Preoperative C-Peptide Predicts Weight Gain After Pancreas Transplantation

Julia Torabi, Juan P. Rocca, Elizabeth Kestenbaum, Maria Ajaimy, Monica DeFeo, Athena Konicki, Luz Liriano-Ward, Yorg Azzi, Cindy Pynadath, Enver Akalin, Milan Kinkhabwala, Jay A. Graham

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Transplant recipients are susceptible to cardiovascular complications, obesity, and increased insulin resistance after transplant. Here we assess weight gain in diabetic recipients after pancreas transplantation. Methods: This is a single-center study of 32 simultaneous pancreas and kidney and 5 pancreas after kidney transplant recipients from 2014 to 2018. Starting C-peptide levels ≤ 0.1 ng/mL were used to denote insulin nondetectability (n = 25) and C-peptide levels > 0.1 ng/mL as insulin detectability (n = 12). Hemoglobin A1c, body mass index (BMI), and weight following transplantation were assessed. Results: Hemoglobin A1c at 1 year was 5.9% in the insulin nondetectable recipients and 5.6% in the insulin detectable group (P =.56). Average BMI after transplant was higher in the insulin detectable group 28.6 versus 24.4 kg/m2 (P =.03) despite no difference in starting BMIs (24.9 versus 24.0 kg/m2, P =.42). The insulin detectable group also had a larger percentage weight change from their starting weight 13.1% versus 0.9 % at 1 year (P =.02). Linear regression demonstrated that starting C-peptide was a significant predictor of weight gain posttransplant. Conclusions: Patients with elevated C-peptides at time of transplant are susceptible to rapid weight gain postoperatively. These patients may benefit from aggressive nutritional management.

Original languageEnglish (US)
Pages (from-to)117-124
Number of pages8
JournalProgress in Transplantation
Volume30
Issue number2
DOIs
StatePublished - Jun 1 2020

Keywords

  • c-peptide
  • simultaneous pancreas-kidney transplantation (SPK)
  • weight gain

ASJC Scopus subject areas

  • Transplantation

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