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      Seasonal Variation of Serum Lipid Levels in Stable Renal Transplant Recipients

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          Abstract

          Background/Aims: Seasonal variation in lipid levels is well described in the general population, but has not been examined in renal transplant recipients (RTR). We sought to determine whether seasonal differences exist in RTR, a group at high risk for hyperlipidemia. Methods: We reviewed our population of 920 adults, identifying primary allograft recipients with survival ≧1 year, stable function, and ≧1 pair of post-6 months ‘winter’ (December 21 to March 20) plus ‘summer’ (June 21 to September 22) fasting lipid measurements within the same year. Correlations between factors affecting lipids and lipid level change were followed by multiple linear regression analysis. Results: 243 patients contributed 344 pairs. When most recent seasonal pair (n = 243) and all pairs (n = 344) were separately analyzed, no seasonal total cholesterol difference (winter vs. summer) was seen (5.08 vs. 5.05 mmol/l, p = 0.80; 5.11 vs. 5.09 mmol/l, p = 0.81 respectively). Opposing variation was seen between hyperlipidemic and nonhyperlipidemic patients (0.08 vs. –0.18 mmol/l for winter minus summer, p = 0.02). In multivariate analysis, seasonal cholesterol variation was predicted by level (p < 0.0001) and hemoglobin change (p = 0.01), while triglyceride variation was predicted only by level (p = 0.01). Conclusion: RTR do not exhibit seasonal variation in lipids, unlike the general population. Factors unique to RTR such as immunosuppressive therapies may act to suppress any seasonal effects.

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          Most cited references 12

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          Seasonal variation in serum cholesterol levels: treatment implications and possible mechanisms.

          A variety of studies have noted seasonal variation in blood lipid levels. Although the mechanism for this phenomenon is not clear, such variation could result in larger numbers of people being diagnosed as having hypercholesterolemia during the winter. We conducted a longitudinal study of seasonal variation in lipid levels in 517 healthy volunteers from a health maintenance organization serving central Massachusetts. Data collected during a 12-month period for each individual included baseline demographics and quarterly anthropometric, blood lipid, dietary, physical activity, light exposure, and behavioral information. Data were analyzed using sinusoidal regression modeling techniques. The average total cholesterol level was 222 mg/dL (5.75 mmol/L) in men and 213 mg/dL (5.52 mmol/L) in women. Amplitude of seasonal variation was 3.9 mg/dL (0.10 mmol/L) in men, with a peak in December, and 5.4 mg/dL (0.14 mmol/L) in women, with a peak in January. Seasonal amplitude was greater in hypercholesterolemic participants. Seasonal changes in plasma volume explained a substantial proportion of the observed variation. Overall, 22% more participants had total cholesterol levels of 240 mg/dL or greater (> or =6.22 mmol/L) in the winter than in the summer. This study confirms seasonal variation in blood lipid levels and suggests greater amplitude in seasonal variability in women and hypercholesterolemic individuals, with changes in plasma volume accounting for much of the variation. A relative plasma hypervolemia during the summer seems to be linked to increases in temperature and/or physical activity. These findings have implications for lipid screening guidelines. Further research is needed to better understand the effects of a relative winter hemoconcentration.
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            Seasonal variation in coronary heart disease in Scotland.

            Seasonality of coronary heart disease (CHD) was examined to determine whether fatal and non-fatal disease have the same annual rhythm. Time series analysis was carried out on retrospective data over a 10 year period and analysed by age groups ( 75 years) and gender. Data by month were obtained for the years 1962-71. The Registrar General provided information on deaths and the Research and Intelligence Unit of the Scottish Home and Health Department on hospital admissions. In Scotland, between 1962 and 1971, 123 000 patients were admitted to hospital for CHD, of whom 29 000 died. There were a further 97 000 CHD deaths outside hospital. These two groups were also examined as one (coronary incidence) - that is, all coronary deaths and coronary admissions discharged alive. STATISTICAL ANALYSIS AND MAIN RESULTS: Where there was a single annual peak, the sine curve was analysed by cosinor analysis. When there were two peaks the analysis was by normal approximation to Poisson distribution. In younger men (under 45 years) admitted to hospital there was a dominant spring peak and an autumn trough. A bimodal pattern of spring and winter peaks was evident for hospital admissions in older male age groups: with increasing age the spring peak diminished and the winter peak increased. In contrast, female hospital admissions showed a dominant winter/summer pattern of seasonal variation. In male and female CHD deaths seasonal variation showed a dominant pattern of winter peaks and summer troughs, with the winter peak spreading into spring in the two youngest male age groups. CHD incidence in women showed a winter/summer rhythm, but in men the spring peak was dominant up to the age of 55. The male, age related spring peak in CHD hospital admissions suggests there is an androgenic risk factor for myocardial infarction operating through an unknown effector mechanism. As age advances and reproduction becomes less important, the well defined winter/summer pattern of seasonal variation of CHD is superimposed, and shows a close relationship with the environment, especially temperature, or the autumn and early winter fall in temperature.
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              Hyperlipidemia in solid organ transplantation.

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                Author and article information

                Journal
                NEC
                Nephron Clin Pract
                10.1159/issn.1660-2110
                Nephron Clinical Practice
                S. Karger AG
                1660-2110
                2007
                February 2007
                16 January 2007
                : 105
                : 3
                : c126-c131
                Affiliations
                aDivision of Nephrology, Department of Medicine, University of Toronto, and bRenal Transplant Program, St. Michael’s Hospital, Toronto, Ont., Canada
                Article
                98644 Nephron Clin Pract 2007;105:c126–c131
                10.1159/000098644
                17228172
                © 2007 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Tables: 5, References: 21, Pages: 1
                Product
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/98644
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