Servicio de Medicina Interna, Hospital San Pedro de Alcántara, Cáceres, Spain.
J Investig Med. 2011 Mar;59(3):602-5. doi: 10.2310/JIM.0b013e31820bf26b.
Metabolic syndrome (MS) is a disease with an inflammatory component. Telmisartan improves insulin resistance in MS, but its relationship with the inflammatory state is unknown. We investigated the effect of 3-month telmisartan therapy on homeostatic model assessment-insulin resistance (HOMA-IR) in hypertensive subjects with MS with regard to the levels of circulating plasma cytokines.
A total of 42 patients were included in this study; 30 were men (71%), aged 50 ± 8.2 years (mean ± SD). Cytokines and metabolic parameters were analyzed before and after treatment with telmisartan.
Twenty-eight patients showed low plasma levels of cytokines (group 1) similar to control subjects, and 14 showed high levels (group 2). Treatment with telmisartan diminished by 35% HOMA-IR in group 1 (4.5 ± 3.1 vs 2.9 ± 2.1), without improvement in group 2. In the multivariate analysis, the predictors of improvement of HOMA-IR in response to telmisartan treatment were low levels of cytokines, whereas systolic and diastolic blood pressure and the elevation of high-sensitivity C-reactive protein had a negative effect.
Our study provides evidence of a more favorable effect of telmisartan on glucose homeostasis in patients with MS and low levels of serum cytokines.
代谢综合征（MS）是一种具有炎症成分的疾病。替米沙坦可改善 MS 患者的胰岛素抵抗，但与炎症状态的关系尚不清楚。我们研究了 3 个月替米沙坦治疗对伴有 MS 的高血压患者稳态模型评估-胰岛素抵抗（HOMA-IR）的影响，以及循环血浆细胞因子水平。
本研究共纳入 42 例患者；30 例为男性（71%），年龄 50 ± 8.2 岁（均值 ± SD）。用替米沙坦治疗前后分析细胞因子和代谢参数。
28 例患者表现出低水平的细胞因子（组 1），与对照组相似，14 例患者表现出高水平（组 2）。替米沙坦治疗使组 1 的 HOMA-IR 降低了 35%（4.5 ± 3.1 与 2.9 ± 2.1），但组 2 没有改善。多变量分析表明，替米沙坦治疗 HOMA-IR 改善的预测因子是低水平的细胞因子，而收缩压和舒张压以及高敏 C 反应蛋白升高则有负面影响。
我们的研究提供了证据，表明替米沙坦对血清细胞因子水平较低的 MS 患者的血糖稳态有更有利的影响。
