Komiya Naoko, Hirose Hiroshi, Kawabe Hiroshi, Itoh Hiroshi, Saito Ikuo
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
J Atheroscler Thromb. 2009 Apr;16(2):137-42. doi: 10.5551/jat.e588. Epub 2009 Apr 30.
Telmisartan, an angiotensin II receptor blocker (ARB), was reported to have partial peroxisome proliferator-activated receptor gamma (PPAR gamma) activity in vitro. Also, adipocyte-derived protein adiponectin, especially its high molecular weight (HMW) form, has been reported to have beneficial effects on insulin resistance and atherosclerosis. We investigated the effects of 3-month telmisartan therapy on various metabolic parameters, including serum HMW adiponectin and high-sensitivity C-reactive protein (hs-CRP) levels in male hypertensive subjects with abdominal obesity.
This study included 19 Japanese male hypertensive subjects, aged 51.2+/-7.6 (mean+/-SD) years, and body mass index 27.7+/-4.1 kg/m(2). In these subjects, 14 were naive to telmisartan treatment (40.0+/-15.7 mg daily), and 5 were changed from other ARBs to telmisartan. Serum HMW adiponectin concentration was assayed using HMW-selective ELISA kit.
In all 19 subjects, systolic/diastolic blood pressure (BP) decreased from 153/98 to 134/85 mmHg (p<0.001 for both). Serum HMW-adiponectin level increased from 2.06+/-0.81 to 2.40+/-0.96 microg/mL (+16.4%, p=0.017). Body weight, glucose, insulin, lipids and hs-CRP did not change during the study period, and there were no adverse effects in any subject. In the newly administered group (n=14), the results were almost the same: BP decreased from 155/98 to 134/84 mmHg (p=0.0015 for both), and serum HMW-adiponectin level increased from 2.07+/-0.68 to 2.39+/-0.99 microg/mL (+15.5%, p=0.089).
These data suggest that telmisartan therapy is efficient for controlling BP, and may exert beneficial effects on HMW adiponectin in male hypertensive subjects with abdominal obesity.
替米沙坦是一种血管紧张素II受体阻滞剂(ARB),据报道在体外具有部分过氧化物酶体增殖物激活受体γ(PPARγ)活性。此外,据报道脂肪细胞衍生蛋白脂联素,尤其是其高分子量(HMW)形式,对胰岛素抵抗和动脉粥样硬化具有有益作用。我们研究了3个月替米沙坦治疗对各种代谢参数的影响,包括腹部肥胖男性高血压患者的血清HMW脂联素和高敏C反应蛋白(hs-CRP)水平。
本研究纳入了19名日本男性高血压患者,年龄51.2±7.6(均值±标准差)岁,体重指数为27.7±4.1kg/m²。在这些受试者中,14名初次接受替米沙坦治疗(每日40.0±15.7mg),5名从其他ARB类药物换用替米沙坦。使用HMW选择性ELISA试剂盒测定血清HMW脂联素浓度。
在所有19名受试者中,收缩压/舒张压(BP)从153/98降至134/85mmHg(两者p均<0.001)。血清HMW脂联素水平从2.06±0.81升至2.40±0.96μg/mL(升高16.4%,p=0.017)。在研究期间体重、血糖、胰岛素、血脂和hs-CRP均未改变,且所有受试者均未出现不良反应。在新用药组(n=14)中,结果几乎相同:BP从155/98降至134/84mmHg(两者p=0.0015),血清HMW脂联素水平从2.07±0.68升至2.39±0.99μg/mL(升高15.5%,p=0.089)。
这些数据表明替米沙坦治疗对控制血压有效,并且可能对腹部肥胖男性高血压患者的HMW脂联素产生有益影响。