Huang Gao-Zhong, Tang Ye-Hua, Wang Bei-Yun, Zhang Bei, Hu Ting-Jun, Zhang Li, Zhang Xiao-Yan, Zhong Yuan
Department of Gerontology, Sixth People's Hospital, Shanghai Jiaotong University, Yisan Road 600, Shanghai 200233, China.
Saudi Med J. 2011 Oct;32(10):1017-21.
To investigate the effects of telmisartan on body fat distribution and insulin sensitivity in patients with hypertension and obesity.
In this prospective, randomized study, outpatients from the Sixth People's Hospital affiliated to Shanghai Jiaotong University, Shanghai, China were treated with telmisartan (n=23), or losartan (n=22) for 16 weeks between December 2009 to January 2011. Parameters such as waist and hip circumference, body mass index, fasting blood glucose, insulin, lipids, serum adiponectin, and tumor necrosis factor-alpha (TNF-alpha) were measured before and after treatment. The abdominal visceral fat area (VFA) and subcutaneous fat area (SFA) were determined by magnetic resonance imaging. Insulin sensitivity was estimated by homeostasis model assessment (HOMA-IR).
Compared with baseline, the systolic and diastolic blood pressure decreased significantly in both groups. However, the levels of HOMA-IR, serum adiponectin, and TNF-alpha only improved in the telmisartan group. Similarly, the VFA was reduced in the telmisartan group, while the SFA did not change in either group.
Telmisartan improves both hemodynamic and metabolic abnormalities found in hypertensive patients with obesity. The additional benefits may be partly due to visceral fat remodeling.
探讨替米沙坦对高血压合并肥胖患者体脂分布及胰岛素敏感性的影响。
在这项前瞻性随机研究中，2009年12月至2011年1月期间，来自中国上海交通大学附属第六人民医院的门诊患者分别接受替米沙坦治疗（n = 23）或氯沙坦治疗（n = 22），为期16周。在治疗前后测量腰围、臀围、体重指数、空腹血糖、胰岛素、血脂、血清脂联素和肿瘤坏死因子-α（TNF-α）等参数。通过磁共振成像测定腹部内脏脂肪面积（VFA）和皮下脂肪面积（SFA）。采用稳态模型评估（HOMA-IR）估算胰岛素敏感性。
与基线相比，两组的收缩压和舒张压均显著降低。然而，仅替米沙坦组的HOMA-IR、血清脂联素和TNF-α水平有所改善。同样，替米沙坦组的VFA降低，而两组的SFA均未改变。
替米沙坦可改善高血压合并肥胖患者的血流动力学和代谢异常。这些额外的益处可能部分归因于内脏脂肪重塑。
