Renal transplant recipients who have low skeletal muscle attenuation (SMAT) are at higher risk for new-onset diabetes after transplantation (NODAT), investigators reported at the virtual 2021 American Transplant Congress.

Ahram Han, MD, and colleagues at Seoul National University College of Medicine in Seoul, Republic of Korea performed morphometric assessments of preoperative abdominal computed tomography (CT) scans of non-diabetic adult patients who underwent renal transplantation from January 2009 to December 2014 at their institution’s transplant center.

The study population included 314 adult renal allograft recipients. The investigators excluded patients with polycystic kidney disease. During a mean follow-up period of 8.9 years, NODAT developed in 59 patients (18.8%).

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On multivariate analysis that included adjustment for known NODAT risk factors such as hepatitis C virus infection and tacrolimus use, patients in the lowest quartile of SMAT had a significant 2-fold increased risk for NODAT compared with those in the second, third, and fourth quartiles, Dr Han and colleagues reported. They found no association between skeletal muscle index and future development of NODAT.

The investigators explained that decreased muscle radiation attenuation on CT scans indicates fat infiltration within muscle. “Such ectopic fat accumulation has recently been recognized as a risk factor for metabolic alterations and cardiovascular disease.”


Han A, Kim H, Chung C, et al. Renal transplant recipients with low skeletal muscle attenuation have a greater risk of developing new-onset diabetes after transplantation. Presented at: ATC 2021 held June 4-9. Abstract 898.