KHẢO SÁT TÌNH TRẠNG KHÁNG INSULIN Ở NGƯỜI BỆNH ĐÁI THÁO ĐƯỜNG MỚI KHỞI PHÁT SAU GHÉP THẬN

Abstract

Objective: To investigate insulin levels and insulin resistance in patients with new-onset diabetes after kidney transplantation (NODAT). Subjects and Methods: A descriptive cross-sectional study was conducted on 81 patients with NODAT, 81 post-kidney transplant patients without diabetes, and 53 age- and sex-matched healthy controls at the 103 Military Hospital from October 2021 to December 2023. Clinical and laboratory data were collected, and insulin resistance indices were calculated using the HOMA2 model, including insulin resistance (HOMA2-IR), insulin sensitivity (HOMA2-S), and beta-cell function (HOMA2-B). Results: The HOMA2-IR index was highest in the NODAT group (0.95), higher than in the non-NODAT group (0.82), and lowest in the healthy control group (0.7), p < 0.001, respectively. Conversely, insulin sensitivity (HOMA2-S) and beta-cell function (HOMA2-B) were lowest in the NODAT group, followed by the non-NODAT group, and highest in the healthy control group, p < 0.001. Among NODAT patients, those with hypertension had higher insulin resistance and lower insulin sensitivity compared to those without hypertension, p < 0.05. Abdominal obesity and BMI showed a positive correlation with HOMA2-IR and insulin levels and a negative correlation with HOMA2-S, p < 0.05. The trough level of Tacrolimus was negatively correlated with HOMA2-IR and insulin levels while positively correlated with HOMA2-S (p < 0.05). Conclusion: Insulin resistance is common and is associated with increased waist circumference, BMI, and trough levels of Tacrolimus in patients with NODAT.