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ORIGINAL RESEARCH article

Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1492871

Hypomagnesemia, insulin secretion and action in patients without diabetes, one year after kidney transplantation

Provisionally accepted
Rasmus Kirkeskov Carlsen Rasmus Kirkeskov Carlsen 1*Anders Åsberg Anders Åsberg 1,2My Svensson My Svensson 3,4Kåre I. Birkeland Kåre I. Birkeland 1,5Hanne S. Jørgensen Hanne S. Jørgensen 6,7Iain Bressendorff Iain Bressendorff 8Hanne L. Gulseth Hanne L. Gulseth 9Karsten Midtvedt Karsten Midtvedt 1Espen Nordheim Espen Nordheim 1Trond Geir Jenssen Trond Geir Jenssen 1
  • 1 Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
  • 2 University of Oslo, Oslo, Norway
  • 3 Akershus University Hospital, Lørenskog, Norway
  • 4 Aalborg University Hospital, Aalborg, Denmark
  • 5 Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
  • 6 Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
  • 7 Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
  • 8 Department of Medicine, Herlev and Gentofte Hospital, Herlev, Denmark
  • 9 Department of Mental Disorders, Division of Mental and Physical Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway

The final, formatted version of the article will be published soon.

    Hypomagnesemia after kidney transplantation has been reported as a potential risk factor for development of post-transplant diabetes mellitus.In kidney transplant recipients undergoing an oral glucose tolerance test during one-year surveillance follow-up we estimated insulin sensitivity with the Matsuda index, a modified Stumvoll index, and HOMA-2IR. First and second phase insulin secretion was assessed using the Stumvoll equation. Participants were categorized into tertiles by plasma magnesium levels, (<0.7, 07-0.78,>0.78 mmol/L).We included 208 patients (62% men, median age 51 years). Patients in the lowest compared to the highest magnesium tertile had higher measured GFR (mean 59 vs 49 mL/min, P=0.002), tacrolimus trough concentration (mean 6.7 vs 5.5 µg/L, P<0.001), and fasting plasma glucose (mean 5.5 vs 5.3 mmol/L, P=0.03). There was no significant difference in the Matsuda index between magnesium tertiles, nor in insulin sensitivity assessed by modified Stumvoll index, HOMA-2IR, first or second phase insulin. Results indicate a non-significant trend towards lower disposition index in the lowest vs highest tertile (p=0.052).In kidney transplant recipients with lower compared to normal plasma magnesium levels we found a higher fasting plasma glucose but no differences in insulin sensitivity indexes nor dynamic insulin measurements.

    Keywords: hypomagnesemia, Kidney Transplantation, Post-transplant diabetes mellitus, insulin secretion, insulin action, Oral glucose tolerance test

    Received: 08 Sep 2024; Accepted: 03 Jan 2025.

    Copyright: © 2025 Carlsen, Åsberg, Svensson, Birkeland, Jørgensen, Bressendorff, Gulseth, Midtvedt, Nordheim and Jenssen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Rasmus Kirkeskov Carlsen, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway

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