Aim: Cardiovascular disease (CVD) is the most important causeof mortality in patients undergoing kidney transplantation. Inaddition to classical CVD risk factors, insulin resistance and fetuin-A,a vascular calcification inhibitor, may also affect the pathogenesisof atherosclerosis in this group of patients. In our study, weinvestigated the risk factors for atherosclerosis in patients whounderwent kidney transplantation and the relationship betweenatherosclerosis and insulin resistance and fetuin-A.Material and Method: The study included 103 kidneytransplant patients (69 males, mean age 35.14±9.51 years; meankidney transplant time 54.99±39.51 months) and 70 healthycontrols. Patients over 18 years of age, with a kidney transplantperiod of at least 6 months, and without diabetes mellitus,acute or chronic infection, acute hepatitis, or malignancy wereincluded in the study. Demographic, clinical and laboratorydata of the control group and patient group were recorded. Allparticipants in the study had carotid-intima media thickness(C-IMT) measured by the same radiologist.Results: Body mass index, systolic and diastolic blood pressures,mean arterial blood pressure values, serum creatinine, cholesterol,triglyceride, high-density lipoprotein, parathyroid hormone,calcium and C-reactive protein (CRP) levels, HOMA insulinresistance values and C-IMT values were higher in the recipientscompared to the control group, and creatinine clearance andserum fetuin-A levels were lower. When the patients wereexamined in three groups according to serum fetuin-A level;In the group with the lowest fetuin-A levels, age (p=0.005),hepatitis B or C disease rate (p=0.005), serum CRP (p=0.001)and C-IMT (p<0.001) were higher, and albumin value (p=0.02)was found to be lower. Multivariant linear regression analysisfound age (ß=0.436; p<0.001) and fetuin-A (ß=−0.229; p=0.04) asindependent risk factors associated with C-IMT.for what ??Conclusion: Apart from the classical CVD risk factors, insulinresistance and low serum fetuin-A levels were also found tobe associated with the development of early atherosclerosisin kidney transplant patients. Prospective long-term studiesshowing the course of serum fetuin-A levels in kidneytransplant patients are needed.
Akgül et al. (Thu,) studied this question.