title: The impact of kidney transplantation on insulin sensitivity.
abstract: To investigate the impact of kidney transplantation (KTx) on insulin sensitivity affecting glucose metabolism. 9 nondiabetic patients awaiting living donor KTx were examined prior to transplantation with an oral glucose tolerance test and a 3-h hyperinsulinaemic-euglycaemic clamp. The clamp was repeated 6 months after KTx. Nine age-, gender- and body mass index (BMI)-matched individuals with normal kidney function served as controls. Endogenous glucose production and glucose disappearance rate (N = 6) were measured in a subgroup of patients with corresponding controls. Results presented as mean [range]. Two patients had pretransplant prediabetes, whereas all others had normal glucose tolerance. After KTx, average glucose infusion rate to maintain euglycaemia during clamp declined significantly from 15.1 [9.1-23.7] to 9.8 [2.8-14.6] μmol/kg/min (P < 0.01) with 20.2 [9.9-33.7] μmol/kg/min in controls. Endogenous glucose production increased from 7.0 [4.8-8.5] to 9.4 [7.4-11.8] μmol/kg/min (P < 0.05) with 7.0 [-3.8 to 10.1] μmol/kg/min in controls. Glucose disappearance rate was unchanged (18.1 [12.9-24.5] vs. 17.1 [12.2-22.7] μmol/kg/min, NS) with 22.3 [14.6-34.3] in controls. In conclusion, insulin sensitivity is reduced 6 months after KTx and characterized mainly by impaired suppression of the endogenous glucose production.
authors.affiliation: Department of Nephrology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Morten B
authors.identifier: http://orcid.org/0000-0001-9681-3134
authors.initials: MB
authors.lastname: Jørgensen
authors.affiliation: Department of Nephrology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Mads
authors.initials: M
authors.lastname: Hornum
authors.affiliation: Clinical Metabolomics Core Facility, Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Gerrit
authors.initials: G
authors.lastname: van Hall
authors.affiliation: Department of Nephrology, Odense University Hospital, Odense, Denmark.
authors.forename: Claus
authors.initials: C
authors.lastname: Bistrup
authors.affiliation: Department of Nephrology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jesper M
authors.initials: JM
authors.lastname: Hansen
authors.affiliation: Department of Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Elisabeth R
authors.initials: ER
authors.lastname: Mathiesen
authors.affiliation: Department of Nephrology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Bo
authors.initials: B
authors.lastname: Feldt-Rasmussen
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D016022:Case-Control Studies; D005260:Female; D005934:Glucagon / Q000097:blood; D005947:Glucose / Q000096:biosynthesis; D015309:Glucose Clamp Technique; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008066:Lipolysis / Q000502:physiology; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin; D005934:Glucagon; D005947:Glucose
keywords: hyperinsulinaemic-euglycaemic clamp; insulin resistance; kidney transplantation