Insulin Secretion and Insulin Resistance Trajectories over 1 Year after Kidney Transplantation: A Multicenter Prospective Cohort Study
Background We investigated the changing patterns of insulin secretion and resistance and risk factors contributing to the development of post-transplant diabetes mellitus (PTDM) in kidney recipients under tacrolimus-based immunosuppression regimen during 1 year after transplantation. Methods This wa...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Endocrine Society
2020-12-01
|
| Series: | Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.e-enm.org/upload/pdf/enm-2020-743.pdf |
| _version_ | 1818382896920002560 |
|---|---|
| author | Jun Bae Bang Chang-Kwon Oh Yu Seun Kim Sung Hoon Kim Hee Chul Yu Chan-Duck Kim Man Ki Ju Byung Jun So Sang Ho Lee Sang Youb Han Cheol Woong Jung Joong Kyung Kim Su Hyung Lee Ja Young Jeon |
| author_facet | Jun Bae Bang Chang-Kwon Oh Yu Seun Kim Sung Hoon Kim Hee Chul Yu Chan-Duck Kim Man Ki Ju Byung Jun So Sang Ho Lee Sang Youb Han Cheol Woong Jung Joong Kyung Kim Su Hyung Lee Ja Young Jeon |
| author_sort | Jun Bae Bang |
| collection | DOAJ |
| description | Background We investigated the changing patterns of insulin secretion and resistance and risk factors contributing to the development of post-transplant diabetes mellitus (PTDM) in kidney recipients under tacrolimus-based immunosuppression regimen during 1 year after transplantation. Methods This was a multicenter prospective cohort study. Of the 168 subjects enrolled in this study, we analyzed a total 87 kidney transplant recipients without diabetes which was assessed by oral glucose tolerance test before transplantation. We evaluated the incidence of PTDM and followed up the index of insulin secretion (insulinogenic index [IGI]) and resistance (homeostatic model assessment for insulin resistance [HOMA-IR]) at 3, 6, 9 months, and 1 year after transplantation by oral glucose tolerance test and diabetes treatment. We also assessed the risk factors for incident PTDM. Results PTDM developed in 23 of 87 subjects (26.4%) during 1 year after transplantation. More than half of total PTDM (56.5%) occurred in the first 3 months after transplantation. During 1 year after transplantation, insulin resistance (HOMA-IR) was increased in both PTDM and no PTDM group. In no PTDM group, the increase in insulin secretory function to overcome insulin resistance was also observed. However, PTDM group showed no increase in insulin secretion function (IGI). Old age, status of prediabetes and episode of acute rejection were significantly associated with the development of PTDM. Conclusion In tacrolimus-based immunosuppressive drugs regimen, impaired insulin secretory function for reduced insulin sensitivity contributed to the development of PTDM than insulin resistance during 1 year after transplantation. |
| first_indexed | 2024-12-14T02:57:46Z |
| format | Article |
| id | doaj.art-141a32032afe41b3b43f128a63add500 |
| institution | Directory Open Access Journal |
| issn | 2093-596X 2093-5978 |
| language | English |
| last_indexed | 2024-12-14T02:57:46Z |
| publishDate | 2020-12-01 |
| publisher | Korean Endocrine Society |
| record_format | Article |
| series | Endocrinology and Metabolism |
| spelling | doaj.art-141a32032afe41b3b43f128a63add5002022-12-21T23:19:35ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782020-12-0135482082910.3803/EnM.2020.7432087Insulin Secretion and Insulin Resistance Trajectories over 1 Year after Kidney Transplantation: A Multicenter Prospective Cohort StudyJun Bae Bang0Chang-Kwon Oh1Yu Seun Kim2Sung Hoon Kim3Hee Chul Yu4Chan-Duck Kim5Man Ki Ju6Byung Jun So7Sang Ho Lee8Sang Youb Han9Cheol Woong Jung10Joong Kyung Kim11Su Hyung Lee12Ja Young Jeon13 Department of Surgery, Ajou University School of Medicine, Suwon, Seoul, Korea Department of Surgery, Ajou University School of Medicine, Suwon, Seoul, Korea Department of Transplantation Surgery and Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea Department of Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Seoul, Korea Department of Surgery, Jeonbuk National University Medical School, Jeonju, Seoul, Korea Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Seoul, Korea Department of Surgery, Yonsei University College of Medicine, Seoul, Korea Department of Surgery, Wonkwang University Hospital, Iksan, Seoul, Korea Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Seoul, Korea Department of Surgery, Korea University College of Medicine, Seoul, Korea Department of Internal Medicine, Bong Seng Memorial Hospital, Busan, Korea Department of Surgery, Ajou University School of Medicine, Suwon, Seoul, Korea Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, KoreaBackground We investigated the changing patterns of insulin secretion and resistance and risk factors contributing to the development of post-transplant diabetes mellitus (PTDM) in kidney recipients under tacrolimus-based immunosuppression regimen during 1 year after transplantation. Methods This was a multicenter prospective cohort study. Of the 168 subjects enrolled in this study, we analyzed a total 87 kidney transplant recipients without diabetes which was assessed by oral glucose tolerance test before transplantation. We evaluated the incidence of PTDM and followed up the index of insulin secretion (insulinogenic index [IGI]) and resistance (homeostatic model assessment for insulin resistance [HOMA-IR]) at 3, 6, 9 months, and 1 year after transplantation by oral glucose tolerance test and diabetes treatment. We also assessed the risk factors for incident PTDM. Results PTDM developed in 23 of 87 subjects (26.4%) during 1 year after transplantation. More than half of total PTDM (56.5%) occurred in the first 3 months after transplantation. During 1 year after transplantation, insulin resistance (HOMA-IR) was increased in both PTDM and no PTDM group. In no PTDM group, the increase in insulin secretory function to overcome insulin resistance was also observed. However, PTDM group showed no increase in insulin secretion function (IGI). Old age, status of prediabetes and episode of acute rejection were significantly associated with the development of PTDM. Conclusion In tacrolimus-based immunosuppressive drugs regimen, impaired insulin secretory function for reduced insulin sensitivity contributed to the development of PTDM than insulin resistance during 1 year after transplantation.http://www.e-enm.org/upload/pdf/enm-2020-743.pdfglucose tolerance testdiabetes mellituskidney transplantationinsulin secretion |
| spellingShingle | Jun Bae Bang Chang-Kwon Oh Yu Seun Kim Sung Hoon Kim Hee Chul Yu Chan-Duck Kim Man Ki Ju Byung Jun So Sang Ho Lee Sang Youb Han Cheol Woong Jung Joong Kyung Kim Su Hyung Lee Ja Young Jeon Insulin Secretion and Insulin Resistance Trajectories over 1 Year after Kidney Transplantation: A Multicenter Prospective Cohort Study Endocrinology and Metabolism glucose tolerance test diabetes mellitus kidney transplantation insulin secretion |
| title | Insulin Secretion and Insulin Resistance Trajectories over 1 Year after Kidney Transplantation: A Multicenter Prospective Cohort Study |
| title_full | Insulin Secretion and Insulin Resistance Trajectories over 1 Year after Kidney Transplantation: A Multicenter Prospective Cohort Study |
| title_fullStr | Insulin Secretion and Insulin Resistance Trajectories over 1 Year after Kidney Transplantation: A Multicenter Prospective Cohort Study |
| title_full_unstemmed | Insulin Secretion and Insulin Resistance Trajectories over 1 Year after Kidney Transplantation: A Multicenter Prospective Cohort Study |
| title_short | Insulin Secretion and Insulin Resistance Trajectories over 1 Year after Kidney Transplantation: A Multicenter Prospective Cohort Study |
| title_sort | insulin secretion and insulin resistance trajectories over 1 year after kidney transplantation a multicenter prospective cohort study |
| topic | glucose tolerance test diabetes mellitus kidney transplantation insulin secretion |
| url | http://www.e-enm.org/upload/pdf/enm-2020-743.pdf |
| work_keys_str_mv | AT junbaebang insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy AT changkwonoh insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy AT yuseunkim insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy AT sunghoonkim insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy AT heechulyu insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy AT chanduckkim insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy AT mankiju insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy AT byungjunso insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy AT sangholee insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy AT sangyoubhan insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy AT cheolwoongjung insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy AT joongkyungkim insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy AT suhyunglee insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy AT jayoungjeon insulinsecretionandinsulinresistancetrajectoriesover1yearafterkidneytransplantationamulticenterprospectivecohortstudy |