title: Insulin resistance and insulin secretion changes in kidney transplant recipients with normal graft function compared with those with delayed graft function early after transplantation.
abstract: BACKGROUND
  We compared insulin resistance (IR) and insulin secretion (IS) among kidney transplant recipients with normal versus delayed graft function (DGF) early after transplantation.
  
  
  METHODS
  We selected 55 kidney transplant recipients without a history of clinical diabetes mellitus. The basal values of glucose (G) and insulin (I) were used to calculate indices of IR and IS before, on the third day, as well as at the end of the first, second, and third weeks after transplantation.
  
  
  RESULTS
  Before transplantation IR was more prevalent (62.5%) than impaired IS (20%; P = .012). Three weeks after engraftment, IR was significantly reduced (P < .001), whereas the reduction in the IS was not significant (P = .17). Splitting the results between normal and delayed functioning grafts showed a significant difference in both IR and IS between the 2 groups on the third day after transplantation (P = .018 and .024, respectively). Regression models showed that only cumulative administered cyclosporine dose and plasma creatinine were significantly (or near significantly) associated with IR (P = .04 and .07, respectively).
  
  
  CONCLUSIONS
  Among patients with DGF there was a significantly greater prevalence of IR and IS compared with successfully engrafted patients in the middle of the first week after transplantation. With resumption of normal kidney function among the DGF group, this difference disappeared at the end of the third week after transplantation.
authors.affiliation: Department of Nephrology, Mashhad University of Medical Sciences, Ghaem Hospital, Mashhad, Iran. drhekmatreza@yahoo.com
authors.forename: R
authors.initials: R
authors.lastname: Hekmat
authors.forename: M L
authors.initials: ML
authors.lastname: Javan
authors.forename: Z
authors.initials: Z
authors.lastname: Javadi
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000453:epidemiology; D051799:Delayed Graft Function / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D007333:Insulin Resistance / Q000502:physiology*; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000378:metabolism / Q000502:physiology; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D012016:Reference Values; D012307:Risk Factors; D055815:Young Adult
chemical_list: D007328:Insulin