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<p>Post-transplant diabetes mellitus (PTDM) is the most frequent metabolic complication after liver transplantation. The role of triglyceride-rich lipoprotein cholesterol (TRL-c) in PTDM risk remains poorly defined. We characterized TRL-c in liver transplant recipients (LTRs) from the TransplantLines cohort (NCT03272841) compared to the general population (PREVEND cohort; NCT03073018) and evaluated its association with incident PTDM. We compared 367 adult LTRs and 4,837 PREVEND participants with TRL-c measurements derived from total cholesterol, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c), all measured by nuclear magnetic resonance spectroscopy. Incident PTDM was assessed using Cox models and adjusted for clinically relevant covariates. Compared with PREVEND participants, LTRs had higher triglycerides, TRL-c, and HDL-c but lower total and LDL-c, irrespective of baseline diabetes status. Among LTRs, TRL-c was highest in those with pre-existing diabetes and lowest in those who remained non-diabetic. During a median follow-up of 7.1 years (IQR 6.2–7.8), 31 (12.6%) LTRs developed PTDM. Incidence was highest in the top TRL-c tertile (<i>p</i> = 0.016). Each 1-SD increase in TRL-c was associated with a 64% higher PTDM risk, independent of other risk factors. TRL-c may help risk stratification after transplant, given it likely captures a dyslipidemic phenotype not represented by conventional lipid measurements.</p>

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Triglyceride-rich lipoprotein cholesterol is elevated in liver transplant recipients and associated with post-transplant diabetes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月17日

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  • Mateo Chvatal-Medina,
  • Adrian Post,
  • Margery A. Connelly,
  • Yakun Li,
  • Han Moshage,
  • Stephan J. L. Bakker,
  • Anna M. Posthumus,
  • Vincent E. de Meijer,
  • Hans Blokzijl,
  • Robin Dullaart,
  • Coby Annema,
  • Stefan P. Berger,
  • Frank A. J. A. Bodewes,
  • Marieke T. de Boer,
  • Kevin Damman,
  • Martin H. de Borst,
  • Arjan Diepstra,
  • Gerard Dijkstra,
  • Caecilia S. E. Doorenbos,
  • Rianne M. Douwes,
  • Michele F. Eisenga,
  • Michiel E. Erasmus,
  • C. Tji Gan,
  • Antonio W. Gomes Neto,
  • Eelko Hak,
  • Bouke G. Hepkema,
  • Jip Jonker,
  • Frank Klont,
  • Tim J. Knobbe,
  • Daan Kremer,
  • Henri G. D. Leuvenink,
  • Willem S. Lexmond,
  • Hubert G. M. Niesters,
  • Gertrude J. Nieuwenhuijs-Moeke,
  • L. Joost van Pelt,
  • Robert A. Pol,
  • Adelita V. Ranchor,
  • Jan Stephan F. Sanders,
  • Marion J. Siebelink,
  • Riemer J. H. J. A. Slart,
  • J. Casper Swarte,
  • Daan J. Touw,
  • Marius C. van den Heuvel,
  • Coretta van Leer-Buter,
  • Marco van Londen,
  • Charlotte A. te Velde-Keyzer,
  • Erik A. M. Verschuuren,
  • Michel J. Vos,
  • Rinse K. Weersma

摘要

Post-transplant diabetes mellitus (PTDM) is the most frequent metabolic complication after liver transplantation. The role of triglyceride-rich lipoprotein cholesterol (TRL-c) in PTDM risk remains poorly defined. We characterized TRL-c in liver transplant recipients (LTRs) from the TransplantLines cohort (NCT03272841) compared to the general population (PREVEND cohort; NCT03073018) and evaluated its association with incident PTDM. We compared 367 adult LTRs and 4,837 PREVEND participants with TRL-c measurements derived from total cholesterol, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c), all measured by nuclear magnetic resonance spectroscopy. Incident PTDM was assessed using Cox models and adjusted for clinically relevant covariates. Compared with PREVEND participants, LTRs had higher triglycerides, TRL-c, and HDL-c but lower total and LDL-c, irrespective of baseline diabetes status. Among LTRs, TRL-c was highest in those with pre-existing diabetes and lowest in those who remained non-diabetic. During a median follow-up of 7.1 years (IQR 6.2–7.8), 31 (12.6%) LTRs developed PTDM. Incidence was highest in the top TRL-c tertile (p = 0.016). Each 1-SD increase in TRL-c was associated with a 64% higher PTDM risk, independent of other risk factors. TRL-c may help risk stratification after transplant, given it likely captures a dyslipidemic phenotype not represented by conventional lipid measurements.