New-onset Diabetes Mellitus Following Successful Kidney Transplantation Facilitates Aortic Stiffening

Abstract

BackgroundFollowing kidney transplantation (KT), new-onset diabetes mellitus (NODM) is one of the most common complications. NODM usually occurs early after KT, and is diagnosed according to the general guidelines relevant for general diabetes mellitus patients. Arterial stiffness is a surrogate marker of cardiovascular risk. According to the literature, a successful KT has only limited and late beneficial effects on aortic elastic properties. The present study aimed to assess whether NODM has any additive value on the worsening of echocardiography-derived aortic elastic properties in transplanted patients. MethodsWe have included 28 nondiabetic post-KT patients in the study, older than 18 years (mean age: 48.2 ± 6.9 years; 13 men, 15 women). After an oral glucose tolerance test, 8 patients were diagnosed with NODM, and their results were compared to 23 age-, sex-, and risk factor-matched controls (mean age: 54.9 ± 11.0 years; 9 men, 14 women). All post-KT patients and matched controls underwent a complete transthoracic 2-dimensional Doppler echocardiography, together with an assessment of echocardiographic aortic elastic properties. The assessments included aortic strain, aortic distensibility, and aortic stiffness index. ResultsAortic elastic properties showed alterations in post-KT patients compared to matched controls (aortic strain: .084 ± .039 vs .057 ± .032, P < .05; aortic distensibility: 2.36 ± 1.09 cm2/dynes 10–6 vs 1.83 ± 1.18 cm2/dynes 10–6, P = .07; aortic stiffness index: 7.15 ± 3.58 vs 11.2 ± 6.1, P < .05). Further deterioration in the aortic stiffness index (14.8 ± 7.6 vs 9.68 ± 4.88, P < .05) was detected in the presence of NODM. ConclusionsNODM following successful KT facilitates aortic stiffening.