Lipid Profile Changes During the First Year After Kidney Transplantation: Risk Factors and Influence of the Immunosuppressive Drug Regimen

Spinelli, G.A.; Felipe, Cláudia Rosso; Park, S.I.; Mandia-Sampaio, E.L.; Tedesco‐Silva, Hélio; Medina-Pestana, J.O.

doi:10.1016/j.transproceed.2011.08.074

Cited by 53 publications

(56 citation statements)

References 25 publications

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“…Several clinical studies have shown that immunosuppressants increase serum levels of cholesterol, TG and LDL-C, usually in a dose-dependent manner. 57,58 In the present study, KTR and CRF patients had increased TG levels compared with those of the control group. Lp (a) and apo B were also significantly higher in CRF cases compared to controls.…”

Section: Discussionsupporting

confidence: 45%

Adiponectin, leptin, nitric oxide, and C-reactive protein levels in kidney transplant recipients: comparison with the hemodialysis and chronic renal failure

2016

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Background: Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in patients with chronic kidney disease (CKD) including kidney transplant recipients (KTR). Secondary lipid metabolism disorders, endothelial dysfunction, and inflammation enhance the risk of CVD development in these patients. The aim of the present study was to investigate the lipid profile, adiponectin, leptin, nitric oxide (NO), and high sensitivity C-reactive protein (hs-CRP) levels in KTR and to compare these parameters with those of the patients with chronic renal failure (CRF), hemodialysis (HD) patients, and healthy controls. Methods: Serum adiponectin and leptin levels were measured by radioimmunoassay; hs-CRP was determined immunoturbidimetrically. Determination of NO was based on the Griess reaction. Results: Compared with the control group, serum NO and adiponectin levels were significantly higher in the KTR, CRF, and HD groups; hs-CRP levels were significantly higher in the KTR and HD groups; leptin levels were significantly higher in the KTR. In addition, serum NO level was significantly higher in the KTR compared to CRF cases. Adiponectin correlated positively with high density lipoprotein-cholesterol in the control and patient groups. A positive correlation was observed between hs-CRP and NO in the KTR and the patients with CRF. Serum adiponectin levels were inversely correlated with hs-CRP and leptin in the HD group. Conclusion: KTR suffer from inflammation and accompanying changes in levels of adipocytokines and NO which contribute to the increased risk of CVD in these patients.

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Section: Discussionsupporting

confidence: 45%

Adiponectin, leptin, nitric oxide, and C-reactive protein levels in kidney transplant recipients: comparison with the hemodialysis and chronic renal failure

2016

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Section: Effects Of Mtor Inhibitors On Lipids "mentioning

confidence: 97%

“…In most clinical studies, sirolimus treatment is associated with a significant increase in LDL cholesterol (40,43,47). In the study performed by Spinelli et al (43), sirolimus treatment was an independent factor associated with plasma LDL cholesterol levels above 121 mg/dl. It has also been reported that treatment with sirolimus is associated with a dramatic increase in plasma triglycerides ranging from 65 to 100% (41,42,43,44,45,47).…”

Section: Effects Of Mtor Inhibitors On Lipids "mentioning

confidence: 97%

“…Among those three trials reporting no difference in lipids between groups, the percentage of mTOR inhibitor-treated patients on lipid lowering therapy were increased in two of them, indicating that mTOR inhibitors might have induced dyslipidemia (41,42). In a study performed on 474 kidney transplant recipients, it was noted that dyslipidemia is frequent 1 year after transplantation and, in multivariate analysis, that treatment by mTOR inhibitors (sirolimus or everolimus) is an independent factor associated with dyslipidemia (43). As discussed later, dyslipidemia is also observed when mTOR inhibitors are used as targeted anti-cancer therapy.…”

Section: Effects Of Mtor Inhibitors On Lipids "mentioning

confidence: 99%

“…Sirolimus (rapamycin) " A significant increase in total cholesterol ranging from 25 to 55% has been observed with sirolimus (40,41,43,44,45,46,47,48). In most clinical studies, sirolimus treatment is associated with a significant increase in LDL cholesterol (40,43,47).…”

Section: Effects Of Mtor Inhibitors On Lipids "mentioning

confidence: 99%

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ENDOCRINE SIDE EFFECTS OF ANTI-CANCER DRUGS: Effects of anti-cancer targeted therapies on lipid and glucose metabolism

Vergès

Walter

Cariou

2014

European Journal of Endocrinology

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During the past years, targeted therapies for cancer have been developed using drugs that have significant metabolic consequences. Among them, the mammalian target of rapamycin (mTOR) inhibitors and, to a much lesser extent, the tyrosine kinase inhibitors (TKIs) are involved. mTOR plays a key role in the regulation of cell growth as well as lipid and glucose metabolism. Treatment with mTOR inhibitors is associated with a significant increase in plasma triglycerides and LDL cholesterol. mTOR inhibitors seem to increase plasma triglycerides by reducing the activity of the lipoprotein lipase which is in charge of the catabolism of triglyceride-rich lipoproteins. The increase in LDL cholesterol observed with mTOR inhibitors seems to be due to a decrease in LDL catabolism secondary to a reduction of LDL receptor expression. In addition, treatment with mTOR inhibitors is associated with a high incidence of hyperglycemia, ranging from 13 to 50% in the clinical trials. The mechanisms responsible for hyperglycemia with new onset diabetes are not clear, but are likely due to the combination of impaired insulin secretion and insulin resistance. TKIs do not induce hyperlipidemia but alter glucose homeostasis. Treatment with TKIs may be associated either with hyperglycemia or hypoglycemia. The molecular mechanism by which TKIs control glucose homeostasis remains unknown. Owing to the metabolic consequences of these agents used as targeted anti-cancer therapies, a specific and personalized follow-up of blood glucose and lipids is recommended when using mTOR inhibitors and of blood glucose when using TKIs.

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Association between preoperative lipid profiles and new‐onset diabetes after transplantation in Chinese kidney transplant recipients: A retrospective cohort study

Gao

Liang

et al. 2021

Clinical Laboratory Analysis

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Background This study investigated the association between the preoperative lipid profiles and new‐onset diabetes after transplantation (NODAT) in Chinese kidney transplant recipients (KTRs). Methods In this study, of 1140 KTRs registered between January 1993 and March 2018 in Zhongshan Hospital, Fudan University, 449 were enrolled. Clinical data, obtained through a chart review of the patient records in the medical record system, were evaluated, and NODAT was diagnosed based on the American Diabetes Association guidelines. Multivariate Cox regression analysis was conducted to determine whether the preoperative lipid profiles in KTRs were independently associated with NODAT incidence. The preoperative lipid profiles were analyzed as continuous variables and grouped into tertiles. Smooth curve fitting was used to confirm the linear associations. Results During a median follow‐up of 28.03 (interquartile range 12.00–84.23) months, 104 of the 449 (23.16%) participants developed NODAT. The multivariate model analysis, adjusted for all potential covariates, showed that increased values of the following parameters were associated with NODAT (hazard ratio, 95% confidence interval): preoperative total cholesterol (TC; 1.25, 1.09–1.58, p = 0.0495), low‐density lipoprotein cholesterol (LDL‐C; 1.33, 1.02–1.75, p = 0.0352), non‐high‐density lipoprotein cholesterol (non‐HDL‐C; 1.41, 1.09–1.82, p = 0.0084), TC/HDL‐C (1.28, 1.06–1.54, p = 0.0109), and non‐HDL‐C/HDL‐C (1.26, 1.05–1.52, p = 0.0138). However, the association between the preoperative triglyceride, HDL‐C, or TG/HDL‐C and NODAT was not significant. Conclusions Preoperative TC, LDL‐C, non‐HDL‐C, TC/HDL‐C, and non‐HDL‐C/HDL‐C were independent risk factors for NODAT.

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Lipid Profile Changes During the First Year After Kidney Transplantation: Risk Factors and Influence of the Immunosuppressive Drug Regimen

Abstract: Dyslipidemia is frequent at 1 year after transplantation. The lack of agreement among changes observed in lipid fractions and ratios suggests that more studies are necessary to guide therapy besides targeting LDL-C concentrations as recommended by current guidelines.

Cited by 53 publications

References 25 publications

Adiponectin, leptin, nitric oxide, and C-reactive protein levels in kidney transplant recipients: comparison with the hemodialysis and chronic renal failure

Adiponectin, leptin, nitric oxide, and C-reactive protein levels in kidney transplant recipients: comparison with the hemodialysis and chronic renal failure

ENDOCRINE SIDE EFFECTS OF ANTI-CANCER DRUGS: Effects of anti-cancer targeted therapies on lipid and glucose metabolism

Association between preoperative lipid profiles and new‐onset diabetes after transplantation in Chinese kidney transplant recipients: A retrospective cohort study

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