Table 1.
Metabolic Derangements due to Individual Immunosuppressants.
| Metabolic derangement | Corticosteroids | Tacrolimus | Cyclosporine | mTOR inhibitors |
|---|---|---|---|---|
| Mechanisms | ↑Gluconeogenesis ↓Insulin production ↑FFA uptake ↓Lipoprotein lipase activity |
↑Gluconeogenesis ↓Cholesterol transport into bile ↓Beta cell proliferation and survival ↓Vasodilators and ↑SVR |
↑Gluconeogenesis ↓Cholesterol transport into bile ↓Beta cell proliferation and survival |
↓Lipoprotein lipase activity ↑Adipose lipase activity ↓Beta cell proliferation |
| Obesity | ++ | − | − | − |
| Impaired glucose tolerance | +++ | ++ | + | − |
| Dyslipidemia | ++ | + | ++ | +++ |
| Hypertension | + | + | ++ | + |
FFA, free fatty acid; SVR, systemic vascular resistance.