Remnant lipoprotein cholesterol is associated with incident new onset diabetes after transplantation in renal transplant recipients


New onset diabetes after transplantation (NODAT) is a frequent and serious complication of renal transplantation resulting in worse graft and patient outcomes. Despite the clinical importance of the topic, pathophysiological mechanisms favoring the development of NODAT are still ill explored and consequently current attempts to define predictive biomarkers have been of limited practical relevance. Remnant lipoprotein (RLP) cholesterol represents an emerging subclass that prospectively associates not only with higher incident cardiovascular disease, but also with increased overall mortality and systemic inflammation. The present work aimed to determine whether RLP cholesterol could serve as such a biomarker that would also provide a novel target for therapeutic intervention.
In this his longitudinal study, we demonstrate that baseline RLP cholesterol levels are significantly associated with incident NODAT in RTR, independent of several recognized risk factors such as immunosuppressive medication use. These results position RLP cholesterol as a relatively easy to determine emerging biomarker with an apparent strong clinical impact in RTR. Therefore, we would encourage clinicians to take RLP cholesterol levels into account during routine clinical assessments and to consider lifestyle and pharmacological interventions if levels are increased.

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