Triglyceride-rich lipoprotein cholesterol is elevated in liver transplant recipients and associated with post-transplant diabetes
5 affiliations
- 1Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen
- 2Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen
- 3Labcorp
- 4Division of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, University of Groningen
- 5Division of Endocrinology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen
Abstract
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.
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BibTeX
@article{chvatalmedina2026triglyceriderich,
title = {{Triglyceride-rich lipoprotein cholesterol is elevated in liver transplant recipients and associated with post-transplant diabetes}},
author = {Mateo Chvatal-Medina and Adrian Post and Margery A. Connelly and Yakun Li and Han Moshage and Stephan J. L. Bakker and Anna M. Posthumus and Vincent E. de Meijer and Hans Blokzijl and Robin Dullaart and Transplant Lines Investigators},
journal = {Scientific Reports},
year = {2026},
month = jul,
doi = {10.1038/s41598-026-62929-x},
url = {https://doi.org/10.1038/s41598-026-62929-x},
note = {CC BY},
}
RIS
TY - JOUR
TI - Triglyceride-rich lipoprotein cholesterol is elevated in liver transplant recipients and associated with post-transplant diabetes
AU - Mateo Chvatal-Medina
AU - Adrian Post
AU - Margery A. Connelly
AU - Yakun Li
AU - Han Moshage
AU - Stephan J. L. Bakker
AU - Anna M. Posthumus
AU - Vincent E. de Meijer
AU - Hans Blokzijl
AU - Robin Dullaart
AU - Transplant Lines Investigators
PY - 2026
DA - 2026/07/01
JO - Scientific Reports
DO - 10.1038/s41598-026-62929-x
UR - https://doi.org/10.1038/s41598-026-62929-x
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.
SN - 2045-2322
ER -