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[摘要]：Background. Body fat accumulation decreases insulin sensitivity. It has being associated with earlier onset of type I diabetes mellitus (DM) and islet graft failure. The aim of this Study was to evaluate whether insulin resistance, characterized by risk factors for type 2 DM, can predict islet graft Survival in type I DM islet transplant (ITx) recipients.Methods. Demographic, anthropometrical, and laboratory data, as well as family history of type 2 DM (first degree relatives), were collected from 44 ITx recipients. Risk factors for type 2 DM, Such as positive family history of type 2 DM (n = 11) and overweight (body mass index >25 kg/m(2); n = 14), were analyzed separately and in combination, which was designated as "type 2 DM phenotype" (n = 5). Differences in Outcomes (time-to-graft dysfunction and failure) were compared using Kaplan-Meier curves. Cox regression analysis was performed to control for possible confounding factors.Results. Neither positive family history of type 2 DM nor overweight at baseline Could predict islet function outcomes after ITx. However, when both risk factors were grouped, the "type 2 DM phenotype" was associated with earlier islet graft failure (mean estimate graft survival 25.7 +/- 9.1 vs. 54.1 +/- 5.2 months, P = 0.022). These results were Sustained after adjustments for confounding variables (OR 5.20, 95% CI 1.12-24.0).Conclusions. Predisposition for type 2 DM can coexist with the type I DM phenotype and is associated with earlier decline in islet graft function. Prospective clinical trials should address whether it is associated with decreased insulin sensitivity and if insulin sensitizers play a role in prolonging islet graft survival. |
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