Family history of diabetes as a new determinant of insulin sensitivity and secretion in patients who have undergone a simultaneous pancreas-kidney transplant

• Published in: Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation Vol. 8; no. 1; p. 29
• Main Authors: Rangel, Erika B, Melaragno, Cláudio S, Neves, Maria Deolinda F, Dib, Sérgio A, Gonzalez, Adriano M, Linhares, Marcelo M, Pacheco-Silva, Alvaro, Sá, João R
• Format: Journal Article
• Language: English
• Published: Turkey 01-03-2010
• Subjects: Adult; Blood Glucose - metabolism; Body Mass Index; C-Peptide - blood; Case-Control Studies; Diabetes Mellitus - genetics; Diabetes Mellitus - metabolism; Diabetes Mellitus - physiopathology; Female; Homeostasis - physiology; Humans; Immunosuppressive Agents - therapeutic use; Insulin - metabolism; Insulin Resistance - physiology; Insulin Secretion; Insulin-Secreting Cells - physiology; Kidney Transplantation - immunology; Kidney Transplantation - physiology; Male; Models, Biological; Pancreas Transplantation - physiology; Pedigree; Prednisone - therapeutic use; Tacrolimus - therapeutic use
• ISSN: 2146-8427

We used homeostasis model assessment to investigate insulin sensitivity and secretion after a simultaneous pancreas-kidney transplant or kidney transplant alone. In that model, fasting plasma glucose and C-peptide levels are used to evaluate insulin sensitivity and beta-cell function.
Factors (eg, age, sex, race, delayed kidney allograft function) were correlated with homeostasis model assessment of beta-cell function and homeostasis model assessment of insulin sensitivity values after simultaneous pancreas-kidney transplant (n=89) or kidney transplant alone (n=68), and the results were compared with those in healthy subjects (n=49).
Homeostasis model assessment of beta-cell function values were similar in patients who underwent kidney transplant alone or a simultaneous pancreas-kidney transplant, and were higher than homeostasis model assessment of beta cell function values in healthy subjects. The homeostasis model assessment of insulin sensitivity showed intermediate values for patients who underwent a simultaneous pancreas-kidney transplant and correlated with prednisone dosages (in those who underwent kidney transplant alone) and tacrolimus levels (in patients who underwent a simultaneous pancreas-kidney transplant). Homeostasis model assessment of beta-cell function values correlated with prednisone dosages in both groups and with tacrolimus levels in only those who underwent a simultaneous pancreas-kidney transplant. The body mass index of subjects who underwent kidney transplant alone correlated with both homeostasis model assessment of beta-cell function results and homeostasis model assessment of insulin sensitivity results. A family history of diabetes in subjects who underwent a simultaneous pancreas-kidney transplant correlated with homeostasis model assessment of beta-cell function results and homeostasis model assessment of insulin sensitivity results.
Immunosuppressive regimen and body mass index were linked with reduced insulin sensitivity after kidney transplant. A family history of diabetes was linked with higher values of insulin secretion and lower insulin sensitivity in patients who underwent a simultaneous pancreas-kidney transplant.