Endocrine Abstracts

Calcineurin inhibitors (CNI, cyclosporine A: CsA and tacrolimus: Tac) cause posttransplant diabetes mellitus, hypercholesterolemia and hypertension. Post-transplant weight gain can be related to the type of CNIs. Distribution of obesity is one of the major predictors of cardiovascular diseases. Several indices assessed upper body obesity such as waist circumference (WC) and waist to hip ratio (WHR) are more accurate than whole body obesity (body mass index: BMI). This study aimed to compare the effects of CNIs on obesity after kidney transplantation.

Methods: The 133 consecutive transplant patients were randomized into 2 groups: CsA (n=62) and Tac (n=71) for two years. In all patients, BMI, body fat percentage, WC, hip circumference (HC) and WHR were measured.

Results: The weight, BMI, body fat percentage, WC and HC were significantly increased up to month 24 in both groups. There was no significant difference in increases of BMI, WC, WHR and body fat percentage between both groups. The ratio of diabetics in CsA group was higher than Tac group (21% vs 1.4%, P<0.001). The ratios of de novo diabetics (4.8% vs 12.7%) and hypertensives (29% vs 26.8%) were similar in the CsA and Tac groups, respectively. Although the abdominal obesity ratios in the CsA and Tac groups increased, the ratios were comparable in the preoperative (17.7% vs 23.9%), after 12 (37.3% vs 39.3%) and 24 (40% vs 45.9%) months of transplant, respectively. There was no significant difference in glucose and lipid profile between CsA and Tac groups.

Conclusion: The type of calcineurin inhibitor used did not affect anthropometrical measurements throughout two years although both of them caused weight gain after transplant.