Relationship between insulin resistance and inflammatory markers and anti-inflammatory effect of losartan in patients with type 2 diabetes and hypertension.
BACKGROUND
It is now well established that vascular inflammation and endothelial dysfunction associated with cardiovascular diseases contributes to insulin resistance.


METHODS
We investigated the relationship between the homeostasis model assessment-insulin resistance index (HOMA-R) and various serum inflammatory markers and the effect of losartan on serum concentrations of these markers in patients with type 2 diabetes and hypertension. The patients were divided into 2 groups according to the value of HOMA-R with 60 patients with values=2.4 in Group A and 44 patients with values>2.5 in Group B. The variables were measured at baseline and after 6 months of treatment with losartan (50 mg/day).


RESULTS
The HOMA-R concentrations were positively related to TNF-alpha (r=0.336, P<0.01) and inversely related to adiponectin (r=-0.405, P<0.01) and extracellular-superoxide dismutase (EC-SOD) (r=-0.452, P<0.01). Stepwise multiple regression analysis showed a significant relationship between HOMA-R and adiponectin (F=8.74) and EC-SOD (F=14.39). In Group B, losartan treatment significantly increased the serum concentrations of EC-SOD and adiponectin and decreased TNF-alpha and HOMA-R.


CONCLUSIONS
Serum EC-SOD concentrations may be a sensitive biochemical marker of insulin resistance in patients with type 2 diabetes and hypertension and that losartan improves insulin sensitivity by increasing EC-SOD and adiponectin production and decreasing TNF-alpha production.
Park
Hyohun
H
Department of Internal Medicine, Saiseikai Suita Hospital, Osaka 564-0013, Japan.
Hasegawa
Goji
G
Obayashi
Hiroshi
H
Fujinami
Aya
A
Ohta
Mitsuhiro
M
Hara
Hirokazu
H
Adachi
Tetsuo
T
Tamaki
Shoko
S
Nakajima
Yoshiki
Y
Kimura
Fumiaki
F
Ogata
Masakazu
M
Fukui
Michiaki
M
Yoshikawa
Toshikazu
T
Nakamura
Naoto
N
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007249:Inflammation / Q000097:blood / Q000188:drug therapy*; D007333:Insulin Resistance; D019808:Losartan / Q000627:therapeutic use*; D008297:Male
D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D019808:Losartan