Association between preoperative lipid profiles and new-onset diabetes after transplantation in Chinese kidney transplant recipients: A retrospective cohort study

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. The multivariate model analysis, adjusted for all potential covariates, showed that increased values of the following parameters were associated with NODAT (hazard ratio, 95% confidence interval): preoperative total cholesterol (TC; 1.25, 1.09-1.58, p = 0.0495), low-density lipoprotein cholesterol (LDL-C; 1.33, 1.02-1.75, p = 0.0352), non-high-density lipoprotein cholesterol (non-HDL-C; 1.41, 1.09-1.82, p = 0.0084), TC/HDL-C (1.28, 1.06-1.54, p = 0.0109), and non-HDL-C/HDL-C (1.26, 1.05-1.52, p = 0.0138). However, the association between the preoperative triglyceride, HDL-C, or TG/HDL-C and NODAT was 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.