Statin therapy is associated with the development of new-onset diabetes after transplantation in liver recipients with high fasting plasma glucose levels

Authors

  • Yongin Cho,

    1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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    • These authors contributed equally to this work.

  • Min Jung Lee,

    1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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    • These authors contributed equally to this work.

  • Eun Yeong Choe,

    1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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  • Chang Hee Jung,

    1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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  • Dong Jin Joo,

    1. Department of Transplantation, Yonsei University College of Medicine, Seoul, Korea
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  • Myoung Soo Kim,

    1. Department of Transplantation, Yonsei University College of Medicine, Seoul, Korea
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  • Bong Soo Cha,

    1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
    2. Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
    3. Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
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  • Joong-Yeol Park,

    Corresponding author
    1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
    • Address reprint requests to Joong-Yeol Park, M.D., Ph.D., Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro, 43-Gil, Songpa-Gu, Seoul 138-736, Korea. Telephone: +82-2-3010-3240; FAX: +82-2-3010-6962; E-mail: jypark@amc.seoul.kr Address reprint requests to Eun Seok Kang, M.D., Ph.D., Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-Ku, Seoul 120-752, Korea. Telephone: +82-2-2228-1968; FAX: +82-2-393-6884; E-mail: edgo@yuhs.ac

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  • Eun Seok Kang

    Corresponding author
    1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
    2. Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
    3. Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
    • Address reprint requests to Joong-Yeol Park, M.D., Ph.D., Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro, 43-Gil, Songpa-Gu, Seoul 138-736, Korea. Telephone: +82-2-3010-3240; FAX: +82-2-3010-6962; E-mail: jypark@amc.seoul.kr Address reprint requests to Eun Seok Kang, M.D., Ph.D., Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-Ku, Seoul 120-752, Korea. Telephone: +82-2-2228-1968; FAX: +82-2-393-6884; E-mail: edgo@yuhs.ac

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  • Yongin Cho and Min Jung Lee participated in the design and performance of the study, the data collection and analysis, the data interpretation, and the writing of the manuscript. Eun Yeong Choe participated in the design and performance of the study, the data analysis, and the data interpretation. Dong Jin Joo participated in the data collection. Myoung Soo Kim, Bong Soo Cha, and Joong-Yeol Park contributed to the discussion. Chang Hee Jung participated in the design and performance of the study and the data collection and analysis. Eun Seok Kang participated in the design and performance of the study, the data collection and analysis, the data interpretation, and the writing of the manuscript.

  • All the authors declare that there is no duality of interest associated with this article.

  • This work was financially supported by the Kiturami Faculty Research Assistance Program of the Yonsei University College of Medicine (6-2012-0148) and by a National Research Foundation grant funded by the Korean Ministry of Education, Science, and Technology through the Basic Research Promotion Fund (NRF-2010-013-E0008 and NRF-2012-000891).

Abstract

New-onset diabetes after transplantation (NODAT) and dyslipidemia are important metabolic complications after liver transplantation (LT) that can adversely affect both allograft and patient survival. Statins are used as first-line therapies for dyslipidemia because of their effectiveness and safety profile. However, it has recently been reported that statin therapy is associated with new-onset diabetes in the nontransplant population. The aim of this study was to investigate the association between statin therapy and the development of NODAT in LT recipients. Three hundred sixty-four LT recipients who underwent transplantation between the ages of 20 and 75 years without a previous history of diabetes were enrolled in this study. We evaluated the incidence of NODAT with respect to statin use as well as other risk factors. The incidence of NODAT was significantly higher in the statin group (31.7%) versus the control group (17.6%, P = 0.03). The mean follow-up period was 37.8 ± 19.0 months for the statin group and 42.7 ± 16.0 months for the control group (P = 0.07). Statin use was significantly associated with NODAT development after adjustments for other risk factors [hazard ratio (HR) = 2.32, 95% confidence interval (CI) = 1.23-4.39, P = 0.01]. Impaired fasting glucose before transplantation was also a risk factor for NODAT development (HR = 2.21, 95% CI = 1.36-3.62, P = 0.001). There were no significant differences in age, body mass index, cumulative corticosteroid dose, or fasting plasma glucose (FPG) levels between the groups. Patients with high FPG levels were more likely to develop NODAT when they were placed on statins after LT (P = 0.002). In conclusion, statin treatment could contribute to the development of NODAT in LT recipients, especially if they have high baseline FPG levels. Liver Transpl 20:557–563, 2014. © 2014 AASLD.

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