Lipotoxicity and Decreased Islet Graft Survival

Abstract Aim: To evaluate if baseline serum lipids are associated with islet graft survival in type 1 diabetes mellitus islet transplant (ITx) recipients. Research design and methods: Baseline fasting lipid profile was collected from 44 ITx recipients. Comparisons were performed between subjects below and above the median values of each lipid fraction. Differences in outcomes were compared by Kaplan-Meier curves and Cox-regression analysis. Results: Subjects with baseline fasting plasma triglycerides and VLDL-cholesterol above median had shorter islet graft survival (triglycerides: 39.7±6.1 vs. 61.3±6.6 months, P=0.029 and VLDL: 41.5±5.7 vs. 62.8±7.3 months, P=0.032). Total, LDL and HDL-cholesterol didn9t influence islet function. Triglycerides (OR=2.97, 95%CI=1.03-8.52, P=0.044) maintained its association with graft failure after adjustments for confounders. Conclusions: Higher baseline triglycerides are associated with earlier decline in islet graft function. Prospective clinical trials should address whether it is directly caused by lipotoxicity and if strategies focusing lowering serum lipids may prolong islet graft survival.