title: Proinsulinemia in simultaneous pancreas and kidney transplant recipients.
abstract: It has been shown that lipid profiles do not differ between pancreas recipients with systemic and portal venous anastomosis. However, it is unclear whether venous drainage from the transplanted pancreas has an impact on recipient atherogenesis and if other factors should be considered. Increased concentration of proinsulin correlates with tachycardia and other risk factors for ischemic heart disease. The aim of this study was to compare proinsulin levels in different types of pancreatic graft venous drainage. Twenty-four simultaneous pancreas and kidney transplantation (SPK) recipients with systemic venous drainage (group S, n = 12) and portal venous drainage (group P, n = 12) under identical immunosuppressive treatment were prospectively observed during 24 months. Following transplantation, only recipients with normoglycemia, normal HbA1c, and normal serum creatine were evaluated. Proinsulin was assessed in fasting state; after glucagon stimulation (Delta-proinsulin), and during oral 75-g glucose tolerance test twice: between 3 and 6 months and 12 to 24 months posttransplantation. All SPK patients had higher proinsulin concentration in fasting state compared with age-matched healthy controls. After stimulation, proinsulin level did not significantly differ between groups; the type of the pancreas venous anastomosis did not change the release of proinsulin and should not have impact on cardiovascular risk factors.
authors.affiliation: Department of Gastroenterology and Metabolic Diseases, Warsaw Medical University, ul. Banacha 1a, 02-097 Warsaw, Poland. marianna@amwaw.edu.pl
authors.forename: M I
authors.initials: MI
authors.lastname: Bak
authors.forename: T
authors.initials: T
authors.lastname: Grochowiecki
authors.forename: Z
authors.initials: Z
authors.lastname: Gałazka
authors.forename: S
authors.initials: S
authors.lastname: Nazarewski
authors.forename: T
authors.initials: T
authors.lastname: Jakimowicz
authors.forename: K
authors.initials: K
authors.lastname: Pietrasik
authors.forename: M
authors.initials: M
authors.lastname: Wojtaszek
authors.forename: M
authors.initials: M
authors.lastname: Durlik
authors.forename: W
authors.initials: W
authors.lastname: Karnafel
authors.forename: J
authors.initials: J
authors.lastname: Szmidt
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000601:surgery*; D004322:Drainage / Q000379:methods; D004359:Drug Therapy, Combination; D005951:Glucose Tolerance Test; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000502:physiology*; D016035:Pancreas Transplantation / Q000379:methods* / Q000502:physiology*; D011169:Portal Vein / Q000601:surgery; D011384:Proinsulin / Q000097:blood*; D012016:Reference Values; D014682:Vena Cava, Inferior / Q000601:surgery
chemical_list: D001786:Blood Glucose; D007166:Immunosuppressive Agents; D011384:Proinsulin