LIPOPROTEIN PROFILE AFTER COMBINED KIDNEY-PANCREAS TRANSPLANTATION ININSULIN-DEPENDENT DIABETES-MELLITUS

In order to evaluate the effect of a combined kidney-pancreas (KP) tra nsplantation in insulin-dependent diabetes mellitus (IDDM) patients on the lipid and lipoprotein profile, 15 KP patients were compared with 11 kidney (K)-transplanted IDDM patients, 19 IDDM patients on hemodial ysis (HD), and 15 nondiabetic control subjects. Cholesterol, triglycer ides, apo AI, and apo B were measured in total plasma and in VLDL, LDL . and HDL of all participants, VLDL-cholesterol, VLDL-triglycerides, a nd VLDL-apo B were significantly lower in KP patients, but not in K pa tients, than in HD patients. In addition, patients in the K, but not i n the KP, group showed high levels of apo B in LDL and an increased tr iglyceride/apo B ratio in VLDLI compared with patients in the HD group . The percentage of apo AI associated with HDL was significantly highe r in both transplanted groups than in the HD group, However, compared with a nondiabetic control population, an increase in VLDL particles a nd in triglyceride content in LDL and HDL still persisted following co mbined KP transplantation. Insulin resistance (probably due to steroid therapy) associated with high peripheral and potentially low hepatic insulin levels (due to the systemic drainage of the transplanted pancr eas! could be the main causes of the remaining lipoprotein abnormaliti es.