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替米沙坦可改善肥胖伴动脉高血压患者的心血代谢状况。

Telmisartan improves cardiometabolic profile in obese patients with arterial hypertension.

机构信息

Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Poland.

出版信息

Kidney Blood Press Res. 2012;35(4):281-9. doi: 10.1159/000334951. Epub 2012 Feb 23.

DOI:10.1159/000334951
PMID:22378488
Abstract

OBJECTIVE

There are several lines of evidence that telmisartan may improve cardiometabolic profile. The aim of the study was to estimate changes of insulin resistance and plasma concentrations of adipokines after long-term antihypertensive treatment with telmisartan in obese hypertensive patients.

METHODS

34 previously untreated obese adults with arterial hypertension were enrolled. Glucose cellular uptake (M value) and the M to insulin ratio (M/I value) were measured by euglycemic-hyperinsulinemic clamp technique, body fat content (by dual-energy X-ray absorptiometry method), as well as plasma concentrations of selected adipokines and cytokines were estimated before and after 6-month telmisartan therapy in 25 patients who completed the study.

RESULTS

Telmisartan therapy was followed by 14.2% decrease of systolic and by 19.6% decrease of diastolic blood pressure. Body fat mass did not change significantly. Both M and M/I values (by 24.4 and by 38.6%, respectively) as well as plasma levels of total and high-molecular-weight adiponectin (by 10.8 and by 23.5%, respectively) increased significantly. Plasma concentrations of high-sensitivity C- reactive protein and interleukin-8 decreased significantly, while those of interleukin-6 and tumor necrosis factor-α tended to decline.

CONCLUSIONS

Telmisartan monotherapy improves cardiometabolic profile in obese hypertensive patients by improving insulin sensitivity and increasing of plasma adiponectin concentration, including its high-molecular-weight fraction, and by suppressing of microinflammation.

摘要

目的

有多项证据表明替米沙坦可能改善心脏代谢指标。本研究旨在评估肥胖高血压患者接受替米沙坦长期降压治疗后胰岛素抵抗和脂联素等血浆浓度的变化。

方法

34 名未经治疗的肥胖高血压成人患者纳入研究。采用正葡萄糖高胰岛素钳夹技术测量葡萄糖细胞摄取(M 值)和 M 与胰岛素的比值(M/I 值),用双能 X 射线吸收法测量体脂含量,以及在 25 名完成研究的患者中分别在替米沙坦治疗前和治疗 6 个月后测定选定的脂联素和细胞因子的血浆浓度。

结果

替米沙坦治疗后收缩压降低 14.2%,舒张压降低 19.6%。体脂质量无显著变化。M 值和 M/I 值分别增加 24.4%和 38.6%,总和高分子量脂联素的血浆水平分别增加 10.8%和 23.5%。高敏 C 反应蛋白和白细胞介素-8 的血浆浓度显著降低,而白细胞介素-6 和肿瘤坏死因子-α的浓度则呈下降趋势。

结论

替米沙坦单药治疗可改善肥胖高血压患者的心脏代谢指标,提高胰岛素敏感性,增加血浆脂联素浓度,包括其高分子量部分,并抑制微炎症。

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