title: Insulin resistance, LDL particle size, and LDL susceptibility to oxidation in pediatric kidney and liver recipients.
abstract: BACKGROUND
  Dyslipidemia is common after solid organ transplantation. We have described hypertriglyceridemia in about 50% of our pediatric kidney, and in about 30% of our liver recipients. The aim of the present study was to find out whether this post-transplantation hypertriglyceridemia after pediatric solid organ transplantation is associated with insulin resistance and the occurrence of small, dense low-density lipoprotein (LDL).
  
  
  METHODS
  Fifty kidney and 25 liver recipients (aged 4 to 18 years) on triple immunosuppression, and 181 control children participated in the study for an average of 5.3 and 6.4 years after kidney and liver transplantation (range 1 to 11 years), respectively. Homeostasis model assessments for insulin resistance (HOMA) were calculated and fasting lipoprotein lipid profile, apolipoprotein A-I and B concentrations, LDL particle diameter, and indices of LDL susceptibility to copper-induced oxidation determined.
  
  
  RESULTS
  Kidney patients had significantly higher serum total, high-density, and low-density lipoprotein cholesterol, triglyceride, apolipoprotein A-I and B concentrations than liver patients or control subjects (P < 0.003 for all). HOMA indices higher than the 95th percentile of Canadian normal children were seen in 50.0% of kidney (of liver 41.2%) recipients younger than 11 years, and in 27.3% of older recipients (of liver 37.5%). Smaller sized LDL or LDL of increased oxidizability was not more frequent in patients than in control children.
  
  
  CONCLUSIONS
  Pediatric kidney recipients had significantly higher lipid and insulin concentrations than healthy control children. Combined hyperlipidemia and features of the dysmetabolic syndrome were common in children after kidney and liver transplantation. However, no small, dense LDL, or LDL prone to oxidation was seen in either group.
authors.affiliation: Paediatric Research Centre, University of Tampere, Tampere, Finland. arja.sirrtola@uta.fi
authors.forename: Arja
authors.initials: A
authors.lastname: Siirtola
authors.forename: Marjatta
authors.initials: M
authors.lastname: Antikainen
authors.forename: Marja
authors.initials: M
authors.lastname: Ala-Houhala
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Koivisto
authors.forename: Tiina
authors.initials: T
authors.lastname: Solakivi
authors.forename: Suvi M
authors.initials: SM
authors.lastname: Virtanen
authors.forename: Hannu
authors.initials: H
authors.lastname: Jokela
authors.forename: Terho
authors.initials: T
authors.lastname: Lehtimäki
authors.forename: Christer
authors.initials: C
authors.lastname: Holmberg
authors.forename: Matti K
authors.initials: MK
authors.lastname: Salo
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000209:etiology; D066298:In Vitro Techniques; D007333:Insulin Resistance; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000502:physiology*; D008055:Lipids / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood* / Q000737:chemistry; D016031:Liver Transplantation / Q000009:adverse effects* / Q000502:physiology*; D008297:Male; D010084:Oxidation-Reduction; D010316:Particle Size
chemical_list: D001786:Blood Glucose; D008055:Lipids; D008077:Lipoproteins, LDL