Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/29870
Full metadata record
DC FieldValueLanguage
dc.contributor.authorChan, Winnieen_UK
dc.contributor.authorBosch, Jos Aen_UK
dc.contributor.authorPhillips, Anna Cen_UK
dc.contributor.authorChin, Shui Haoen_UK
dc.contributor.authorAntonysunil, Adaikalaen_UK
dc.contributor.authorInston, Nicholasen_UK
dc.contributor.authorMoore, Sueen_UK
dc.contributor.authorKaur, Okdeepen_UK
dc.contributor.authorMcTernan, Philip Gen_UK
dc.contributor.authorBorrows, Richarden_UK
dc.date.accessioned2019-07-17T00:01:30Z-
dc.date.available2019-07-17T00:01:30Z-
dc.date.issued2018-01en_UK
dc.identifier.urihttp://hdl.handle.net/1893/29870-
dc.description.abstractObjective Cardiovascular disease is the leading cause of death in kidney transplant recipients (KTRs), yet incompletely accountable by traditional risk factors. Inflammation is an unconventional cardiovascular risk factor, with gut-derived endotoxemia potentially driving inflammation and endothelial disease. Comparable data are lacking in kidney transplantation. This study investigated the associations of endotoxemia with inflammation, endothelial activation, and 5-year cardiovascular events in KTRs. Determinants of endotoxemia were also explored. Design and Methods This is a single-center cross-sectional study with prospective follow-up from a prevalent cohort of 128 KTRs. Main Outcome Measures Demographic, nutritional and clinical predictors of inflammation (high-sensitivity C-reactive protein [hsCRP]), endothelial activation (sE-selectin), and endotoxemia (endotoxin) were assessed. Follow-up data on 5-year cardiovascular event rates were collected. Results Endotoxemia (P = .03), reduced 25-hydroxyvitamin D (P = .04), high fructose intake (P < .001), decreased fiber intake (P < .001), and abdominal obesity (P = .002) were independently associated with elevated hsCRP. In turn, endotoxemia (P = .007) and increasing hsCRP (P = .02) were both independently associated with raised sE-selectin. Furthermore, endotoxemia predicted increased cardiovascular event rate (P = .02), independent of hsCRP and a global measure of cardiovascular risk estimated by a validated algorithm of 7-year risk for major adverse cardiac events in kidney transplantation. Determinants of endotoxemia included reduced 25-hydroxyvitamin D (P < .001), hypertriglyceridemia (P < .001), increased fructose intake (P = .01), and abdominal obesity (P = .01). Conclusions Endotoxemia in KTRs contributes to inflammation, endothelial activation, and increased cardiovascular events. This study highlights the clinical relevance of endotoxemia in KTRs, suggesting future interventional targets.en_UK
dc.language.isoenen_UK
dc.publisherElsevier BVen_UK
dc.relationChan W, Bosch JA, Phillips AC, Chin SH, Antonysunil A, Inston N, Moore S, Kaur O, McTernan PG & Borrows R (2018) The Associations of Endotoxemia With Systemic Inflammation, Endothelial Activation, and Cardiovascular Outcome in Kidney Transplantation. Journal of Renal Nutrition, 28 (1), pp. 13-27. https://doi.org/10.1053/j.jrn.2017.06.004en_UK
dc.rightsAccepted refereed manuscript of: Chan W, Bosch JA, Phillips AC, Chin SH, Antonysunil A, Inston N, Moore S, Kaur O, McTernan PG & Borrows R (2018) The Associations of Endotoxemia With Systemic Inflammation, Endothelial Activation, and Cardiovascular Outcome in Kidney Transplantation. Journal of Renal Nutrition, 28 (1), pp. 13-27. DOI: https://doi.org/10.1053/j.jrn.2017.06.004 © 2017, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/en_UK
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/en_UK
dc.subjectEndotoxemiaen_UK
dc.subjectInflammationen_UK
dc.subjectEndothelial Activationen_UK
dc.subjectCardiovascularen_UK
dc.subjectKidney Transplantationen_UK
dc.titleThe Associations of Endotoxemia With Systemic Inflammation, Endothelial Activation, and Cardiovascular Outcome in Kidney Transplantationen_UK
dc.typeJournal Articleen_UK
dc.rights.embargodate2019-07-16en_UK
dc.identifier.doi10.1053/j.jrn.2017.06.004en_UK
dc.identifier.pmid29089280en_UK
dc.citation.jtitleJournal of Renal Nutritionen_UK
dc.citation.issn1051-2276en_UK
dc.citation.volume28en_UK
dc.citation.issue1en_UK
dc.citation.spage13en_UK
dc.citation.epage27en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusAM - Accepted Manuscripten_UK
dc.contributor.funderUniversity of Birminghamen_UK
dc.author.emaila.c.whittaker@stir.ac.uken_UK
dc.citation.date28/10/2017en_UK
dc.contributor.affiliationUniversity of Birminghamen_UK
dc.contributor.affiliationUniversity of Birminghamen_UK
dc.contributor.affiliationUniversity of Birminghamen_UK
dc.contributor.affiliationUniversity of Leicesteren_UK
dc.contributor.affiliationUniversity of Warwicken_UK
dc.contributor.affiliationUniversity Hospitals Birminghamen_UK
dc.contributor.affiliationUniversity Hospitals Birminghamen_UK
dc.contributor.affiliationImperial College Londonen_UK
dc.contributor.affiliationUniversity of Warwicken_UK
dc.contributor.affiliationUniversity of Birminghamen_UK
dc.identifier.isiWOS:000424138500004en_UK
dc.identifier.scopusid2-s2.0-85032357215en_UK
dc.identifier.wtid1410976en_UK
dc.contributor.orcid0000-0002-2070-8490en_UK
dc.contributor.orcid0000-0002-5461-0598en_UK
dc.date.accepted2017-09-01en_UK
dc.date.filedepositdate2019-07-12en_UK
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles

Files in This Item:
File Description SizeFormat 
Chan_et_al_The_associations_of_endotexemia_Journal_of_Renal_Nutrition_2017.pdfFulltext - Accepted Version1.13 MBAdobe PDFView/Open


This item is protected by original copyright



A file in this item is licensed under a Creative Commons License Creative Commons

Items in the Repository are protected by copyright, with all rights reserved, unless otherwise indicated.

If you believe that any material held in STORRE infringes copyright, please contact library@stir.ac.uk providing details and we will remove the Work from public display in STORRE and investigate your claim.