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

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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Publication Details

Journal
Scientific Reports
Published
2026-07-17
DOI
https://doi.org/10.1038/s41598-026-62929-x
Primary Topic
Liver Disease Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
0.00

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article

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

Henri G. D. Leuvenink, António W. Gomes‐Neto, Hubert G.M. Niesters, Margery A. Connelly et al.
Scientific Reports
Liver Disease Diagnosis and Treatment
article

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

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

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.

Scientific Reports
University Medical Center Groningen (NL), University of Groningen (NL), LabCorp (United States) (US)
Hartstichting, Nierstichting, Astellas Pharma, Netherlands
Good health and well-being
Openalex Percentile: Top 8%
Liver Disease Diagnosis and Treatment
DOIOpen Access PDFOpenAlex
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