Leptin – A new marker for development of post-transplant diabetes mellitus?

Abstract

IntroductionObese patients have increased leptin production and selective resistance to its central anti-adipogenic effects, yet its pro-inflammatory immunostimulating effects persist. Material and methodsIn a group of 70 patients who underwent primary kidney transplantation (KT) we examined adiponectin and leptin levels at the time of KT and 6 months post-transplantation. Patients with diabetes mellitus type 1 or type 2 at the time of KT were excluded from the study. ResultsWe found that leptin levels significantly increased during the post-transplant period (P = 0.0065). Overall, leptin levels were positively correlated with the level of triacylglycerols, post-transplant diabetes mellitus (PTDM) development and acute rejection (AR). We discovered that, in particular, high leptin levels were associated with AR [OR 2.1273; 95% CI 1.0130–4.4671 (P = 0.0461)] and PTDM development [OR 7.200; 95% CI 1.0310–50.2836 (P = 0.0465)], whereas, low adiponectin levels represent a risk factor for the development of insulin resistance [HR 38.6135; 95% CI 13.3844–67.7699 (P < 0.0001)] and obesity [HR 3.0821; 95% CI 0.8700–10.9192 (P = 0.0053)]. ConclusionWe found that a high serum concentration of leptin before KT is associated with both PTDM development and AR and merits further investigation in relation to KT.