Okada Kenta, Hirano Tsutomu, Ran Jianmin, Adachi Mitsuru
First Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan.
Hypertens Res. 2004 Apr;27(4):293-9. doi: 10.1291/hypres.27.293.
Although angiotensin II receptor blockers (ARBs) have been recommended as a first line of anti-hypertensive agents in patients with diabetes, it remains unclear whether ARBs have a favorable effect on insulin action and triglyceride (TG) metabolism, both of which are impaired in type 2 diabetes. In this study we addressed this issue by investigating how a newly developed ARB, olmesartan medoxomil, influenced insulin sensitivity and TG metabolism in fructose-fed rats, a representative animal model of insulin resistance. Olmesartan was administrated as a 0.01% drinking solution ad libitum to rats either fed normal chow or fructose-enriched chow (60%) for 21 days. Olmesartan treatment markedly decreased both systolic and diastolic blood pressure in both chow-fed and fructose-fed animals. The area under the curve of insulin (AUCI) was substantially greater in fructose-fed rats in the intravenous glucose tolerance test, and olmesartan treatment significantly reduced the AUCI. Olmesartan significantly improved the insulin sensitivity index in fructose-fed rats assessed by Bergman's minimal model without affecting insulin-independent glucose disposal. Olmesartan significantly decreased plasma TG and non-esterified fatty acid levels in fructose-fed rats without affecting lipoprotein lipase mass. The TG secretion rate determined by the triton WR1339 technique was two-fold higher in fructose-fed rats, but olmesartan restored the TG secretion to a normal rate. Olmesartan did not affect plasma parameters, insulin sensitivity or TG metabolism in chow-fed rats. Olmesartan ameliorates insulin resistance and overproduction of TG in fructose-fed rats, and these effects appear to be independent of its hypotensive action.
尽管血管紧张素 II 受体阻滞剂(ARBs)已被推荐作为糖尿病患者的一线抗高血压药物,但 ARBs 对胰岛素作用和甘油三酯(TG)代谢是否有有利影响仍不清楚,而这两者在 2 型糖尿病中均受损。在本研究中,我们通过研究一种新开发的 ARB 奥美沙坦酯如何影响果糖喂养大鼠(一种胰岛素抵抗的代表性动物模型)的胰岛素敏感性和 TG 代谢来解决这个问题。将奥美沙坦作为 0.01%的饮水溶液随意给予正常饲料喂养或高果糖饲料(60%)喂养 21 天的大鼠。奥美沙坦治疗显著降低了正常饲料喂养和果糖喂养动物的收缩压和舒张压。在静脉葡萄糖耐量试验中,果糖喂养大鼠的胰岛素曲线下面积(AUCI)显著更大,而奥美沙坦治疗显著降低了 AUCI。通过伯格曼最小模型评估,奥美沙坦显著改善了果糖喂养大鼠的胰岛素敏感性指数,而不影响非胰岛素依赖的葡萄糖处置。奥美沙坦显著降低了果糖喂养大鼠的血浆 TG 和非酯化脂肪酸水平,而不影响脂蛋白脂肪酶质量。用 Triton WR1339 技术测定的果糖喂养大鼠的 TG 分泌率高出两倍,但奥美沙坦将 TG 分泌恢复到正常水平。奥美沙坦对正常饲料喂养大鼠的血浆参数、胰岛素敏感性或 TG 代谢没有影响。奥美沙坦改善了果糖喂养大鼠的胰岛素抵抗和 TG 过度产生,并且这些作用似乎与其降压作用无关。