Hypothalamic-pituitary-gonadal axis disturbance and its association with insulin resistance in kidney transplant recipients

• Autor(a) principal: Balcázar-Hernández,Lourdes
• Data de Publicação: 2022
• Outros Autores: Mendoza-Zubieta,Victoria, González-Virla,Baldomero, González-García,Brenda, Osorio-Olvera,Mariana, Peñaloza-Juarez,Jesús Ubaldo, Irisson-Mora,Irene, Cruz-López,Martha, Rodríguez-Gómez,Raúl, Espinoza-Pérez,Ramón, Vargas-Ortega,Guadalupe
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Jornal Brasileiro de Nefrologia
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002022005028401
• topic: Kidney Transplantation; Hy- pogonadism; Estradiol; Testosterone; Go- nadotropins; Hyperinsulinism

Abstract Objective: To evaluate hypothalamic-pi- tuitary-gonadal (HPG) axis alterations at 1 and 12 months after kidney transplan- tation (KT) and their association with in- sulin resistance. Methods: A retrospective clinical study was conducted in a tertiary care center in kidney transplantation recipients (KTRs) aged 18- 50 years with primary kidney disease and stable renal graft function. LH, FSH, E2/T, and HOMA-IR were assessed at 1 and 12 months after KT. Results: Twenty-five KTRs were included; 53% were men, and the mean age was 30.6±7.7 years. BMI was 22.3 (20.4-24.6) kg/m2, and 36% had hypogonadism at 1 month vs 8% at 12 months (p=0.001). Re- mission of hypogonadism was observed in all men, while in women, hypogonadotropic hypogonadism persisted in two KTRs at 12 months. A positive correlation between go- nadotrophins and age at 1 and 12 months was evident. Fifty-six percent of patients had insulin resistance (IR) at 1 month and 36% at 12 months (p=0.256). HOMA-IR showed a negative correlation with E2 (r=- 0.60; p=0.050) and T (r=-0.709; p=0.049) at 1 month, with no correlation at 12 months. HOMA-IR at 12 months after KT correlated positively with BMI (r=0.52; p=0.011) and tacrolimus dose (r=0.53; p=0.016). Conclusion: Successful KT restores the HPG axis in the first year. Hypogonadism had a negative correlation with IR in the early pe- riod after KT, but it was not significant at 12 months.