Tacrolimus and angiotensin receptor blockers associated with changes in serum adiponectin level in new-onset diabetes after renal transplantation: single-center cross-sectional analysis.

We analysed whether pre- and post-transplant serum adiponectin levels in renal transplant patients were associated with new-onset diabetes after transplantation (NODAT). The mean post-transplant follow-up duration was 47.9 months. Of 98 previously non-diabetic renal transplant patients, 12 were diagnosed with NODAT and 86 without (non-NODAT). There was a significant inverse correlation between mean post-transplant serum adiponectin level and homeostasis model assessment for insulin resistance (HOMA-IR) (r = -0.22, P = 0.03), and a positive correlation between follow-up duration after transplantation and HOMA-IR (r = 0.28, P = 0.005). The mean pre- and post-transplant serum adiponectin levels in NODAT patients were significantly lower than those in non-NODAT patients (13.3 vs. 21.0 microg/ml and 13.0 vs. 16.4 microg/ml, P = 0.01 and 0.03 respectively). In addition, the post-transplant serum adiponectin level in patients treated with tacrolimus (TAC) was significantly lower than that in patients with cyclosporine (14.3 vs. 18.7 microg/ml, P = 0.01), while, that level in patients treated with angiotensin receptor blockers (ARB) was significantly higher than that in patients without treatment of ARB (17.9 vs. 14.7 microg/ml, P = 0.01). Our results indicate that post-transplant serum adiponectin levels are decreased after transplantation in association with insulin resistance in the development of NODAT, and that TAC and ARB influence the level of adiponectin in serum.