New-onset diabetes after
renal transplantation (NODAT) is known to be a potent risk factor for cardiovascular events. We therefore investigated the incidence and risk factors for NODAT, and evaluated
surrogate endpoints of
atherosclerosis in Japanese patients with stable renal function after
renal transplantation. Seventy-nine patients were enrolled in the study, and a 75 g oral
glucose tolerance test (OGTT) was performed in subjects excluding patients with known NODAT. We evaluated the risk factors for NODAT and the degree of
atherosclerosis, determined by brachial-ankle pulse wave velocity (baPWV), ankle-brachial blood pressure index (ABPI) and intima-media thickness (IMT) of the carotid artery. Eleven patients diagnosed as NODAT had significantly higher fasting plasma
glucose before
transplantation, blood pressure, and incidence of hepatitis C virus (HCV)
infection than patients without NODAT. Multivariate regression analysis revealed that the independent determinant of NODAT was fasting plasma
glucose pre-
transplantation, HCV
infection and systolic blood pressure. The baPWV in patients with NODAT was significantly higher compared to that in patients without NODAT. In addition, the independent determinant of baPWV evaluated by multivariate regression analysis was an increase in systolic blood pressure and age, and a decrease of
adiponectin levels. In conclusion, we found that high fasting plasma
glucose prior to
transplantation, HCV
infection and
high blood pressure are risk factors for NODAT in Japanese patients after
renal transplantation. Since NODAT patients have advanced arterial stiffness probably due to
high blood pressure, strict control of blood pressure will be important for preventing the development of
cardiovascular disease in NODAT.