Pathogenic analysis of post-transplantation obesity: A comprehensive systematic review

Table 3 Summary of metabolic effects and mechanisms of common

Immunosuppressant	Major metabolic effects	Proposed mechanisms	Ref.
Glucocorticoids	Hyperphagia, central adiposity, insulin resistance	↑ Appetite via central regulation; ↓ adiponectin, ↑ leptin resistance	[11]
Tacrolimus (CNI)	Impaired glucose tolerance, β-cell apoptosis	Inhibition of PI3K/Akt/mTOR; microbiome alterations	[15]
Cyclosporine (CNI)	Dyslipidemia, insulin resistance	Mitochondrial dysfunction, oxidative stress	[18]
Mycophenolate Mofetil	Dyslipidemia	Synergistic effects when combined with steroids/CNIs	[18]
Azathioprine	Less studied; associated with lipid alterations	Likely indirect or combined effects	[18]

CNI: Calcineurin inhibitor.