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Malyala R, Rapi L, Nash MM, et al. Serum Apolipoprotein B and A1 Concentrations Predict Late-Onset Posttransplant Diabetes Mellitus in Prevalent Adult Kidney Transplant Recipients. Can J Kidney Health Dis. 2019;6:2054358119850536doi: 10.1177/2054358119850536.
Malyala, R., Rapi, L., Nash, M. M., & Prasad, G. V. R. (2019). Serum Apolipoprotein B and A1 Concentrations Predict Late-Onset Posttransplant Diabetes Mellitus in Prevalent Adult Kidney Transplant Recipients. Canadian journal of kidney health and disease, 62054358119850536. https://doi.org/10.1177/2054358119850536
Malyala, Rohit, et al. "Serum Apolipoprotein B and A1 Concentrations Predict Late-Onset Posttransplant Diabetes Mellitus in Prevalent Adult Kidney Transplant Recipients." Canadian journal of kidney health and disease vol. 6 (2019): 2054358119850536. doi: https://doi.org/10.1177/2054358119850536
Malyala R, Rapi L, Nash MM, Prasad GVR. Serum Apolipoprotein B and A1 Concentrations Predict Late-Onset Posttransplant Diabetes Mellitus in Prevalent Adult Kidney Transplant Recipients. Can J Kidney Health Dis. 2019 May 25;6:2054358119850536. doi: 10.1177/2054358119850536. eCollection 2019. PMID: 31205732; PMCID: PMC6535897.
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Can J Kidney Health Dis. 2019 May 25;6:2054358119850536. doi: 10.1177/2054358119850536. eCollection 2019.

Serum Apolipoprotein B and A1 Concentrations Predict Late-Onset Posttransplant Diabetes Mellitus in Prevalent Adult Kidney Transplant Recipients.

Canadian journal of kidney health and disease

Rohit Malyala, Lindita Rapi, Michelle M Nash, G V Ramesh Prasad

Affiliations

  1. Kidney Transplant Program, St. Michael's Hospital, Toronto, ON, Canada.
  2. Division of Nephrology, Department of Medicine, University of Toronto, ON, Canada.

PMID: 31205732 PMCID: PMC6535897 DOI: 10.1177/2054358119850536

Abstract

BACKGROUND: Glucose metabolism links closely to cholesterol metabolism. Posttransplant diabetes mellitus (PTDM) adversely affects posttransplant outcomes, but its risk factors in relation to cholesterol metabolism have not been fully delineated. The apolipoprotein B/A1 (Apo B/A1) ratio, which is associated with insulin resistance, has not been evaluated in kidney transplant recipients as a risk factor for PTDM.

OBJECTIVE: The objective of this study was to determine whether serum apolipoprotein profiles predict late PTDM, defined as a new onset diabetes occurring greater than 3 months posttransplant.

DESIGN: Retrospective chart review of a prevalent population of kidney transplant recipients.

SETTING: Large transplant center in Ontario, Canada.

PATIENTS: We identified 1104 previously nondiabetic adults who received a kidney transplant between January 1, 1998, and December 1, 2015, and were followed at 1 transplant center.

MEASUREMENTS: Recipients provided testing for serum apolipoprotein B (Apo B) and apolipoprotein A1 (Apo A1) concentrations from 2010, either at 3 months posttransplant for new transplant recipients or the next clinic visit for prevalent recipients. Late PTDM defined using Canadian Diabetes Association criteria as occurring ≥3 months posttransplant was recorded until May 1, 2016.

METHODS: All analyses were conducted with R, version 3.4.0 (The R Foundation for Statistical Computing). Comparisons were made using Student

RESULTS: There were 53 incident late PTDM cases, or 1.71 cases per 100 patient-years. Incident late PTDM differed between the highest and lowest quartiles for Apo B/A1 ratio, 2.47 per 100 patient-years vs 0.88 per 100 patient-years (

LIMITATIONS: Posttransplant diabetes mellitus cases occurring before apolipoprotein testing was implemented were not included in the analysis.

CONCLUSIONS: Apolipoproteins B and A1 better predict late PTDM than conventional markers of cholesterol metabolism.

Keywords: cardiovascular disease; diabetes; metabolic syndrome; tacrolimus; transplantation

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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