title: Influence of long term cyclosporine therapy on insulin and its precursors secretion in patients after heart transplantation.
abstract: Diabetes mellitus is a very well recognized risk factor for coronary artery disease in non-transplant patients. With the introduction of new immunosuppressive agents in solid organ recipients, there is an interest in medical complications of immunosuppressive therapy. An influence of long-term cyclosporine-A (CyA) therapy on glucose metabolism was analyzed in a group of 122 heart transplant recipients who developed hyperglycemia after heart transplantation. Based on WHO criteria for diagnosis of diabetes two groups were identified: group 1 (102 pts) included pts with impaired glycemic control and group 2 (20 pts) with clinical diabetes. Fasting insulin, proinsulin, C-peptide, HbA1c and cyclosporine-A trough levels were determined 12-18 months post surgery in clinically stable period without transplant rejection. The immunosuppressive treatment in both groups was the same and consisted of cyclosporine A, azathioprine and prednisone. We observed a statistically significant negative correlation between CyA concentration and insulin in both groups, a statistically significant negative correlation between CyA concentration and proinsulin, C-peptide blood level in group 1 and statistically significant positive correlation between CyA and glucose blood level in both groups.
authors.affiliation: Dept of Cardiac Surgery & Transplantation, Silesian Centre for Heart Disease, Zabrze, Poland.
authors.forename: Teresa
authors.initials: T
authors.lastname: Zielińska
authors.forename: Michał
authors.initials: M
authors.lastname: Zakliczyński
authors.forename: Marta
authors.initials: M
authors.lastname: Szewczyk
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Zielińska-Kukla
authors.forename: Jerzy
authors.initials: J
authors.lastname: Foremny
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Kalarus
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Religia
authors.forename: Marian
authors.initials: M
authors.lastname: Zembala
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000008:administration & dosage* / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D016027:Heart Transplantation; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D007329:Insulin Antagonists / Q000008:administration & dosage* / Q000009:adverse effects*; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011384:Proinsulin / Q000037:antagonists & inhibitors / Q000097:blood / Q000378:metabolism*
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D003404:Creatinine; D016572:Cyclosporine; D006442:Glycated Hemoglobin; D007166:Immunosuppressive Agents; D007328:Insulin; D007329:Insulin Antagonists; D011384:Proinsulin