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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Increased de novo lipogenesis (DNL), the metabolic pathway synthesizing fatty acids from carbohydrate, is associated with metabolic disturbances and insulin resistance. This study examined the association between selected circulating DNL-related fatty acids and the development of post-transplantation diabetes mellitus (PTDM) in kidney transplant recipients (KTR).
We included KTR from the TransplantLines Food and Nutrition Biobank and Cohort study with a functioning graft at least 1 year. Plasma phospholipid and triglyceride levels of myristic (C14:0), palmitic (C16:0), palmitoleic (C16:1n7), stearic (C18:0), cis-vaccenic (C18:1n7), and oleic acid (C18:1n9) were measured by gas chromatography. Associations with PTDM development were analyzed using Cox regression and Fine-Gray competing risk.
There were 464 KTR (mean age 52±13 years, 58% male, median 5 years after transplantation) included in the analyses. The mean estimated glomerular filtration rate was 53±20 ml/min/1.73m2, glycated hemoglobin (HbA1C) 5.7% (IQR 5.4-5.9), and 54% had metabolic syndrome. None of them had diabetes at baseline evaluation. The median prednisolone dose was 10 (IQR 7.5-10)g/day. There were 55% who used calcineurin inhibitor and 2.8% that used mTOR inhibitor for their immunosuppressive medications. The median of each fatty acid concentration was as follow: myristic acid (C14:0) 1.28 (IQR 0.99-1.61) mol%; palmitic acid (C16:0) 24.56 (23.68-25.71) mol%; palmitoleic acid (C16:1n7) 2.29 (IQR 1.83-2.78) mol%; cis-vaccenic Acid (C18:1n7) 1.84 (IQR 1.68-2.06) mol%; stearic acid (C18:0) 6.25 (IQR 5.80-6.73) mol%; oleic acid (c18:1n9) 20.88 (IQR 19.13-22.87) mol%. Over a median follow-up of 5.3 years (IQR 4.9-6.0), 55 KTR (12%) developed PTDM. Higher myristic (C14:0) and palmitic acid (C16:0) concentrations were independently associated with increased risk of development of PTDM (hazard ratio (HR) per standard deviation increase 1.29 [95% Confidence Interval (CI) 1.04-1.60, p=0.018]; and 1.33 [95% CI: 1.06-1.67, p=0.015], respectively). These associations remained statistically significant after accounting for the competing risks of mortality and graft failure (subdistribution Hazard Ratio (sHR) [95% CI] per standard deviation increase = 1.26 [95% CI 1.03-1.55, p=0.027] and 1.33 [95% CI 1.06-1.67, p=0.018], respectively) (Table 1). No significant associations were observed between the stearic (C18:0), cis-vaccenic (C18:1n7), or oleic acid (C18:1n9) and PTDM.
Higher concentrations of palmitic and myristic acids were associated with increased PTDM risk, supporting their role as potential biomarkers and implicating DNL-related fatty acids in PTDM pathogenesis.
