β-cell dysfunction rather than insulin resistance is the main contributing factor for the development of postrenal transplantation diabetes mellitus

J. H. Nam, J. I. Mun, S. I. Kim, Shin-Wook Kang, K. H. Choi, K. Park, C. W. Ahn, B. S. Cha, Y. D. Song, Sungkil Lim, K. R. Kim, Hyun Chul Lee, K. B. Huh

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127 Citations (Scopus)

Abstract

Background. Our study was undertaken to investigate the pathogenesis and possible risk factors for postrenal transplantation diabetes mellitus (PTDM). Methods. We recruited 114 patients with normal glucose tolerance (NGT) and performed both 75-g oral glucose tolerance tests (OGTT) and short insulin tolerance tests 1 week before and 9-12 months after transplantation. Results. The subjects were classified into three groups by World Health Organization criteria on the basis of OGTT after transplantation: (a) 36 (31.6%) subjects with normal glucose tolerance; (b) 51 (45.7%) subjects with impaired glucose tolerance (IGT); and (c) 27 (23.7%) subjects with postrenal transplantation diabetes mellitus. Dosages of steroid and cyclosporine were equivalent among the three groups. Before transplantation, the fasting and 2-hr plasma glucose and proinsulin/insulin (PI/I) ratios were significantly higher in the IGT and PTDM groups than in the NGT group, but the insulin sensitivity index (ISI) was not significantly different among the three groups. In addition, the area under the curve-insulin on OGTT was significantly lower in the PTDM group than in the NGT group. After transplantation, however, the ISI was increased in all groups. Furthermore, the ISI and PI/I ratios revealed significantly higher values in the PTDM group than in the NGT group after transplantation. Conclusions. These results revealed that fasting and 2-hr plasma glucose levels, as well as the proinsulin/insulin ratio before transplantation, are both possible indicators of β-cell dysfunction and may be predictors for the development of PTDM. Furthermore, β-cell dysfunction, rather than insulin resistance, was proven to be the main factor for the pathogenesis of PTDM.

Original languageEnglish
Pages (from-to)1417-1423
Number of pages7
JournalTransplantation
Volume71
Issue number10
DOIs
Publication statusPublished - 2001 May 27

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Insulin Resistance
Diabetes Mellitus
Transplantation
Glucose
Proinsulin
Insulin
Glucose Tolerance Test
Glucose Intolerance
Fasting
Cyclosporine
Area Under Curve
Steroids

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Nam, J. H. ; Mun, J. I. ; Kim, S. I. ; Kang, Shin-Wook ; Choi, K. H. ; Park, K. ; Ahn, C. W. ; Cha, B. S. ; Song, Y. D. ; Lim, Sungkil ; Kim, K. R. ; Lee, Hyun Chul ; Huh, K. B. / β-cell dysfunction rather than insulin resistance is the main contributing factor for the development of postrenal transplantation diabetes mellitus. In: Transplantation. 2001 ; Vol. 71, No. 10. pp. 1417-1423.
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title = "β-cell dysfunction rather than insulin resistance is the main contributing factor for the development of postrenal transplantation diabetes mellitus",
abstract = "Background. Our study was undertaken to investigate the pathogenesis and possible risk factors for postrenal transplantation diabetes mellitus (PTDM). Methods. We recruited 114 patients with normal glucose tolerance (NGT) and performed both 75-g oral glucose tolerance tests (OGTT) and short insulin tolerance tests 1 week before and 9-12 months after transplantation. Results. The subjects were classified into three groups by World Health Organization criteria on the basis of OGTT after transplantation: (a) 36 (31.6{\%}) subjects with normal glucose tolerance; (b) 51 (45.7{\%}) subjects with impaired glucose tolerance (IGT); and (c) 27 (23.7{\%}) subjects with postrenal transplantation diabetes mellitus. Dosages of steroid and cyclosporine were equivalent among the three groups. Before transplantation, the fasting and 2-hr plasma glucose and proinsulin/insulin (PI/I) ratios were significantly higher in the IGT and PTDM groups than in the NGT group, but the insulin sensitivity index (ISI) was not significantly different among the three groups. In addition, the area under the curve-insulin on OGTT was significantly lower in the PTDM group than in the NGT group. After transplantation, however, the ISI was increased in all groups. Furthermore, the ISI and PI/I ratios revealed significantly higher values in the PTDM group than in the NGT group after transplantation. Conclusions. These results revealed that fasting and 2-hr plasma glucose levels, as well as the proinsulin/insulin ratio before transplantation, are both possible indicators of β-cell dysfunction and may be predictors for the development of PTDM. Furthermore, β-cell dysfunction, rather than insulin resistance, was proven to be the main factor for the pathogenesis of PTDM.",
author = "Nam, {J. H.} and Mun, {J. I.} and Kim, {S. I.} and Shin-Wook Kang and Choi, {K. H.} and K. Park and Ahn, {C. W.} and Cha, {B. S.} and Song, {Y. D.} and Sungkil Lim and Kim, {K. R.} and Lee, {Hyun Chul} and Huh, {K. B.}",
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β-cell dysfunction rather than insulin resistance is the main contributing factor for the development of postrenal transplantation diabetes mellitus. / Nam, J. H.; Mun, J. I.; Kim, S. I.; Kang, Shin-Wook; Choi, K. H.; Park, K.; Ahn, C. W.; Cha, B. S.; Song, Y. D.; Lim, Sungkil; Kim, K. R.; Lee, Hyun Chul; Huh, K. B.

In: Transplantation, Vol. 71, No. 10, 27.05.2001, p. 1417-1423.

Research output: Contribution to journalArticle

TY - JOUR

T1 - β-cell dysfunction rather than insulin resistance is the main contributing factor for the development of postrenal transplantation diabetes mellitus

AU - Nam, J. H.

AU - Mun, J. I.

AU - Kim, S. I.

AU - Kang, Shin-Wook

AU - Choi, K. H.

AU - Park, K.

AU - Ahn, C. W.

AU - Cha, B. S.

AU - Song, Y. D.

AU - Lim, Sungkil

AU - Kim, K. R.

AU - Lee, Hyun Chul

AU - Huh, K. B.

PY - 2001/5/27

Y1 - 2001/5/27

N2 - Background. Our study was undertaken to investigate the pathogenesis and possible risk factors for postrenal transplantation diabetes mellitus (PTDM). Methods. We recruited 114 patients with normal glucose tolerance (NGT) and performed both 75-g oral glucose tolerance tests (OGTT) and short insulin tolerance tests 1 week before and 9-12 months after transplantation. Results. The subjects were classified into three groups by World Health Organization criteria on the basis of OGTT after transplantation: (a) 36 (31.6%) subjects with normal glucose tolerance; (b) 51 (45.7%) subjects with impaired glucose tolerance (IGT); and (c) 27 (23.7%) subjects with postrenal transplantation diabetes mellitus. Dosages of steroid and cyclosporine were equivalent among the three groups. Before transplantation, the fasting and 2-hr plasma glucose and proinsulin/insulin (PI/I) ratios were significantly higher in the IGT and PTDM groups than in the NGT group, but the insulin sensitivity index (ISI) was not significantly different among the three groups. In addition, the area under the curve-insulin on OGTT was significantly lower in the PTDM group than in the NGT group. After transplantation, however, the ISI was increased in all groups. Furthermore, the ISI and PI/I ratios revealed significantly higher values in the PTDM group than in the NGT group after transplantation. Conclusions. These results revealed that fasting and 2-hr plasma glucose levels, as well as the proinsulin/insulin ratio before transplantation, are both possible indicators of β-cell dysfunction and may be predictors for the development of PTDM. Furthermore, β-cell dysfunction, rather than insulin resistance, was proven to be the main factor for the pathogenesis of PTDM.

AB - Background. Our study was undertaken to investigate the pathogenesis and possible risk factors for postrenal transplantation diabetes mellitus (PTDM). Methods. We recruited 114 patients with normal glucose tolerance (NGT) and performed both 75-g oral glucose tolerance tests (OGTT) and short insulin tolerance tests 1 week before and 9-12 months after transplantation. Results. The subjects were classified into three groups by World Health Organization criteria on the basis of OGTT after transplantation: (a) 36 (31.6%) subjects with normal glucose tolerance; (b) 51 (45.7%) subjects with impaired glucose tolerance (IGT); and (c) 27 (23.7%) subjects with postrenal transplantation diabetes mellitus. Dosages of steroid and cyclosporine were equivalent among the three groups. Before transplantation, the fasting and 2-hr plasma glucose and proinsulin/insulin (PI/I) ratios were significantly higher in the IGT and PTDM groups than in the NGT group, but the insulin sensitivity index (ISI) was not significantly different among the three groups. In addition, the area under the curve-insulin on OGTT was significantly lower in the PTDM group than in the NGT group. After transplantation, however, the ISI was increased in all groups. Furthermore, the ISI and PI/I ratios revealed significantly higher values in the PTDM group than in the NGT group after transplantation. Conclusions. These results revealed that fasting and 2-hr plasma glucose levels, as well as the proinsulin/insulin ratio before transplantation, are both possible indicators of β-cell dysfunction and may be predictors for the development of PTDM. Furthermore, β-cell dysfunction, rather than insulin resistance, was proven to be the main factor for the pathogenesis of PTDM.

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U2 - 10.1097/00007890-200105270-00011

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