Increased cardiovascular disease (CVD) risk is a clinically significant feature of type I diabetes (T1D). Several CVD markers were shown to regress or stabilize after functionally curing T1D via islet cell transplant (ICT), yet the inverse is unknown: does recipients’ CVD health at first ICT predict clinical outcomes following ICT. In 30 patients receiving 1-3 ICTs, CVD markers and basic labs were measured at first ICT (e.g., lipids, blood pressure, blood counts/chemistries, and carotid intima-media thickness [CIMT]), along with clinical outcomes (e.g., C-peptide/insulin from four distinct metabolic tests) measured serially after first ICT (mean [range] 2.1 [0.3-8.7] years). Multivariable regression of repeated measures determined longitudinal associations, adjusting for recipient demographics, BMI, ICT number, and islet equivalents transplanted. Mean (SD) age, T1D duration, and BMI at first ICT were 47.3 (11.5) and 29.4 (12.0) years, and 22.9 (1.9), respectively; 80% female. Lower LDL/HDL pre-ICT predicted greater fasting C-peptide (n=759 observations, p=0.01) and multiple measures of stimulated C-peptide and insulin (n=68-76, all p≤0.04); lower triglycerides pre-ICT (n=811, p=0.003) and systolic blood pressure day of first ICT (n=1142, p=0.007) predicted greater fasting C-peptide. Low (normal) hemoglobin and percent eosinophils the day of first ICT also predicted greater fasting C-peptide (n=1142, all p=0.002) and stimulated C-peptide and insulin (n=73-107, all p≤0.048). Lower recipient CIMT pre-ICT predicted greater acute insulin response post-ICT (n=42, p=0.04). Multiple traditional CVD protective factors, along with lower hemoglobin and eosinophils (both recently shown to be CVD protective factors), at first ICT predicted better outcomes. These results may be clinically significant as improving CVD health pre-ICT (e.g., with diet, exercise, and/or medications) may further support its success.
K.K. Danielson: None. R.S. Monson: None. Y. Li: None. B. Rydzon: None.
