Atherosclerotic vascular disease and its correlates in stable black South African kidney transplant recipients

Abstract

BackgroundDespite remarkable improvement in renal function attributable to kidney transplantation, the burden of cardiovascular disease (CVD) among kidney transplant recipients (KTRs) remains high in the post-transplant period. Aggressive use of statins in KTRs may make lipoprotein ratios correlate better with atherosclerotic vascular disease (AsVD) when compared with traditional lipid profile parameters. We therefore evaluated the clinical and echocardiographic correlates of AsVD among non-diabetic, stable, black KTRs in South Africa.MethodsThis was a cross-sectional study of 41 adult (18–65 years), non-diabetic, stable KTRs and 41 age- and sex-matched healthy controls. An interviewer-administered questionnaire was used to obtain information on participants’ sociodemographic and cardiovascular risk factors. Anthropometric parameters were measured. Urine and blood samples were obtained and analyzed. Echocardiography was performed and carotid intima media thickness (CIMT) was assessed in both right and left carotid arteries. Spearman’s rank correlation and binary logistic regression were performed to determine the relationship between CVD risk factors and AsVD.ResultsAsVD was present in 46.3% of KTRs compared to 17.1% of healthy controls (p = 0.004). Left ventricular hypertrophy was present in 92.7% of the KTRs. There were statistically significant differences in waist–hip ratio, systolic blood pressure, mean arterial pressure, urine albumin–creatinine ratio, serum fibrinogen, serum creatinine, estimated glomerular filtration rate, left atrial diameter, left ventricular mass (LVM), and left ventricular mass index (LVMI) between KTRs and controls. A positive relationship was seen between CIMT and certain risk factors for CVD including LVM, LVMI, and mitral valve deceleration time, (p < 0.001). Castelli index 2 and lipoprotein combine index (LCI) showed positive correlation with CIMT. On multivariate analysis, increasing age and kidney transplant status were independent predictors of AsVD after controlling for other risk factors.ConclusionAsVD was common among KTRs. Older age and kidney transplant status independently predicted AsVD. Castelli index 2 and LCI correlated with AsVD better than serum lipid parameters.

Fasting plasma glucose, lipid ratios, and atherogenic coefficient are the risk factors for hypertension in chronic kidney disease patients on hemodialysis: A report from the Regional High Speciality Hospital of Peninsular Yucatan, Mexico

“…Nevertheless, AC, CRI-I, and CRI-II were found to be the significant predictors for MAP, holding age, sex and FPG adjusted in the models. A cross-sectional study among 41 patients with kidney transplantation in South Africa, reported that CRI-II and lipoprotein combine index had higher association with atherosclerotic vascular disease than serum lipid parameters (Oguntola et al 2018). Results from our study, suggest the relevance of lipids ratios (AC, CRI-I, and CRI-II) over individual lipid parameters among CKD patients under hemodialysis.…”

Association of circulating PCSK9 concentration with cardiovascular metabolic markers and outcomes in stable coronary artery disease patients with or without diabetes: a prospective, observational cohort study

“…Interestingly, in whole stable CAD patients, we found that PCSK9 was significantly and positively related to LCI and HGI, two novel lipid- or glycemic derived indicators and the potential cardiovascular outcomes predictors. [ 26 , 36 ]. It was worth mentioning that, we did not find the association between PCSK9 and some indictors, mainly HDL-C, TG and their derived indexes in DM patients, which may be due to the higher heterogeneous in metabolic phenotypes.…”

The correlation of retinol-binding protein-4 and lipoprotein combine index with the prevalence and diagnosis of acute coronary syndrome

“…We searched Medline by "lipoprotein combine index" and got three literatures only. A cross-sectional study found that LCI correlated with the atherosclerotic vascular disease better than serum lipid parameters [40]. Stephen et al found that LCI was a predictive indicator of CAD [10,41].…”