TY - JOUR
T1 - Triglyceride-rich lipoprotein cholesterol is elevated in liver transplant recipients and associated with post-transplant diabetes
AU - Transplant Lines Investigators
AU - Chvatal-Medina, Mateo
AU - Post, Adrian
AU - Connelly, Margery A
AU - Li, Yakun
AU - Moshage, Han
AU - Bakker, Stephan J L
AU - Posthumus, Anna M
AU - de Meijer, Vincent E
AU - Blokzijl, Hans
AU - Dullaart, Robin
AU - Annema-de Jong, Coby
AU - Berger, Stefan P
AU - Bodewes, Frank
AU - de Boer, Marieke T.
AU - Damman, Kevin
AU - de Borst, Martin
AU - Diepstra, Arjan
AU - Dijkstra, G.
AU - Doorenbos, Sietske
AU - Douwes, Rianne
AU - Eisenga, Michele
AU - Erasmus, Michiel E.
AU - Gan, C T
AU - Gomes Neto, António
AU - Hak, Eelko
AU - Hepkema, Bouke
AU - Jonker, Jip
AU - Klont, Frank
AU - Knobbe, Tim
AU - Kremer, Daan
AU - Leuvenink, Henri G.D.
AU - Lexmond, Willem
AU - de Meijer, Vincent E.
AU - Niesters, Hubertus G. M.
AU - Nieuwenhuijs, Gertrude J.
AU - van Pelt, L. Joost
AU - Pol, Robert
AU - Posthumus, Anna
AU - Ranchor, Adelita V.
AU - Sanders, J S Sanders
AU - Siebelink, Marion
AU - Slart, Riemer
AU - Swarte, J Casper
AU - Touw, Daan
AU - van den Heuvel, Marius
AU - van Leer-Buter, C
AU - van Londen, Marco
AU - te Velde-Keyzer, C A
AU - Verschuuren, Erik A.M.
AU - Vos, Michel
AU - Weersma, Rinse
N1 - © 2026. The Author(s).
PY - 2026/7/17
Y1 - 2026/7/17
N2 - 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.
AB - 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.
U2 - 10.1038/s41598-026-62929-x
DO - 10.1038/s41598-026-62929-x
M3 - Article
C2 - 42469387
SN - 2045-2322
JO - Scientific Reports
JF - Scientific Reports
ER -