Atherosclerosis in Patients Undergoing Kidney Transplantation: Insulin Resistance and Its Relationship with Serum Fetuin-A
Fetuin-A and Atherosclerosis in Kidney Transplant Recipients
DOI:
https://doi.org/10.5281/zenodo.19242391Keywords:
insulin resistance, Atherosclerosis, Kidney transplantation, fetuin-AAbstract
Objective: Cardiovascular disease (CVD) is the most important cause of mortality in patients undergoing kidney transplantation. In addition to classical CVD risk factors, insulin resistance and vascular calcification inhibitor fetuin-A may also affect the pathogenesis of atherosclerosis in this group of patients. In our study, we investigated the risk factors for atherosclerosis in patients who underwent kidney transplantation and the relationship between atherosclerosis and insulin resistance and fetuin-A.
Materials and Methods: The study included 103 kidney transplant patients (69 males, mean age 35.14 ± 9.51 years; mean kidney transplant time 54.99 ± 39.51 months) and 70 healthy controls. Patients over 18 years of age, with a kidney transplant period of at least 6 months, and without diabetes mellitus, acute or chronic infection, acute hepatitis, or malignancy were included in the study. Demographic, clinical and laboratory data of the control group and patient group were recorded. All participants in the study had carotid-intima media thickness (C-IMT) measured by the same radiologist.
Results: Body mass index, systolic and diastolic blood pressures, mean arterial blood pressure values, serum creatinine, cholesterol, triglyceride, high-density lipoprotein, parathyroid hormone, calcium and C-reactive protein (CRP) levels, HOMA insulin resistance values and C-IMT values were higher in the recipients compared to the control group, and creatinine clearance and serum fetuin-A levels were lower. When the patients were examined in three groups according to serum fetuin-A level; In the group with the lowest fetuin-A levels, age (p=0.005), hepatitis B or C disease rate (p=0.005), serum CRP (p=0.001) and C-IMT (p<0.001) were higher, and albumin value (p=0.02) was found to be lower. Multivariant linear regression analysis found age (ß=0.436; p<0.001) and fetuin-A (ß=−0.229; p=0.04) as independent risk factors.
Conclusion: Apart from the classical CVD risk factors, insulin resistance and low serum fetuin-A levels were also found to be associated with the development of early atherosclerosis in kidney transplant patients. Prospective long-term studies showing the course of serum fetuin-A levels in kidney transplant patients are needed.
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