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Metabolic and hormonal effects of tacrolimus (FK506) or cyclosporin immunosuppression following renal transplantation
Author(s) -
Dmitrewski J.,
Krentz A. J.,
Mayer A. D.,
Buckels J. A. C.,
Barnes A. D.,
Smith J.,
Nattrass M.
Publication year - 2001
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1046/j.1463-1326.2001.00132.x
Subject(s) - tacrolimus , immunosuppression , medicine , transplantation , postprandial , endocrinology , insulin , kidney transplantation
Summary 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.