The Relationship Between Chronic Inflammation and Glucidic-Lipidic Profile Disorders in Kidney Transplant Recipients

Open access


Introduction: Chronic inflammation has a proven role in atherogenesis, lipid profile parameters being related to cytokine production. In kidney transplant recipients, interleukin 6 (IL-6) is significantly associated with graft-related outcomes and also alterations of cholesterol and triglyceride metabolism. The aim of this study was to investigate the relationship between chronic inflammation and glucidic-lipidic metabolism disorders in a group of patients with kidney transplantation as renal replacement therapy. Methods: A prospective observational study which enrolled thirtysix non-diabetic kidney transplant recipients was conducted in the Nephrology and Peritoneal Dialysis Department, County Clinic Hospital of Tirgu Mures. The study group was divided as following: recipients with serum IL-6 concentration higher than 3.8 pg/ml (group A) and IL-6 within the normal range (group B). Results: Allograft recipients with higher serum IL-6 had significant higher erytrocyte sedimentation rate(ESR, p=0.0067). Patients with over-the-range levels of IL-6 had significant higher levels of serum cholesterol and LDL-cholesterol respectively (p=0.0242 and p=0.0081). Serum Apo-B was also significant higher in Group A than Group B. Protein excretion was significant higher in patients from group A (p=0.0013). No statistical significant relationship could be proven between elevated levels of IL-6 and hbA1c, insulin and glycosuria disturbances in the two groups. Also, we found no statistical significant association between resistivity and pulsatility indices (both hilum and intragraft) or carotid intima media thickness. Conclusion: Serum interleukin 6 is related to lipid profile disorders and less to glucidic metabolism anomalies in non-diabetic kidney transplant recipients.

1. Kaysen GA. The microinflammatory state in uremia: Causes and potential consequences. J Am Soc Nephrol 2001;12:1549-1557.

2. Willerson JT, Ridker PM. Inflammation as a cardiovascular risk factor. Circulation 2004;109: II2-II10.

3. Psychari SN, Sinos L, Iatrou C, Liakos G, Apostolou TS. Relations of inflammatory markers to lipid levels and autonomic tone in patients with moderate and severe chronic kidney disease and in patients under maintenance hemodialysis. Clin Nephrol. 2005;64(6):419-27.

4. Vazquez MA, Jeyarajah DR, Kielar ML, Lu CY. Long-termoutcomes of renaltransplantation: A result of the originalendowment of the donor kidney and the inflammatoryresponse to both alloantigens and injury. Curr Opin NephrolHypertens 2000;9:643-648.

5. Gotsman I, Grabie N, Gupta R, et al. Impaired regulatory T-cell response and enhanced atherosclerosis in the absence of inducible costimulatorymolecule. Circulation 2006;114:2047-055.

6. Martinez-Castelao A, Sarrias X, Bestard O,et al. Arterial elasticity measurement in renal transplant patientsunder anticalcineurin immunosuppression. TransplantProc.2005;37:3788-3790.

7. Abedini S, Holme I, Marz W et al. Inflammation in renal transplantation. Clin J Am Soc Nephrol 2009;4:1246-1254.

8. Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 2005;352:1685-1695.

9. Khovidhunkit W, Kim MS, Memon RA, et al. Effects of infection and inflammation on lipid and lipoprotein metabolism: mechanisms and consequences to the host. J. Lipid Res. 2004;45:1169-1196.

10. Nonogaki K, Fuller GM, Fuentes NL,et al. Interleukin-6 stimulates hepatic triglyceride secretion in rats. Endocrinology. 1995;136:2143-2149.

11. Ettinger WH, Varma VK, Sorci-Thomas M,et al. Cytokines decrease apolipoprotein accumulation in medium from Hep G2 cells. Arterioscler. Thromb. 1994;14:8-13.

12. Dahle DO, Mjøen G, Oqvist B, et al. Inflammation-associated graft loss in renal transplant recipients, Nephrol. Dial. Transplant. 2011;26:3756-3761.

13. Levey AS, Bosch JP, Lewis J, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999;130:461-470.

14. Levey AS, Green T, Kusek JW, Beck GJ, MDRD Study Group. A simplified equation to predict glomerular filtration rate from serum creatinine J Am Soc Nephrol 2000;11:155A

15. Akdis M et al. Interleukins, from 1 to 37, and interferon- c: receptors, functions and roles in diseases. J Allergy Clin Immunol. 2011;127(3):701-721.

16. De Serres SA, Vadivel N, Mfarrej BG, et al. Monocyte-secreted inflammatory cytokines are associated with transplant glomerulopathy in renal allograft recipients. Transplantation 2011;15;91(5):552-559.

17. Gyanendra Kumar Sonkar, Sangeeta Singh, Satyendra Kumar Sonkar, Usha Singh, Rana Gopal Singh. Evaluation of serum interleukin 6 and tumour necrosis factor alpha levels, and their association with various non-immunological parameters in renal transplant recipients. Singapore Med J 2013;54(9):511-515.

18. Gullestad L, Simonsen S, Ueland T, et al. Possible role of proinflammatory cytokines in heart allograft coronary artery disease. Am J Cardiol 1999;84:999-1003.

19. Fernández-Real JM, Broch M, Vendrell J, Rieart W. Interleukin-6 gene polymorphism and lipid abnormalities in healthy subjects. J Clin Endocrinol Metab 2000;85:1334-1339.

20. Greenberg AS, Nordan RP, McIntosh J,et al. Interleukin-6 reduces lipoprotein lipase activity in adipose tissue of mice in vivo and in 3T3-L1 adipocytes: a possible role for interleukin-6 in cancer cachexia. Cancer Res. 1992;52:4113-4116

21. Hingorani S, Gooley T, Pao E, Sandmaier B, McDonald G. Urinary cytokines after HCT: evidence for renal inflammation in the pathogenesis of proteinuria and kidney disease. Bone Marrow Transplant. 2014;49(3):403-409.

Acta Medica Marisiensis

The Journal of The University of Medicine and Pharmacy of Targu-Mures

Journal Information


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 70 70 11
PDF Downloads 18 18 3