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Coronary artery calcium may stabilize following islet cell transplantation in patients with type 1 diabetes
Author(s) -
Madrigal Jessica M.,
Monson Rebecca S.,
Hatipoglu Betul,
Oberholzer José,
Kondos George T.,
Varady Krista A.,
Danielson Kirstie K.
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13059
Subject(s) - medicine , transplantation , creatinine , islet , diabetes mellitus , calcium , cardiology , artery , kidney transplantation , gastroenterology , endocrinology , urology , surgery
Islet cell transplantation can functionally cure type 1 diabetes and also improve carotid intima‐media thickness. This study provides a preliminary description of changes in coronary artery calcium following islet transplantation, and associated factors. Coronary artery calcium was measured in 14 patients with type 1 diabetes (11 had measures both pre‐ and post‐transplant [mean 2.3 years]) in the University of Illinois at Chicago's clinical trial. Multivariable mixed‐effects linear regression of repeated measures was used to quantify calcium change and determine if this change was longitudinally associated with risk/protective factors. Thirteen of the patients were female, with mean baseline age, diabetes duration, and BMI of 47.6 and 28.7 years, and 23.1, respectively. Over half (57%) had detectable coronary artery calcium pre‐transplant. Minimal change (0.39 mm 3 /y, P = .02) occurred in coronary artery calcium levels pre‐ to post‐transplant. No patient met criteria for calcium progression. Coronary artery calcium was positively associated with total and small VLDL particles ( P ≤ .02), statin dose ( P = .02), and urine albumin‐to‐creatinine ratio ( P = .04) and negatively associated with free fatty acids ( P = .03), total HDL ( P = .03), large HDL particles ( P = .005), and tacrolimus dose ( P = .02). Islet transplant may stabilize coronary artery calcium, with optimal management of lipids and kidney function remaining key therapeutic targets. [ NCT 00679041].