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


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

Add Comment 0 Comments

In Press

14 Mar 2024 : Case report  

Treatment of Cavernous Transformation of Portal Vein Caused by Hepatic Cystic Echinococcosis Using Ex Vivo ...

Ann Transplant In Press; DOI: 10.12659/AOT.942358  

15 Mar 2024 : Review article  

Approaches and Challenges in the Current Management of Cytomegalovirus in Transplant Recipients: Highlighti...

Ann Transplant In Press; DOI: 10.12659/AOT.941185  

18 Mar 2024 : Original article  

Does Antibiotic Use Increase the Risk of Post-Transplantation Diabetes Mellitus? A Retrospective Study of R...

Ann Transplant In Press; DOI: 10.12659/AOT.943282  

20 Mar 2024 : Original article  

Transplant Nephrectomy: A Comparative Study of Timing and Techniques in a Single Institution

Ann Transplant In Press; DOI: 10.12659/AOT.942252  

Most Viewed Current Articles

05 Apr 2022 : Original article  

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

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

22 Nov 2022 : Original article  

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

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