Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
Hypertens Res. 2010 Mar;33(3):209-13. doi: 10.1038/hr.2009.212. Epub 2010 Jan 15.
The aim of this study was to evaluate the effect of candesartan on inflammatory biomarkers in hypertensive patients with and without type 2 diabetes mellitus after a standardized oral fat load (OFL). A total of 219 patients were enrolled: 106 patients were assigned to the non-diabetic hypertensive (NH) group, and 113 to the diabetic hypertensive (DH) group. All patients received candesartan therapy for 6 months and underwent a standardized OFL at baseline and after 6 months of therapy. We evaluated systolic blood pressure (SBP) and diastolic blood pressure (DBP), blood glucose (BG), triglycerides (Tg), soluble intercellular adhesion molecule-1 (sICAM-1), interleukin-6 (IL-6) and high-sensitivity C reactive protein (Hs-CRP). At baseline, glycated hemoglobin, homeostasis model assessment insulin resistance index, BG, fasting plasma insulin, Tg, sICAM-1, IL-6 and Hs-CRP in the DH group were significantly higher, whereas high-density lipoprotein-cholesterol value was significantly lower compared to NH group. After 6 months of candesartan therapy, sICAM-1, IL-6 and Hs-CRP were significantly lower compared to baseline in both groups; furthermore, there was a significant decrease of SBP and DBP values in both groups. After the OFL administered at baseline, there was an increase of Tg, sICAM-1, IL-6 and Hs-CRP in both groups. After the OFL administered after 6 months of therapy, instead, there was no significant variation of BG, Tg or sICAM-1 value in both groups, whereas there was an increase of IL-6 and Hs-CRP compared to time 0. We observed that candesartan treatment attenuated the inflammatory answer in both groups of patients, even if more efficiently in nondiabetic ones.
本研究旨在评估坎地沙坦对口服脂肪负荷（OFL）后伴或不伴 2 型糖尿病的高血压患者的炎症生物标志物的影响。共纳入 219 例患者：106 例患者被分配到非糖尿病高血压（NH）组，113 例患者被分配到糖尿病高血压（DH）组。所有患者均接受坎地沙坦治疗 6 个月，并在基线和治疗 6 个月后进行标准化 OFL。我们评估了收缩压（SBP）和舒张压（DBP）、血糖（BG）、三酰甘油（Tg）、可溶性细胞间黏附分子-1（sICAM-1）、白细胞介素-6（IL-6）和高敏 C 反应蛋白（Hs-CRP）。在基线时，DH 组的糖化血红蛋白、稳态模型评估胰岛素抵抗指数、BG、空腹血浆胰岛素、Tg、sICAM-1、IL-6 和 Hs-CRP 明显更高，而高密度脂蛋白胆固醇值明显更低。在坎地沙坦治疗 6 个月后，与基线相比，两组的 sICAM-1、IL-6 和 Hs-CRP 均明显降低；此外，两组的 SBP 和 DBP 值均显著降低。在基线进行 OFL 后，两组的 Tg、sICAM-1、IL-6 和 Hs-CRP 均增加。在治疗 6 个月后进行 OFL 后，两组的 BG、Tg 或 sICAM-1 值没有明显变化，但与 0 时相比，IL-6 和 Hs-CRP 增加。我们观察到坎地沙坦治疗减轻了两组患者的炎症反应，即使在非糖尿病患者中更有效。
