Risk of New-Onset Diabetes after Kidney Transplantation and Proportion of Veillonella

Patients undergoing kidney transplantation are at risk for new-onset diabetes after transplantation (NODAT). NODAT is a common complication after kidney transplantation; however, according to researchers in the Republic of Korea, the mechanism of NODAT is not fully understood. Results of recent studies suggest that in the general population gut bacteria play a key role in diabetes.

The researchers, led by K. Ji Eun, conducted a study designed to examine the gut microbiota on NODAT in kidney transplant recipients. Results of the study were reported during a poster session at the virtual American Transplant Congress 2020 in a poster titled Proportion of Veillonella and the Risk of New-Onset Diabetes Mellitus after Kidney Transplantation.

Stool samples were collected from 46 transplant recipients at three time points: prior to transplantation, 3 months following transplantation, and 12 months following transplantation. Stool DNA extraction and 16s DNA metagenome sequencing were performed. The development of post-transplantation diabetes mellitus was defined as hemoglobin A1c level ≥6.5% or initiation of the use of diabetes medications.

Of the 46 transplant recipients, 11 were diagnosed with pre-transplant diabetes mellitus. During follow-up of 2.1 years, 15 of the remaining 35 patients were diagnosed with NODAT.

Results of the 16s DNA analysis showed significant differences among patients without diabetes, those with NODAT, and those with pre-transplant diabetes in change of abundance in genus Veillonella according to the time after transplant. In patients without diabetes, there was a significant increase in the proportion of Veillonella at 3 months post-transplant; there was no increase in patients with NODAT or pre-transplant diabetes.

In unadjusted analysis, patients with reduced abundance of Veillonella at 3 months post-transplant compared with 3 months pre-transplant had a 6.0-fold increased risk of developing NODAT compared with those without reduced abundance of Veillonella (hazard ratio [HR], 6.00; 95% confidence interval [CI], 1.87-19.2; P=.003). Following adjustment for age, sex, body mass index, dialysis duration, and desensitization, the adjusted HR was 5.85 (95% CI, 1.62-21.28), P=.007.

“The reduction of Veillonella at 3 months after transplantation is significantly associated with NODAT,” the researchers said.

Source: Eun KJi, Kim H, Cho H, et al. Proportion of Veillonella and the Risk of New-Onset Diabetes Mellitus after Kidney Transplantation. Abstract of a poster presented at the virtual American Transplant Congress 2020 (Abstract B-047), May30, 2020.