Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

26 September 2012

Influence of conversion from cyclosporine A to tacrolimus on insulin sensitivity assessed by euglicaemic hyperinsulinemic clamp technique in patients after kidney transplantation

Maciej BułanowskiABCDEF, Jerzy ChudekC, Andrzej WięcekABCDEF

DOI: 10.12659/AOT.883459

Ann Transplant 2012; 17(3): 61-68

Abstract

Background: Recent studies have shown diabetogenic properties of calcineurin inhibitors, but the mechanism of more pronounced diabetogenic effect of tacrolimus (TAC) has not been completely elucidated. The study was designed to answer 2 questions: Does conversion from CyA to TAC influence tissue insulin sensitivity in patients after kidney transplantation? Are there any additional factors influencing insulin sensitivity in these patients?
Material/Methods: Fifteen non-diabetic kidney transplant recipients, receiving CyA-based regimen were recruited to the study. Enrolled patients required conversion to TAC-based treatment due to CyA adverse effects. Euglicaemic-hyperinsulinemic clamp was performed shortly before and 3 months after conversion from CyA to TAC.
Results: Two out of 15 patients developed PTDM shortly after conversion. Mean insulin sensitivity indices: glucose cell uptake (M value) and glucose cell uptake to insulin plasma concentration ratio (M/I) did not change significantly after 3 months of TAC treatment compared to initial values. Significant negative correlations between increase of body mass and both: changes of M values (–0.576; p=0.02) and M/I ratios (–0.819; p<0.001) were observed. Similar correlations were observed between changes of BMI and M values (–0.575; p=0.02) or M/I ratios (–0.800; p<0.001). A significant positive correlation between changes of eGFR values and M/I ratios (0.591; p=0.03) was noted.
Conclusions: Tissue insulin sensitivity estimated by hyperinsulinemic, euglycaemic clamp technique did not change significantly after conversion from CyA to TAC therapy in patients after kidney transplantation. Weight gain and eGFR decrease are associated with decrease of insulin sensitivity in these patients.

Keywords: Kidney Transplantation, Diabetes mellitus, insulin sensitivity, calcineurin inhibitors

0 Comments

In Press

20 Jan 2022 : Original article  

Impact on Waitlist Outcomes from Changes in the Medical Eligibility of Candidates for Simultaneous Liver-Ki...

Ann Transplant In Press; DOI: 10.12659/AOT.934850  

19 Jan 2022 : Original article  

Carbohydrate Metabolism Disorders in Relation to Cardiac Allograft Vasculopathy (CAV) Intensification in He...

Ann Transplant In Press; DOI: 10.12659/AOT.933420  

18 Jan 2022 : Original article  

PLGA+Fe₃O₄+PFP Nanoparticles Drug-Delivery Demonstrates Potential Anti-Tumor Effects on Tumor Cells

Ann Transplant In Press; DOI: 10.12659/AOT.933246  

17 Jan 2022 : Original article  

Impact of Thyroid Incidentaloma on Liver Transplant: A Study of 1010 Recipients at a Single Center

Ann Transplant In Press; DOI: 10.12659/AOT.934988  

Most Viewed Current Articles

29 Dec 2021 : Original article  

Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...

DOI :10.12659/AOT.933588

Ann Transplant 2021; 26:e933588

22 Dec 2021 : Original article  

Comparison of Coronary Artery Calcium Scoring with Dobutamine Stress Echo for Detection of Coronary Artery ...

DOI :10.12659/AOT.934163

Ann Transplant 2021; 26:e934163

12 Jan 2022 : Original article  

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

01 Dec 2021 : Original article  

Solid-Phase C1q/C3d Fixing Readouts Correlate with High Median Fluorescence Intensity (MFI) De Novo Donor-S...

DOI :10.12659/AOT.934175

Ann Transplant 2021; 26:e934175

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358