Frequency and Risk Factors for Posttransplant Diabetes Mellitus in Iranian Renal Transplant Patients S. Ossareh, S. Naseem, M.A. Faraji, M. Bahrami Asl, and A. Yousefnejad ABSTRACT Posttransplant diabetes mellitus (PTDM) is a frequent complication of renal transplantation. This study was performed to determine the prevalence of and risk factors for PTDM among Iranian renal transplant recipients. In this cross-sectional study, 300 patients were studied in 2007. It included questionnaires with clinical data and blood samples. PTDM was defined as DM without a pretransplant history. The 184 (61.3%) male and 116 (38.7%) female patients of overall mean age of 41.2  13.5 years were 67.4  48.6 months after the procedure. PTDM was observed in 24 patients (8%). The mean interval to develop PTDM was 19.9  31.5 months. The mean age of PTDM patients was significantly higher than non-PTDM patients: 49.4  13.4 vs 40.6  13.4 years (P  .005). The mean serum high-density lipoprotein (HDL) was higher among PTDM compared with non-PTDM patients: 71.4  21 vs 58.6  14.6 (P  .005). There was a trend toward higher serum low-density lipoprotein (LDL) among PTDM patients: 109.2  29.5 vs 96.2  25.2 (P = .06). A recent admission was more frequent among PTDM patients (58.3% vs 28.7%; P  .005), as was history of hepatitis C virus (HCV) infection (6% vs 1%; P  .01). There was no significant difference in doses of immunosuppressive drugs and doses atenolol, mean body mass index, DM family history, rejection, cytomegalovirus (CMV) infection, or frequency of positive anti-HCV antibody between the 2 groups. Our study showed an 8% prevalence of PTDM. Mean age, history of recent admissions and HCV infection, as well as mean plasma HDL and LDL levels were higher among PTDM patients. P OSTTRANSPLANT DIABETES MELLITUS (PTDM) is a frequent complication of renal transplantation, vary- ing from 2% to 50% of cases in different series. 1 It is likely that patients with PTDM are at increased risk to develop diabetic microvascular complications, including nephropathy, as ob- served among patients with preexistent diabetes mellitus. 2 PTDM is associated with impaired long-term renal allograft survival and function. 3,4 In the early renal transplantation era, corticosteroids were recognized as the main risk factor to develop PTDM. 4 With the introduction of cyclosporine and reduction of the steroid doses after transplantation, other factors such as sex, age, obesity, cyclosporine and tacrolimus, race, hepatitis C virus (HCV) and cytomegalovirus (CMV) infections have been introduced as risk factors to develop PTDM. 3,5–7 This study was performed to determine the prevalence of and risk factors for PTDM among a group of Iranian renal transplant recipients. PATIENTS AND METHODS In this cross-sectional survey we studied 300 renal patients who regularly visited a referral laboratory for their regular bimonthly examinations between March and August 2007. These patients had undergone transplantation in various transplant centers, mainly Tehran. Questionnaires were completed by 4 trained medical students, including demographic data, family history of DM, type and dose of immunosuppressive and other drugs affecting blood sugar, and history of HCV or CMV infection, prior DM diagnosis, systemic infection, recent admission, or graft rejection. Patients were examined for height and weight to calculate body mass index (BMI) as BMI = weight (kg)/height 2 (m 2 ). Blood samples were obtained for routine laboratory tests as well as fasting blood sugar, lipid profile, and hepatitis C antibody. PTDM was defined as a fasting blood sugar  126 mg/dL or a previous diagnosis of DM with the patient on treatment despite no pretransplantation history of DM. Qualitative data were presented as mean values  SDs. From the Department of Internal Medicine, Nephrology Ward, Hasheminejad Kidney Center, Iran University of Medical Sci- ences, Tehran, Iran. Address reprint requests to Shahrzad Ossareh, Department of Internal Medicine, Nephrology Ward, Hasheminejad Kidney Cen- ter, Iran University of Medical Sciences, Vanak Square, Tehran 19697, Iran. E-mail: ossareh_s@yahoo.com 0041-1345/09/$–see front matter © 2009 by Elsevier Inc. All rights reserved. doi:10.1016/j.transproceed.2009.07.054 360 Park Avenue South, New York, NY 10010-1710 2814 Transplantation Proceedings, 41, 2814 –2816 (2009)