Session Name: Kidney: Cardiovascular and Metabolic Complications
Session Date & Time: None. Available on demand.
*Purpose: Decreased muscle radiation attenuation on computed tomography (CT) is indicative of fat infiltration within the muscle. Such ectopic fat accumulation has recently been recognized as a risk factor for metabolic alterations and cardiovascular disease. Here we examined the possible association between skeletal muscle attenuation and future development of new-onset diabetes after transplantation (NODAT) in renal allograft recipients.
*Methods: We performed a morphometric assessment of preoperative abdominal CT scans of non-diabetic adult patients who underwent renal transplants between January 2009 and December 2014 in our transplant center. Mean skeletal muscle attenuation (SMAT), skeletal muscle index (SMI; height normalized skeletal muscle area) were assessed for non-contrast CT scans at the level of L3 vertebra. Patients with polycystic kidney disease were excluded. We examined the association between CT morphometric indices and NODAT development.
*Results: Our study population included 314 adult renal allograft recipients who did not have diabetes mellitus at the time of transplant. A total of 59 (18.8%) patients developed NODAT during the mean follow-up period of 8.9 years. According to univariate cox analysis, SMAT but not SMI showed significant association with future NODAT development (HR of the lowest quartile of SMAT 2.44, 95% CI 1.45-4.09, p=<0.001; HR for SMI 1.02, 95%CI 0.99-105, p=1.55; Figure 1). Other patient and transplant factors that showed significant association with NODAT development in univariate analysis were age (HR 1.03), BMI (HR 1.16), previous diagnosis of hypertension (HR 2.67). In the multivariate model including the factors mentioned above and other known risk factors of NODAT such as HCV and tacrolimus use, SMAT remained a significant factor (HR of the lowest quartile of SMAT 1.96, 95% CI 1.04-3.69, p=0.039) along with age (HR 1.03, 95% CI 1.00-1.06, p=0.023).
*Conclusions: Our study shows that decreased muscle attenuation in preoperative CT scans is associated with the development of NODAT in renal allograft recipients independent of known risk factors.
To cite this abstract in AMA style:Han A, Kim H, Chung C, Ko H, Choi K, Min S, Min S, Ha J. Renal Transplant Recipients with Low Skeletal Muscle Attenuation Have a Greater Risk of Developing New-onset Diabetes After Transplantation [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/renal-transplant-recipients-with-low-skeletal-muscle-attenuation-have-a-greater-risk-of-developing-new-onset-diabetes-after-transplantation/. Accessed September 23, 2021.
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