Influence of Long Term Cyclosporine Therapy on Insulin and Its Precursors Secretion in Patients after Heart Transplantation
Teresa Zielinska, Michal Zakliczynski, Marta Szewczyk, Aleksandra Zielinska-Kukla, Jerzy Foremny, Zbigniew Kalarus, Zbigniew Religia, Marian Zembala
Ann Transplant 2003; 8(1): 10-12
Diabetes mellitus is a very well recognized risk factor for coronary artery disease in non-transplant patients. With the introduction of new immunosuppressive agents in solid organ recipients, there is an interest in medical complications of immunosuppressive therapy. An influence of long-term cyclosporine-A (CyA) therapy on glucose metabolism was analyzed in a group of 122 heart transplant recipients who developed hyperglycemia after heart transplantation. Based on WHO criteria for diagnosis of diabetes two groups were identified: group 1 (102 pts) included pts with impaired glycemic control and group 2 (20 pts) with clinical diabetes. Fasting insulin, proinsulin, C-peptide, HbA1c and cyclosporine-A trough levels were determined 12-18 months post surgery in clinically stable period without transplant rejection. The immunosuppressive treatment in both groups was the same and consisted of cyclosporine A, azathioprine and prednisone. We observed a statistically significant negative correlation between CyA concentration and insulin in both groups, a statistically significant negative correlation between CyA concentration and proinsulin, C-peptide blood level in group 1and statistically significant positive correlation between CyA and glucose blood level in both groups.
Keywords: Heart Transplantation, Cyclosporine-A, diabetes, Insulin