The Incidence of Posttransplantation Diabetes Mellitus During Follow-up in Kidney Transplant Recipients and Relationship to Fok1 Vitamin D Receptor Polymorphism

Abstract Background Posttransplantation diabetes mellitus (PTDM) is a common, serious complication of kidney transplantation. The purpose of this study was to investigate the incidence of and risk factors for PTDM in relationship to Fok1 vitamin D receptor (VDR) polymorphisms. Methods One hundred five kidney transplant recipients with normal glucose values before transplantation were recruited for this study. All patients underwent fasting plasma glucose (FPG) determinations followed by oral glucose tolerance tests (OGTTs) among normal FPG recipients. Every recipient underwent Fok1 VDR polymorphism analysis using polymerase chain reaction (PCR)–restriction fragment length polymorphism (RFLP). Results Among 105 recipients, 16 (15.24%) developed new-onset PTDM within 6 months after kidney transplantation. Compared with 89 non-PTDM recipients, the mean age was significantly higher among recipients with PTDM: 47.81 ± 15.54 vs 36.62 ± 11.43 years ( P = .001). Patients treated with tacrolimus were more susceptible to PTDM (56.25% vs 28.09%; P = .027). The distribution frequencies of Fok1 genotypes in this cohort followed the Hardy-Weinberg equilibrium. The frequencies of 3 genotypes (FF/Ff/ff; P = .040) and 2 alleles (F/f; P = .009) differed between the 2 groups. Multivariate analysis by logistic regression showed age older than 40 years (odds ratio, 7.774; P = .005), VDR Fok1 f allele (odds ratio, 11.765; P = .012), and tacrolimus therapy (odds ratio, 7.499; P = .007) to be related to the development of PTDM. Conclusions The incidence of newly diagnosed PTDM in this study was 15.24%. Fok1 VDR polymorphism was a genetic marker predicting PTDM risk. Age older than 40 years and tacrolimus were independent risk factors for PTDM.