To analyze whether tacrolimus can affect the expression of peroxisome proliferator-activated receptor-γ (PPAR- γ) in peripheral blood mononuclear cell (PBMC) of renal transplantation recipients after transplantation, to validate whether the above process participates in the occurrence of the new onset diabetes after transplantation (NODAT).

The clinical data of 255 patients who underwent renal transplantation and took tacrolimus after transplantation in the First Aaffiliated Hospital of Wenzhou Medical University from 2011 to 2015 were analyzed retrospectively, among which 49 recipients were diagnosed with NODAT according to the diagnostic criteria released by American Diabetes Association (2014 edition). According to the selection criteria, 30 of the 49 recipients with NODAT were divided into the NODAT group; and 30 recipients of 206 recipients without NODAT were matched with the NODAT group at 1 ∶1 according to sex, age, time after transplantation and glucocorticoid dosage, these recipients were selected as the control group. PBMC was isolated and the total mRNA were extracted by TRIzol, and then the cDNA was synthesized by reverse transcription. The expression of PPAR-γ in PBMC was detected by quantitative PCR. Paired t-test was used to compare the age, body mass index, high density lipoprotein (HDL), serum creatinine, blood concentration of tacrolimus and relative expression of whole blood PPAR-γ between the two groups. The chi-square test was used to compare the proportion of NODAT in different gender recipients. P<0.05 was considered statistically significant.

The incidence of NODAT was 19.2%(49/255), the ratios of female and male recipients were 9.2% (7/76) and 23.5% (42/179) respectively, which had statistical difference (χ²=6.094, P<0.05). Thirty recipients in NODAT group were treated with hypoglycemic drugs or insulin to control blood glucose. The average fasting blood glucose was (5.2±0.8) mmoL/L.There was no significant difference in age, body mass index, HDL, serum creatinine and blood concentration of tacrolimus between the two groups (t=1.50, 2.03, 0.78, 0.72 and -0.67, P all >0.05). The immunosuppressive regimen of two groups was tacrolimus+ mycophenolate mofetil+ glucocorticoid. During the half-year follow-up period, the glucocorticoid dosage between the NODAT group and the control group was (5.0±1.7) and (5.0±1.4) mg/d respectively, which had no significant difference (t=0.00, P>0.05). The relative expression of PPAR-γ in PBMC of NODAT group and control group was (0.37±0.04) and (0.49±0.04) respectively, which had significant difference (t=2.064, P<0.05).

Tacrolimus may participate in the occurrence of NODAT by surpressed the expression of PPAR-γ in PBMC.