What characterizes patients with PTDM?

Patients with post-transplantation diabetes mellitus (PTDM) tend to be older and have higher BMI, triglyceride levels, and hypertension, according to a study. 

One hundred six adult recipients of heart transplantation (HT) followed for >1 year were included in this study. Of these, 56 had PTDM and 50 had non PTDM. 

The authors performed untargeted metabolomics by ultra-high-performance liquid chromatography—tandem mass spectrometry. They then obtained demographics, clinical data, and drug information at the time of sample collection. 

PTDM patients were older (p=0.003), with higher BMI scores (p=0.010), higher triglyceride levels (p=0.007), and a higher hypertension prevalence (p=0.001), compared with non-PTDM patients. 

The authors detected a total of 1,174 metabolites, of which 99 were significantly differentially abundant (variable importance in projection >1; p<0.05; fold change >1.5 or <0.67). 

In KEGG functional enrichment analysis, these differentially expressed metabolites could be further enriched in ABC transporter, carbon metabolism, retrograde endocannabinoid signalling, and phospholipase D signalling pathway. 

Moreover, glutamate, diacylglycerol, and D-sorbitol were significantly altered in PTDM vs non-PTDM through metabolomics. 

“These findings may provide a novel understanding of the pathological mechanism of PTDM and could be used to predict the development and progression of PTDM,” the authors said.  

“PTDM is a common metabolic complication following HT, which not only leads to elevated microvascular morbidity but also seriously affects graft function and recipient survival,” they noted.