[Improvement of insulin sensitivity after renal transplantation measured by a glucose clamp technique].
There is much evidence indicating that indicates end-stage renal failure induces insulin resistance. We examined the effects of renal transplantation on insulin resistance with an insulin clamp technique. Insulin sensitivity and insulin secretion rates were measured in 13 renal transplant patients, 7 hemodialysis patients, and 6 healthy controls. Insulin sensitivity was assessed with the euglycemic insulin clamp technique. The clamp was applied for 120 minutes and the average of the glucose disposal rates measured from 90 to 120 minutes was regarded as insulin sensitivity. There was a significant increase in the glucose disposal rate in the renal transplantation patients (6.67 +/- 1.44 mg/kg/min) compared to the hemodialysis patients (4.54 +/- 1.44 mg/kg/min) (p < 0.05). Also, there was a significant decrease in the glucose disposal rates in the hemodialysis patients (4.45 +/- 1.44 mg/kg/min) compared to the healthy controls (7.25 +/- 2.07 mg/kg/min) (p < 0.05). There was no significant difference in the glucose disposal rates between the renal transplant patients and the healthy controls. However, patients treated with beta-blockers had lower glucose disposal rates compared to patients without beta-blockers (4.67 +/- 1.58 vs 6.67 +/- 1.44 mg/kg/min, p < 0.05). In this study, we found that insulin resistance, shown by the euglycemic insulin clamp technique, was recovered after successful renal transplantation that but, beta-blockers affected insulin resistance. In conclusion shows that, the hyperglycemic clamp technique, although many factors such as medication may affect insulin sensitivity, renal transplantation restores insulin resistance found in renal failure patients, but not insulin secretion.
Shimizu
M
M
Second Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Iino
Y
Y
Terashi
A
A
D000328:Adult; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007333:Insulin Resistance; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged