title: Adiponectin Fractions Influence the Development of Posttransplant Diabetes Mellitus and Cardiovascular Disease in Japanese Renal Transplant Recipients.
abstract: BACKGROUND
  A few studies have investigated the role of adiponectin fraction for cardiovascular disease (CVD) in RTx recipients.
  
  
  METHODS
  We studied 57 adult subjects (39 males, 18 females; 10 cadaveric donors) with at least three years of allograft survival (median 251 months). We examined clinical backgrounds such as treated drugs, blood pressure (BP, mmHg), body mass index (BMI), and blood chemistry including cholesterol (total, LDL-C, HDL-C), glucose, glycated hemoglobin (HbA1c), and serum high and low-molecular-weight (HMW/LMW) ADPN fractions with regard to the associations of the visceral and subcutaneous fat areas on CT scan. We also analyzed the associations of CVD and post-transplant diabetes (PTDM) with ADPN fractions and the fat areas.
  
  
  RESULTS
  The visceral fat area was inversely correlated with serum HMW and LMW ADPN levels and HMW ADPN ratio (r = -0.400, p = 0.002 and r = -0.296, p = 0.025 and r = -0.444, p<0.001, respectively). Furthermore, the visceral fat area was positively with the LMW ADPN ratio (r = 0.467, p<0.001), but no significant correlation was noted between the subcutaneous fat area and the ADPN ratio. On multiple regression analysis, eGFR and the visceral fat area were significant reducing factors of HMW ADPN levels, and the alteration of eGFR was identified as an increasing factor of HMW ADPN levels. Patients with CVD had larger visceral fat area (p = 0.004), lower HMW ADPN ratio (p = 0.022) and higher LMW ADPN ratio (p = 0.049). In addition, the higher HMW ADPN ratio and statin treatment were identified as reducing factors of the development of CVD, but the LDL-C level was an aggravating factor. Moreover, the higher LMW ADPN ratio and the visceral fat area were aggravating factors of PTDM.
  
  
  CONCLUSIONS
  Even in Japanese renal transplant recipients, visceral fat area and ADPN fractions were significant factors for the development of both CVD and PTDM.
authors.affiliation: Department of Nephrology, Kanazawa Medical University School of Medicine, Uchinada, Ishikawa, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Adachi
authors.affiliation: Department of Nephrology, Kanazawa Medical University School of Medicine, Uchinada, Ishikawa, Japan.
authors.forename: Kanae
authors.initials: K
authors.lastname: Nakayama
authors.affiliation: Department of Nephrology, Kanazawa Medical University School of Medicine, Uchinada, Ishikawa, Japan.
authors.forename: Norifumi
authors.initials: N
authors.lastname: Hayashi
authors.affiliation: Department of Nephrology, Kanazawa Medical University School of Medicine, Uchinada, Ishikawa, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Matsui
authors.affiliation: Department of Nephrology, Kanazawa Medical University School of Medicine, Uchinada, Ishikawa, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Fujimoto
authors.affiliation: Department of Nephrology, Kanazawa Medical University School of Medicine, Uchinada, Ishikawa, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Yamaya
authors.affiliation: Department of Radiology, Kanazawa Medical University School of Medicine, Uchinada, Ishikawa, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Tonami
authors.affiliation: Department of Nephrology, Kanazawa Medical University School of Medicine, Uchinada, Ishikawa, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yokoyama
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D001774:Blood Chemical Analysis; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D007564:Japan; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin