Obesity, adiponectin and inflammation as predictors of new-onset diabetes mellitus after kidney transplantation

B. Bayés, M. L. Granada, M. C. Pastor, R. Lauzurica, I. Salinas, A. Sanmartí, A. Espinal, A. Serra, M. Navarro, J. Bonal, R. Romero

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67 Citations (Scopus)

Abstract

The high incidence of new-onset diabetes mellitus after transplantation (NODAT) suggests the need to find new factors to explain the pathogenesis. Our objectives were (1) to confirm that low levels of pre-transplant adiponectin are an independent risk factor for the development of NODAT in a larger transplanted population; (2) to analyze whether adiponectin is a better predictor of NODAT than other inflammatory markers (C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and pregnancy-associated plasma protein A (PAPP-A)) and (3) to assess the relationship between obesity, inflammatory markers and NODAT. One hundred ninety-nine non-diabetic patients (128 men; age: 53 ± 11 years; body mass index (BMI) 24.98 ± 3.76 kg/m2) were included. Pre-transplant plasma glucose, insulin, adiponectin, CRP, TNF-α, IL-6 and PAPP-A were measured. Forty-five patients developed NODAT. Patients with NODAT had a greater BMI (p = 0.005). Adiponectin was lower (p < 0.001) and CRP higher (p = 0.032) in patients with NODAT. Multivariate logistic regression and Cox analysis showed that the calcineurin inhibitor used, pre-transplant BMI and adiponectin were predictors of NODAT. ROC analysis showed that an adiponectin concentration of 11.4 μg/mL had a significant negative prediction for NODAT risk (sensitivity: 81% and specificity: 70%). Of the inflammatory markers studied, adiponectin proved to be an independent predictor of NODAT. © 2006 The Authors.
Original languageEnglish
Pages (from-to)416-422
JournalAmerican Journal of Transplantation
Volume7
Issue number2
DOIs
Publication statusPublished - 1 Feb 2007

Keywords

  • Adiponectin
  • CRP
  • IL-6
  • Inflammation
  • Kidney transplantation
  • New-onset diabetes mellitus after transplantation (NODAT)
  • Obesity
  • PAPP-A
  • TNF-α

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