Changes in lipid and carbohydrate metabolism under mTOR- and calcineurin-based immunosuppressive regimen in adult patients after liver transplantation

European Journal of Internal Medicine
Anca ZimmermannTim Zimmermann

Abstract

Cardiovascular disease is a leading cause of long-term mortality after liver transplantation (LT). Life long immunosuppression harbors the risk of metabolic alterations. We aimed to analyze the impact of calcineurin (CNI)-only containing regimen (group A) compared to mTOR-containing regimen (group B) on lipid and carbohydrate metabolism. 92 adult patients after LT, University of Mainz (group A-78 patients, group B-14 patients; 65 M/27 F; mean age 59+/-10.2years; mean time from LT 5.8+/-5years). Clinical data, comorbidities, and medication were assessed. Fasting lipid profile including small dense LDLs (sdLDL) and oral glucose tolerance tests were performed. Group B had significantly higher levels of total cholesterol (TC), LDL-cholesterol (LDL-C), triglycerides (TG) and sdLDL, with persistence of higher TC, TG, sdLDLs (mg/dl) after exclusion of patients under lipid lowering medication. Concentrations above the upper limits of normal were found: for LDL-C in 9% of group A/35.7% of group B (p=0.016); for TG: in 32.1% of group A/92.9% in group B (p=0.0001). A positive correlation between time since LT (years) and sdLDL (mg/dl) was found in group B (p=0.018). In patients without previously known diabetes, NODAT and impaired glucose...Continue Reading

References

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Jun 27, 2002·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Marina BerenguerJoaquín Berenguer
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Citations

Apr 7, 2016·International Journal of Molecular Sciences·Stefano Gitto, Erica Villa
Oct 20, 2018·Transplantation·Giacomo GermaniKymberly D Watt
Jan 24, 2019·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Mohammad Bilal SiddiquiMohammad Shadab Siddiqui
Oct 15, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Thomas G Cotter, Michael Charlton
Nov 3, 2016·Current Opinion in Lipidology·Maaike Kockx, Leonard Kritharides
Feb 23, 2019·Expert Review of Gastroenterology & Hepatology·Stefano GittoPatrizia Burra
Mar 15, 2019·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Lee S NguyenJoe-Elie Salem
Dec 15, 2019·Nutrients·Barbara LattanziManuela Merli

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