Rheological Properties of Red Blood Cells in Kidney Transplant Recipients: The Role of Lipid Profile and Type of Immunosuppresion

The atherogenic index of plasma is associated with an increased risk of diabetes in non-obese adults: a cohort study

Objective

This study aims to investigate the relationship between the atherogenic index of plasma (AIP) and diabetes risk in Chinese non-obese adults. This is important because the incidence of diabetes is significant in non-obese populations, and evidence regarding this association is limited.

Methods

We conducted a retrospective cohort study with 82,977 Chinese non-obese adults. We used Cox proportional hazards regression to assess the relationship between baseline AIP levels and diabetes incidence. We also employed cubic spline functions and smooth curve fitting to investigate potential nonlinear relationships. Sensitivity and subgroup analyses were conducted to validate our findings.

Results

The median follow-up duration for these participants was 3.10 years, during which 1,041 subjects (1.25%) were diagnosed with diabetes. Adjusted analyses demonstrated a strong positive association between AIP and the risk of diabetes onset (HR 2.07; 95% CI: 1.63-2.63; p < 0.001). The risk of diabetes increased with higher AIP quartiles, especially between the highest (Q4) and lowest (Q1) quartiles (adjusted HR 1.55; 95% CI: 1.27-1.89). We also identified a nonlinear relationship between AIP and diabetes risk. Sensitivity and subgroup analyses confirmed these findings. Furthermore, E-value analysis indicated that the results were robust against unmeasured confounding variables.

Conclusion

Our findings highlight a positive, nonlinear association between AIP and diabetes risk in Chinese non-obese adults. Lowering triglycerides (TG) or increasing high-density lipoprotein cholesterol (HDL-C) levels may help reduce this risk.

Early-Onset Coronary Artery Disease after Pediatric Kidney Transplantation: Implicating the Angiogenesis Inhibitor, Endostatin

Pediatric kidney transplant recipients have a higher rate of coronary artery disease (CAD) as adults. The angiogenesis inhibitor, endostatin, has been implicated in the development of atherosclerosis. Endostatin levels will vary between adult patients who received a kidney transplant as a child. We conducted a study in young adult patients who had undergone pediatric kidney (n = 12) or liver transplantation (n = 8). Coronary arterial calcification was measured using electron beam CT. Values were compared with age-matched control subjects from an epidemiologic database. Serum endostatin levels were measured using enzyme-linked immunosorbent assay. Risk factors for atherosclerosis were assessed. Kidney transplant recipients had a higher rate of CAD compared with liver transplant recipients (33 vs 0%, P = 0.03). Mean (± standard error of mean) serum endostatin levels were higher in kidney transplant recipients compared with liver transplant recipients (26 ± 7 vs 14 ± 3 ng/mL, P = 0.04) and control subjects (26 ± 7 vs 11 ± 1 ng/ mL, P = 0.01). Pediatric kidney transplantation is associated with a higher rate of adult-onset CAD compared with liver transplantation. Endostatin levels were greater in kidney transplant recipients compared with liver transplant recipients and healthy control subjects. Endostatin may play a role in the development of atherosclerosis after kidney transplantation and may serve as a biomarker for atherosclerotic disease.

A long-term study of dyslipidemia and dyslipoproteinemia in stable post-renal transplant patients

BACKGROUND

Dyslipidemia is a major risk factor for atherosclerotic disease in renal transplant patients.

METHODS

The serum levels of lipids and lipoproteins were determined in the same 12 post-renal transplant patients (TX) 10-29 and 73-122 months after transplantation. Thirteen healthy subjects--i.e., without diabetes, endocrine disease, liver disease, active inflammatory disease, glucose intolerance, malignancy, obesity, and urinary protein--were used as a reference group. TX patients had stable renal function. Twelve patients received cyclosporine A and prednisone, six received lovastatin, and one received rapa and prednisone. Lipids and lipoprotein (apo)AI and B were determined using Roche kits. An anti-apoB antibody was used to separate apoB-containing apoCIII and apoE lipoproteins as triglyceride-rich lipoproteins (TRLs) in the non-HDL fraction from apoCIIInonB and apoEnonB in the HDL fraction.

RESULTS

In both groups of post-renal transplant patients, a statistically significant increase of TG, TC, and non-HDL-C levels was observed. Moreover, statistically significant changes were shown in total apoCIII and apoCIIInonB, as well as in TG/HDL-C and apoAI/apoCIII ratios, as compared to the reference group. On the other hand, in TX patients 73-122 months after transplantation, significantly higher concentrations of TC, LDL-C, and especially non-HDL-C were observed. It was shown that apoCIII, apoCIIInonB, apoB:CIII, and lipid and lipoprotein ratios as risk factors of atherosclerosis and renal risk factors were higher in these patients 73-122 months after transplantation.

CONCLUSION

TX patients in a long-term study showed that they had disturbed lipoprotein composition, and its consequence was hyperlipidemia, perhaps partly due to the increased use of immunosuppressants and steroids.