title: Lipotoxicity and decreased islet graft survival.
abstract: OBJECTIVE To evaluate if baseline serum lipids are associated with islet graft survival in type 1 diabetes islet transplant (ITx) recipients. RESEARCH DESIGN AND METHODS Baseline fasting lipid profile was collected from 44 ITx recipients. Comparisons were performed between subjects below and above the median values of each lipid fraction. Differences in outcomes were compared by Kaplan-Meier curves and Cox regression analysis. RESULTS Subjects with baseline fasting plasma triglycerides and VLDL cholesterol above the median had shorter islet graft survival (triglycerides: 39.7 +/- 6.1 vs. 61.3 +/- 6.6 months, P = 0.029, and VLDL: 41.5 +/- 5.7 vs. 62.8 +/- 7.3 months, P = 0.032). Total, LDL, and HDL cholesterol did not influence islet function. Triglycerides (odds ratio 2.97 [95% CI 1.03-8.52], P = 0.044) maintained its association with graft failure after adjustments for confounders. CONCLUSIONS Higher baseline triglycerides are associated with earlier decline in islet graft function. Prospective clinical trials should address whether it is directly caused by lipotoxicity and if strategies focusing on lowering serum lipids may prolong islet graft survival.
authors.affiliation: Diabetes Research Institute, Miami, Florida, USA.
authors.forename: Cristiane B
authors.initials: CB
authors.lastname: Leitão
authors.forename: Karina
authors.initials: K
authors.lastname: Bernetti
authors.forename: Thipaporn
authors.initials: T
authors.lastname: Tharavanij
authors.forename: Pablo
authors.initials: P
authors.lastname: Cure
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Lauriola
authors.forename: Per-Olof
authors.initials: PO
authors.lastname: Berggren
authors.forename: Camillo
authors.initials: C
authors.lastname: Ricordi
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Alejandro
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000473:pathology / Q000628:therapy*; D005500:Follow-Up Studies; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007515:Islets of Langerhans / Q000473:pathology*; D016381:Islets of Langerhans Transplantation / Q000534:rehabilitation; D008055:Lipids / Q000009:adverse effects* / Q000097:blood* / Q000494:pharmacology; D008875:Middle Aged; D012189:Retrospective Studies; D014184:Transplantation, Homologous
chemical_list: D008055:Lipids