J Korean Soc Transplant.  2017 Sep;31(3):126-132. 10.4285/jkstn.2017.31.3.126.

Changes in Insulin Sensitivity and Lipid Profile in Renal Transplant Recipients Converted from Cyclosporine or Standard Release Tacrolimus to Once-Daily Prolonged Release Tacrolimus

• Yang JW
• Kim YN
• Shin HS
• Jung Y
• Rim H

• KMID: 2392419
• DOI: http://doi.org/10.4285/jkstn.2017.31.3.126

Abstract

BACKGROUND
Tacrolimus (Tac) can cause impaired insulin release and dyslipidemia, and may affect the development of post-transplant diabetes mellitus. However, these effects on insulin sensitivity and lipid profile have not been compared in renal transplant recipients receiving traditional twice-daily tacrolimus (TacBID) or cyclosporine and those receiving once-daily prolonged release formulation of tacrolimus (TacOD).
METHODS
We conducted an observational prospective study of 15 stable non-diabetic renal transplant recipients to observe the changes in insulin sensitivity and lipid profiles for 1 year at a tertiary hospital. We evaluated the levels of hemoglobin A1c, total cholesterol, high density lipoprotein, low density lipoprotein, triglycerides, apolipoprotein A1, apolipoprotein B, serum creatinine, fasting plasma glucose, fasting insulin, homeostatic model assessment of β-cell (HOMA-β) and HOMA-insulin resistance index at baseline and at 2 and 4 months. To analyze differences in parameters, we conducted a Wilcoxon rank sum test and general linear model (GLM)-repeated measures analysis of variance (ANOVA) in both groups (cyclosporine to TacOD conversion group/TacBID to TacOD conversion group).
RESULTS
At baseline, parameters did not differ between groups. GLM-repeated measures ANOVA revealed no change in insulin sensitivity or lipid profile after conversion at baseline or at 2 and 4 months. There were no complications after conversion from standard TacBID or cyclosporine to TacOD.
CONCLUSIONS
There was no change in insulin sensitivity or lipid profile in renal transplant recipients. Any conversion from TacBID to TacOD should be performed in a controlled manner under close surveillance.

Keyword

Cyclosporine; Insulin resistance; Kidney transplantation; Tacrolimus

MeSH Terms

Apolipoprotein A-I
Apolipoproteins
Blood Glucose
Cholesterol
Creatinine
Cyclosporine*
Diabetes Mellitus
Dyslipidemias
Fasting
Insulin Resistance*
Insulin*
Kidney Transplantation
Linear Models
Lipoproteins
Prospective Studies
Tacrolimus*
Tertiary Care Centers
Transplant Recipients*
Triglycerides
Apolipoprotein A-I
Apolipoproteins
Cholesterol
Creatinine
Cyclosporine
Insulin
Lipoproteins
Tacrolimus
Triglycerides

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