / metabolism
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome

Substances

  • Hypoglycemic Agents
  • Immunosuppressive Agents
  • Receptors, Interleukin-2