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

Add Comment 0 Comments

In Press

Original article  

Prognostic Nutritional Index Trajectories Predict Kidney Function in Kidney Transplant Recipients: A Latent...

Ann Transplant In Press; DOI: 10.12659/AOT.947388  

Original article  

Impact of Preoperative Treatment on Donor Hepatic Steatosis in Living Donor Liver Transplantation

Ann Transplant In Press; DOI: 10.12659/AOT.947772  

Original article  

Effects of Donor-Recipient Race Matching on Kidney Transplant Survival

Ann Transplant In Press; DOI: 10.12659/AOT.947720  

Most Viewed Current Articles

03 Jan 2023 : Original article   6,962

Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...

DOI :10.12659/AOT.938467

Ann Transplant 2023; 28:e938467

15 Aug 2023 : Review article   6,947

Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ Transplantation

DOI :10.12659/AOT.939750

Ann Transplant 2023; 28:e939750

16 May 2023 : Original article   6,717

Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...

DOI :10.12659/AOT.939258

Ann Transplant 2023; 28:e939258

28 May 2024 : Original article   6,132

Effect of Dexmedetomidine Combined with Remifentanil on Emergence Agitation During Awakening from Sevoflura...

DOI :10.12659/AOT.943281

Ann Transplant 2024; 29:e943281

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