Effect of amlodipine on insulin resistance & tumor necrosis factor-alpha levels in hypertensive obese type 2 diabetic patients.
OBJECTIVE
Tumour necrosis factor-alpha (TNF-alpha) has been suggested to play a key role in insulin resistance (IR) in obesity and may contribute to the development of type 2 diabetes mellitus. Recently, studies are focused on the effect of antihypertensive drugs on insulin sensitivity and cytokines. We undertook this study to evaluate the effect of amlodipine, a long-acting dihydropyridine calcium channel blocker treatment on TNF-alpha, homeostasis model assessment (HOMA) IR and leptin levels in obese hypertensive type 2 diabetic patients.


METHODS
Amlodipine 5-10 mg for 12 wk was given to type 2 diabetic patients in the amlodipine group. Pre- and post-treatment values of laboratory parameters in the amlodipine group were compared with those of normotensive nondiabetic obese controls. At baseline blood pressures (BP) and metabolic parameters were measured in all patients and repeated after 12 wk in the amlodipine group.


RESULTS
Basal waist-to-hip ratio, systolic and diastolic BPs, fasting glucose, TNF-alpha and HOMAIR values of the amlodipine group were higher than the control group. No difference was detected in body mass index, fasting insulin, hemoglobin A1c and leptin values between groups. The systolic and diastolic BPs, fasting glucose, HOMA-IR and TNF-alpha values decreased significantly after the treatment. But, there was no correlation between percentage change in TNF-alpha and HOMA-IR.


CONCLUSIONS
Besides reducing BP, amlodipine seemed to improve IR and decrease TNF-alpha levels. In this context, these properties may provide additional benefits of antihypertensive drug regimens chosen for this population, but larger group interventions are needed.
Ersoy
Canan
C
Department of Endocrinology & Metabolism, Uludağ University Medical School, Bursa, Turkey. ecanan@uludag.edu.tr
Imamoğlu
Sazi
S
Budak
Ferah
F
Tuncel
Ercan
E
Ertürk
Erdinç
E
Oral
Barbaros
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D017311:Amlodipine / Q000378:metabolism / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000378:metabolism / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005260:Female; D006706:Homeostasis; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism; D007333:Insulin Resistance; D020738:Leptin / Q000378:metabolism; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism*; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
D002121:Calcium Channel Blockers; D020738:Leptin; D008055:Lipids; D014409:Tumor Necrosis Factor-alpha; D017311:Amlodipine