Impact of cyclosporine and low-dose steroid therapy on insulin sensitivity and beta-cell function in patients with long-term liver grafts |
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| Authors: | T Konrad Bernd Markus Carl Allers Paolo Vicini Gianna Toffolo Christos Lakos Katrin Viehmann Ernst Hanisch Albrecht Encke Claudio Cobelli Klaus-Henning Usadel |
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| Institution: | (1) Department of Internal Medicine I, Study Group for Clinical Physiology and Transplantation Physiology, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60 590 Frankfurt, Germany Tel.: + 49-69-6301-5396 Fax: + 49-69-6301-6405, DE;(2) Clinic for General and Vascular Surgery, Johann Wolfgang Goethe-University, 60 590 Frankfurt, Germany, DE;(3) Department of Bioengineering, University of Washington, Seattle, WA 98195, USA, US;(4) Department of Electronics and Computer Engineering, University of Padova, 35 131 Padova, Italy, IT |
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| Abstract: | To examine whether factors controlling glucose tolerance, i. e., insulin sensitivity (SI) and first- (Φ
1) and second-phase insulin secretion (Φ
2), are impaired in after orthotopic liver transplantation (OLT), they were assesssed in patients that had undergone OLT for
cirrhosis (n = 10) with cyclosporin A and low-dose steroid therapy (5 mg prednisone per day) and were compared with those of healthy matched
control subjects (n = 10). These factors were determined by means of computer-based analysis of frequently sampled intravenous glucose tolerance
tests (FSIGTT). Glucose and insulin profiles (posthepatic insulin) did not differ between both groups, whereas C-peptide levels
(prehepatic insulin) were elevated in the transplant group after the FSIGTT, indicating an increased hepatic insulin degradation.
SI and Φ
1 did not differ between both groups. Φ
2, however, was significantly enhanced (23.94 ± 2.63 vs 13.88 ± 1.25 min–1, P < 0.05). These results indicate that cyclosporine and low-dose steroid therapy do not impair SI and Φ
1. However, enhanced Φ
2 compensates the increased hepatic insulin clearance.
Received: 17 November 1998 Revised: 19 June 2000 Accepted: 16 August 2000 |
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| Keywords: | Liver transplantation Glucose tolerance Insulin sensitivity Beta-cell secretion Cyclosporin A Corticosteroids |
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