Introduction

Dyslipidemia (DL) is a critical comorbidity that occurs after renal transplantation and can lead to cardiovascular diseases. The relationship between the development of DL and glucocorticoid receptor (NR3C1) polymorphism was previously reported by the authors. However, a confirmation study of the implication of DL in polymorphism and the effect of DL on allograft prognosis has not been conducted yet. In this study, we validated the clinical implications of the NR3C1 Bcl I G allele and assessed risk factors for developing DL and graft survival.

Methods

Two hundred forty-seven consequent renal allograft recipients (153 men and 94 women) who underwent transplantation under tacrolimus (TAC)-based immunosuppression between February 2002 and August 2015 were evaluated. Susceptibility to DL was validated in 76 recipients who underwent transplantation between September 2011 and August 2015. Risk factors for developing DL and allograft prognosis were assessed in all the 247 patients.

Results

In the validation study, the incidence of DL was significantly higher in the patients with the NR3C1 Bcl I G allele than in those with the CC genotype (p = 0.009). After validation, 92 recipients (37.2%) were diagnosed as having DL after transplantation. No significant differences in mean body mass index, acute rejection rate, ABO incompatibility, and the incidence of diabetes mellitus or hyperuricemia were observed. The occurrence of DL was associated with female sex and older age (p = 0.002 and 0.026, respectively). No significant differences were observed in the immunosuppressant pharmacokinetic parameters. The incidence of DL was significantly higher in the patients with the NR3C1 Bcl I G allele than in those with the CC genotype (p = 0.002). The multivariate analysis revealed that the NR3C1 Bcl I G allele, female sex, and age of >47 years were significant risk factors for developing DL (odds ratios, 2.16, 2.43, and 1.78, respectively; 95% confidence intervals, 1.24-3.76, 1.39-4.24, and 1.07-3.26, respectively; Table 1). No significant difference in graft survival was found between the two groups.

Conclusions

The incidence of DL in our cohort was 37.2%. The NR3C1 Bcl I G allele may allow prediction of the occurrence of DL. These findings may aid in predicting patients&[prime] risk of developing DL.

Funding

None