THE EFFECT OF FK506 VERSUS CYCLOSPORINE ON GLUCOSE AND LIPID-METABOLISM - A RANDOMIZED TRIAL

In order to evaluate the effect of cyclosporine (CsA) versus FK506 on glucose and lipid metabolism, an oral glucose tolerance test (OGTT) wa s performed in 101 patients after orthotopic liver transplantation (OL T) (mean interval after OLT: 511 days). The liver graft recipients had been randomized prospectively to two groups prior to OLT to receive e ither immunosuppression with CsA, azathioprine, and corticosteroids (C sA group) or FK506 and corticosteroids (FR group). Along with the OGTT , serum insulin, insulin C-peptide and glucagon as web as serum lipids were monitored. There was no statistically significant difference in the occurrence of impaired glucose tolerance (IGT) or manifest diabete s mellitus disease between the two groups. In fact, not a single patie nt developed new-onset diabetes in any group. In male and female patie nts, serum levels of cholesterol and triglycerides increased significa ntly under FK506 and CsA treatment after OLT, Cholesterol was signific antly higher in the CsA group in men, in women this was marked, but no t significant. While triglycerides were significantly higher in women on CsA treatment, there was no such difference in men. In conclusion, both CsA and FK506 proved to have similar effects on glucose metabolis m, while there was a different spectrum of serum lipid alterations.