Abstract:
:Post-transplant diabetes mellitus (PTDM) is a serious complication in renal transplant recipients. Branched-chain amino acids (BCAAs) are involved in the pathogenesis of insulin resistance. We determined the association of plasma BCAAs with PTDM and included adult renal transplant recipients (≥18 y) with a functioning graft for ≥1 year in this cross-sectional cohort study with prospective follow-up. Plasma BCAAs were measured in 518 subjects using nuclear magnetic resonance spectroscopy. We excluded subjects with a history of diabetes, leaving 368 non-diabetic renal transplant recipients eligible for analyses. Cox proportional hazards analyses were used to assess the association of BCAAs with the development of PTDM. Mean age was 51.1 ± 13.6 y (53.6% men) and plasma BCAA was 377.6 ± 82.5 µM. During median follow-up of 5.3 (IQR, 4.2-6.0) y, 38 (9.8%) patients developed PTDM. BCAAs were associated with a higher risk of developing PTDM (HR: 1.43, 95% CI 1.08-1.89) per SD change (p = 0.01), independent of age and sex. Adjustment for other potential confounders did not significantly change this association, although adjustment for HbA1c eliminated it. The association was mediated to a considerable extent (53%) by HbA1c. The association was also modified by HbA1c; BCAAs were only associated with renal transplant recipients without prediabetes (HbA1c < 5.7%). In conclusion, high concentrations of plasma BCAAs are associated with developing PTDM in renal transplant recipients. Alterations in BCAAs may represent an early predictive biomarker for PTDM.
journal_name
J Clin Medjournal_title
Journal of clinical medicineauthors
Osté MCJ,Flores-Guerrero JL,Gruppen EG,Kieneker LM,Connelly MA,Otvos JD,Dullaart RPF,Bakker SJLdoi
10.3390/jcm9020511subject
Has Abstractpub_date
2020-02-13 00:00:00issue
2issn
2077-0383pii
jcm9020511journal_volume
9pub_type
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journal_title:Journal of clinical medicine
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更新日期:2018-05-23 00:00:00
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更新日期:2019-02-25 00:00:00
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更新日期:2021-01-09 00:00:00
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journal_title:Journal of clinical medicine
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更新日期:2020-04-01 00:00:00
abstract::Interventions for main carers of adult patients with anorexia nervosa (AN) can reduce the caregiving burden and increase caregiver skills. However, the effectiveness and feasibility for carers of adolescent patients, the optimal form of the intervention and long-term outcomes are largely unknown. We evaluated the effi...
journal_title:Journal of clinical medicine
pub_type: 杂志文章
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更新日期:2020-06-18 00:00:00
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journal_title:Journal of clinical medicine
pub_type: 杂志文章
doi:10.3390/jcm8020267
更新日期:2019-02-21 00:00:00
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更新日期:2020-01-24 00:00:00
abstract:BACKGROUND AND AIMS:The Multidimensional Prognostic Index (MPI), an objective and quantifiable tool based on the Comprehensive Geriatric Assessment, has been shown to predict adverse outcomes in European cohorts. We conducted a validation study of the original MPI, and of adapted versions that accounted for the use of ...
journal_title:Journal of clinical medicine
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abstract::Liver transplantation is increasingly dependent on the use of extended criteria donors (ECD) to increase the organ donor pool and address rising demand. This has necessitated the adoption of innovative technologies and strategies to protect these higher-risk grafts from the deleterious effects of traditional preservat...
journal_title:Journal of clinical medicine
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更新日期:2020-04-07 00:00:00
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