Background: The purpose of this study was to determine whether the level of adiponectin in serum of renal transplant patients is associated with arterial stiffness related to new onset diabetes after transplantation (...Background: The purpose of this study was to determine whether the level of adiponectin in serum of renal transplant patients is associated with arterial stiffness related to new onset diabetes after transplantation (NODAT). Methods: A total of 90 previously non-diabetic patients who underwent renal transplantation between 1999 and 2009 were enrolled. We evaluated their diabetic risk factors, lipid profiles, brachial-ankle pulse wave velocity (baPWV), ankle-brachial blood pressure index (ABPI) and serum adiponectin level before and after transplantation. Results: Eleven (12.2%) patients were diagnosed with NODAT and 79 (87.8%) without (non-NO-DAT). The mean post-transplant serum adiponectin level in NODAT patients was significantly lower than that in non-NODAT patients (11.9 vs. 16.4 μg/ml, p = 0.01), whereas the mean baPWV level in NODAT patients was significantly higher (1686 vs. 1468 cm/s, p = 0.016). We found a significant inverse correlation between mean pre-transplant serum adiponectin and baPWV level (r = -0.27, p = 0.011). Furthermore, patients with lower pretransplant serum adiponectin levels (<20 μg/ml) developed NODAT significantly more frequently than those with higher levels (p = 0.038) and the mean baPWV level in the former was also significantly higher (1520 vs. 1412 cm/s, p = 0.047). Conclusion: Our results indicate that low pre-transplant serum adiponectin level is associated with arterial stiffness in development of NODAT in patients who undergo renal transplantation.展开更多
目的:综述近年来国内外学者对环孢素A和他克莫司诱发移植后新发糖尿病的机制研究,为临床合理用药提供依据。方法:检索国内外相关文献,进行整理和综合分析。结果:NODAT(new-onset diabetes after transplantation)即移植后新发糖尿病,也...目的:综述近年来国内外学者对环孢素A和他克莫司诱发移植后新发糖尿病的机制研究,为临床合理用药提供依据。方法:检索国内外相关文献,进行整理和综合分析。结果:NODAT(new-onset diabetes after transplantation)即移植后新发糖尿病,也称PTDM(post-transplant diabetes mellitus),是器官移植患者常见、严重的并发症。NODAT发病的危险因素包括年龄、性别、高剂量类固醇、体重指数、家族史和免疫抑制剂,其中免疫抑制剂的使用是发病的高危因素。环孢素A和他克莫司是两种主要的免疫抑制剂,应用免疫抑制剂可以减少移植后急性排斥反应的发生率,提高患者的生存率,但使用免疫抑制剂会诱发NODAT,他克莫司导致NODAT发生率高于环孢素A,具体机制目前尚无定论。结论:临床医生可以根据他克莫司导致NODAT发生率高于环孢素A的机制,制定合理的给药方案。展开更多
文摘Background: The purpose of this study was to determine whether the level of adiponectin in serum of renal transplant patients is associated with arterial stiffness related to new onset diabetes after transplantation (NODAT). Methods: A total of 90 previously non-diabetic patients who underwent renal transplantation between 1999 and 2009 were enrolled. We evaluated their diabetic risk factors, lipid profiles, brachial-ankle pulse wave velocity (baPWV), ankle-brachial blood pressure index (ABPI) and serum adiponectin level before and after transplantation. Results: Eleven (12.2%) patients were diagnosed with NODAT and 79 (87.8%) without (non-NO-DAT). The mean post-transplant serum adiponectin level in NODAT patients was significantly lower than that in non-NODAT patients (11.9 vs. 16.4 μg/ml, p = 0.01), whereas the mean baPWV level in NODAT patients was significantly higher (1686 vs. 1468 cm/s, p = 0.016). We found a significant inverse correlation between mean pre-transplant serum adiponectin and baPWV level (r = -0.27, p = 0.011). Furthermore, patients with lower pretransplant serum adiponectin levels (<20 μg/ml) developed NODAT significantly more frequently than those with higher levels (p = 0.038) and the mean baPWV level in the former was also significantly higher (1520 vs. 1412 cm/s, p = 0.047). Conclusion: Our results indicate that low pre-transplant serum adiponectin level is associated with arterial stiffness in development of NODAT in patients who undergo renal transplantation.
