The impact of kidney transplantation on insulin sensitivity
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The impact of kidney transplantation on insulin sensitivity. / Jørgensen, Morten B; Hornum, Mads; van Hall, Gerrit; Bistrup, Claus; Hansen, Jesper M; Mathiesen, Elisabeth R; Feldt-Rasmussen, Bo.
In: Transplant International, Vol. 30, No. 3, 03.2017, p. 295-304.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - The impact of kidney transplantation on insulin sensitivity
AU - Jørgensen, Morten B
AU - Hornum, Mads
AU - van Hall, Gerrit
AU - Bistrup, Claus
AU - Hansen, Jesper M
AU - Mathiesen, Elisabeth R
AU - Feldt-Rasmussen, Bo
N1 - © 2016 Steunstichting ESOT.
PY - 2017/3
Y1 - 2017/3
N2 - 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.
AB - 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.
KW - Journal Article
U2 - 10.1111/tri.12907
DO - 10.1111/tri.12907
M3 - Journal article
C2 - 28000288
VL - 30
SP - 295
EP - 304
JO - Transplant International
JF - Transplant International
SN - 0934-0874
IS - 3
ER -
ID: 177088985