Incidence and risk factors of posttransplant diabetes mellitus in lung transplant recipients: a retrospective cohort study

Abstract

Background: Post-transplantation diabetes mellitus (PTDM) is a common complication after lung transplantation. Its incidence and risk factors are not well defined, and clarifying them is important for guiding prevention and improving patient outcomes. This study aimed to investigate the incidence of PTDM in lung transplant recipients, while also identifying its associated risk factors. The objective is to provide new insights that could inform clinical interventions and strategies for risk reduction. Methods: Data were collected from 158 patients who underwent lung transplantation at a tertiary hospital in Guangzhou, China, between February 2023 and August 2024. The risk factors for PTDM were analyzed using both univariate and multivariate logistic regression models. Results: During the follow-up period, 36.08% (57/158) of patients developed PTDM. Multivariate logistic regression analysis identified several factors that appeared to be independently associated with PTDM after lung transplantation, including cardiac insufficiency [odds ratio (OR) =2.491; P=0.04], hyperlipidemia (OR =7.699; P=0.02), age >45 years (OR =3.822; P=0.02), geriatric nutritional risk index (GNRI) ≤92 (OR =2.529; P=0.02), and hemoglobin A1c (HbA1c) >5.7% (OR =2.414; P=0.02). Conclusions: Preoperative cardiac insufficiency, dyslipidemia, elevated HbA1c, advanced age, and a low GNRI may be associated with an increased risk of PTDM following lung transplantation. These findings underscore the potential importance of comprehensive metabolic assessment and multidisciplinary management; however, prospective studies are needed to confirm these associations and guide preventive strategies.