CYP3A4 and GCK genetic polymorphisms are the risk factors of tacrolimus-induced new-onset diabetes after transplantation in renal transplant recipients

Eur J Clin Pharmacol. 2018 Jun;74(6):723-729. doi: 10.1007/s00228-018-2442-4. Epub 2018 Mar 15.

Abstract

Purpose: We intend to investigate the association between tacrolimus-induced new-onset diabetes after transplantation (NODAT) and polymorphisms of CYP3A4, CYP3A5, ATP-binding cassette transporter sub-family C member 8 (ABCC8), and glucokinase (GCK) in renal transplant recipients.

Methods: Polymorphisms of CYP3A4 *18B, CYP3A5 *3, ABCC8 T-3C, and GCK G-30A were genotyped in 169 renal transplant recipients. Trough concentrations of tacrolimus were detected by an ELISA kit. The relative materials were collected in all patients and volunteers. The association of NODAT and polymorphisms was analyzed.

Results: CYP3A4 *18B and GCK G-30A were related to NODAT (p < 0.05). The lower concentration/dose or fasting serum glucose was in CYP3A4 *1/*1 carriers than that in *18B/*18B carriers in all the renal transplant recipients (p < 0.05), respectively. Genotype of ABCC8 T-3C was associated with fasting serum glucose in both NODAT and non-NODAT patients (p < 0.05). Furthermore, family history of DM (OR = 3.734, p = 0.002), concentration/dose above 70 ([ng/mL]/[mg/kg]) (OR = 2.154, p = 0.034) and GCK G-30A (OR = 2.272, p = 0.026) were independently correlated with the incidence of NODAT in logistic regression.

Conclusions: The polymorphisms of CYP3A4 *18B and GCK G-30A were related to NODAT induced by tacrolimus.

Keywords: Cytochrome P450; Glucokinase; New-onset diabetes after transplantation; Renal transplantation; Single nucleotide polymorphisms; Tacrolimus.

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Cytochrome P-450 CYP3A / genetics*
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / genetics*
  • Female
  • Genotype
  • Glucokinase / genetics*
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Kidney Transplantation
  • Male
  • Middle Aged
  • Polymorphism, Single Nucleotide
  • Sulfonylurea Receptors / genetics
  • Tacrolimus / adverse effects*

Substances

  • ABCC8 protein, human
  • Blood Glucose
  • Immunosuppressive Agents
  • Sulfonylurea Receptors
  • CYP3A5 protein, human
  • Cytochrome P-450 CYP3A
  • CYP3A4 protein, human
  • Glucokinase
  • Tacrolimus