Adipokines in type 1 diabetes after successful pancreas transplantation: normal visfatin and retinol-binding-protein-4, but increased total adiponectin fasting concentrations

MariettaStadler*,†,‡,AngelaStorka§,EvaAnnaTheuer†,MichaelKrebs–,ElenaVojtassakova§,PeterNowotny–,GiovanniPacini**,ThomasKa¨stenbauer†,AntonLuger–,RudolfPrager*,†,MichaelWolzt§andChristianAnderwald§,–*HietzingHospital,ThirdMedicalDepartmentofMetabolicDiseasesandNephrology,Vienna,Austria,†KarlLandsteinerInstituteofMetabolicDiseasesandNephrology,Vienna,Austria,‡MedicalUniversityVienna,DepartmentofEmergencyMedicine,Vienna,Austria,§MedicalUniversityVienna,DepartmentofClinicalPharmacology,Vienna,Austria,–MedicalUniversityVienna,DivisionofEndocrinologyandMetabolism,DepartmentofInternalMedicine3,Vienna,Austria,**MetabolicUnit,InstituteofBiomedicalEngineering,ISIB-CNR,Padua,ItalySummaryObjectiveIntype1diabetesmellitus(T1DM),thereleaseofmanyhormones, not only from beta-cells, but also from adipocytes(adipokines) may be altered. After successful pancreas–kidney-transplantation(PKTx),T1DMpatientscanreverttoanondiabeticmetabolism, but it is unclear whether alterations of adipokines arestillpresentafterPKTx.Design, patients and measurementsConcentrations ofadipokines [visfatin, retinol-binding protein-4 (RBP-4), adiponec-tin, high molecular weight (HMW) adiponectin] were measured atfasting in 10 PKTx and in 19 T1DM. Nondiabetic healthy controls(CON, n = 9) and six nondiabetic patients after kidney transplan-tation (KTx) were examined as control groups. In PKTx, KTx andCON, indices of insulin sensitivity (OGIS) and beta cell function(adaptationindex,AI)werecalculatedfrom75 goralglucosetoler-ancetest(OGTT)data.Results Fasting serum visfatin (T1DM: 56 ± 4 lg/l, PKTx:42 ± 6 lg/l, KTx: 39 ± 3 lg/l, CON: 40 ± 3 lg/l) and RBP-4(T1DM: 490 ± 26 lg/l, PKTx: 346 ± 39 lg/l, KTx: 401 ± 13 lg/l,CON: 359 ± 36 lg/l) was increased by 40% and 36%, respectively(each P <0AE03) in T1DM only. Levels were positively correlatedwith HbA1c in all subjects (visfatin: r =0AE43, P <0AE004; RBP-4:r =0AE46, P <0AE03). Fasting plasma adiponectin was 80% higher inT1DM and in PKTx (T1DM: 18 ± 2 mg/l, PKTx: 18 ± 3 mg/l,KTx:12 ± 3 mg/l,CON:10 ± 1 mg/l;P <0AE04)andwaspositivelycorrelated with diabetes duration (r =0AE37, P <0AE02). HMW/totaladiponectin ratio was increased in T1DM (P <0AE02). PKTxdisplayed a normoglycaemic metabolism as insulin sensitive asCON,butAIwaslowerthaninCONandKT(P <0AE01).Conclusions T1DM after successful PKTx show normal fastingvisfatin and RBP-4 levels and HMW-adiponectin/adiponectin-ratio, whichareelevated in T1DM, whereas totaladiponectin levelsaresimilarlyincreasedinT1DMandPKTxpatients.(Received 10 March 2009; returned for revision 26 March 2009;finallyrevised22June2009;accepted9September2009)IntroductionIn type 1 diabetes mellitus (T1DM), evidence has been providedfor altered release of hormones from adipocytes (adipokines).