Effects of systemic delivery of insulin on plasma lipids and lipoprotein concentrations in pancreas transplant recipients.
OBJECTIVE
To determine whether pancreas transplantation alters lipid and lipoprotein concentrations and whether peripheral hyperinsulinemia is always associated with altered lipid levels.


METHODS
We assessed the lipid profiles of seven pancreas-kidney recipients with insulin-dependent diabetes mellitus, seven kidney recipients without diabetes who received the same immunosuppressive agents, and eight normal subjects.


METHODS
In the three study groups, fasting and postprandial plasma glucose, insulin, C-peptide, cholesterol, triglyceride, free fatty acid, and apolipoprotein A-I, A-II, C-II, and C-III concentrations were determined.


RESULTS
Fasting and postprandial glucose concentrations did not differ between the two transplant groups; however, peripheral insulin concentrations were twice as high (P < 0.05) in the pancreas-kidney recipients as in the kidney recipients both before (102 +/- 15 versus 53 +/- 6 pmol/L) and after (123 +/- 22 versus 61 +/- 6 nmol/L per 6 hours) ingestion of a meal. Preprandial and postprandial insulin levels in both transplant groups also were greater (P < 0.05) than those in normal subjects (35 +/- 6 pmol/L and 40 +/- 7 nmol/L per 6 hours, respectively). Despite significant differences in insulin concentrations, no differences were noted in total cholesterol, high-density or low-density lipoprotein cholesterol, plasma free fatty acids, or apolipoprotein A-I, A-II, C-II, and C-III concentrations among the study groups. Plasma triglyceride concentrations in the two transplant groups were similar (114 +/- 20 versus 142 +/- 18 mg/dL) and were slightly more than those in the normal subjects (80 +/- 7 mg/dL).


CONCLUSIONS
Despite peripheral hyperinsulinemia, pancreas transplantation can result in normal or near-normal lipid and lipoprotein concentrations. Thus, systemic delivery of insulin does not invariably produce an atherogenic lipid profile.
Katz
H H
HH
Division of Endocrinology/Metabolism and Internal Medicine, Mayo Clinic Rochester, MN 55905.
Nguyen
T T
TT
Velosa
J A
JA
Robertson
R P
RP
Rizza
R A
RA
D000328:Adult; D001053:Apolipoproteins / Q000032:analysis*; D001786:Blood Glucose / Q000032:analysis*; D002096:C-Peptide / Q000097:blood; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D004435:Eating; D005215:Fasting; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood* / Q000209:etiology; D007328:Insulin / Q000097:blood*; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000502:physiology*; D014280:Triglycerides / Q000097:blood*
D001053:Apolipoproteins; D001786:Blood Glucose; D002096:C-Peptide; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol