title: Metabolic and hormonal effects of tacrolimus (FK506) or cyclosporin immunosuppression following renal transplantation.
abstract: Twelve renal transplant recipients randomised to receive immunosuppression with either tacrolimus (FK506) or cyclosporin underwent oral glucose tolerance tests (OGTT) a median of 8 months (range 7-9) after transplantation. Six healthy subjects acted as controls. Compared with the controls, both transplant groups had significantly elevated fasting (p < 0.05 for both groups) and postprandial (p < 0.001 for tacrolimus and p < 0.05 for cyclosporin) blood glucose concentrations. Fasting hyperinsulinaemia was observed in both transplant groups (p < 0.05) relative to the control subjects. Glucose-stimulated plasma immunoreactive insulin concentrations in the tacrolimus-treatment group were significantly higher than in the cyclosporin group (p < 0.05) and the controls (p < 0.001). Postprandial blood alanine concentrations were also significantly elevated in the tacrolimus group compared with both the controls (p < 0.001) and cyclosporin-treated patients (p < 0.001). The raised insulin concentrations with normal or increased blood glucose concentrations after renal transplantation suggests that insulin resistance was more marked in patients receiving tacrolimus-based immunosuppression.
authors.affiliation: Transplantation Unit, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Dmitrewski
authors.forename: A J
authors.initials: AJ
authors.lastname: Krentz
authors.forename: A D
authors.initials: AD
authors.lastname: Mayer
authors.forename: J A
authors.initials: JA
authors.lastname: Buckels
authors.forename: A D
authors.initials: AD
authors.lastname: Barnes
authors.forename: J
authors.initials: J
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Nattrass
mesh_terms: D000409:Alanine / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood; D016572:Cyclosporine / Q000627:therapeutic use*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D005990:Glycerol / Q000097:blood; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood / Q000378:metabolism; D007333:Insulin Resistance / Q000276:immunology; D000078790:Insulin Secretion; D007657:Ketone Bodies / Q000097:blood; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D007773:Lactates / Q000097:blood; D019518:Postprandial Period; D011773:Pyruvates / Q000378:metabolism; D012016:Reference Values; D016559:Tacrolimus / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D005230:Fatty Acids, Nonesterified; D007166:Immunosuppressive Agents; D007328:Insulin; D007657:Ketone Bodies; D007773:Lactates; D011773:Pyruvates; D016572:Cyclosporine; D000409:Alanine; D005990:Glycerol; D016559:Tacrolimus