Presentation Authors: Rikiya Taoka*, Yohei Abe, Hirohito Naito, Yasuyuki Miyauchi, Yuki Matsuoka, Motofumi Tajima, Takuma Kato, Hiroyuki Tsunemori, Nobufumi Ueda, Mikio Sugimoto, Yoshiyuki Kakehi, Kagawa, Japan
Introduction: New-onset diabetes after kidney transplantation (NODAT) has an adverse impact on patient survival. Recently, an excessive accumulation of adipose tissue is widely identified as a risk factor for the development of NODAT. Clinically, body mass index (BMI) and abdominal circumference (AC) have been frequently used to assess the adipose tissue accumulation, while BMI and AC cannot directly measure it. In this study, we measured body fat area (BFA) by computed tomography to estimate the accumulation of adipose tissue accurately. The aim of this study is to indicate whether the preoperative BFA can predict the development of NODAT more accurately in comparison with BMI and AC.
Methods: We conducted a retrospective study of 62 patients without diabetes mellitus who received living donor kidney transplantation in our institute between July 2005 and April 2016. NODAT was diagnosed according to the American Diabetes Association definitions. In addition, using a single 5-mm slice at the level of the umbilicus of preoperative abdominal computed tomography, BFA was calculated with a Ziostation workstation (Ziosoft Inc., Tokyo, Japan). We investigated the association between the value of preoperative BFA, BMI, or AC and the development of NODAT in kidney transplant recipients.
Results: Eight patients (12.9%) developed NODAT during a mean follow-up period of 78.1 months. The value of preoperative BMI, AC, and BFA in NODAT patients were much higher than those in patients without NODAT (p=0.05, p=0.02, and p < 0.01, respectively). In addition, the correlation analyses revealed that BFA had strong relationships with BMI (r=0.68, p < 0.01) and AC (r=0.77, p < 0.01). However, ROC curve analyses demonstrated that BFA had a considerable predictive accuracy for the development of NODAT with area under the curve of 0.803 (sensitivity 75%, specificity 87%) rather than BMI and AC.
Conclusions: This is the first study showing the association between preoperative BFA and the development of NODAT. Preoperative BFA could be a predictive marker of NODAT in kidney transplant recipients. These findings underline the importance of routine preoperative BFA measurements in medical practice.