Effects of telmisartan on fat distribution in individuals with the metabolic syndrome.
BACKGROUND
Visceral fat obesity plays an essential role in the clustering of atherosclerotic multiple risk factors in the metabolic syndrome. Telmisartan, an angiotensin II type 1 receptor blocker, has partial agonistic properties for peroxisome proliferator-activated receptor gamma, which is a key regulator of adipocyte differentiation and function.


METHODS
This study aimed to clarify the impact of telmisartan on fat distribution and insulin sensitivity in the metabolic syndrome. In this open-label, prospective, randomized study, patients with the metabolic syndrome (waist circumference: men >or= 85 cm, women >or= 90 cm) were treated either with amlodipine (n = 26) or with telmisartan (n = 27) for 24 weeks, and fat distribution and insulin sensitivity were determined.


RESULTS
Systolic and diastolic blood pressure were decreased in both groups to a comparable level. However, insulin and glucose levels during an oral 75 g glucose loading were decreased only in the telmisartan group. The visceral fat area, determined by abdominal computed tomography scan, was reduced in the telmisartan group after 24 weeks' treatment, but the subcutaneous fat area did not change in either group.


CONCLUSIONS
The results imply that telmisartan could treat both the hemodynamic and metabolic aberrations seen in patients with the metabolic syndrome, improving insulin resistance and glucose intolerance at least partly through visceral fat remodeling.
Shimabukuro
Michio
M
Second Department of Internal Medicine, Faculty of Medicine, University of the Ryukyus, Okinawa and Diabetes and Life-style Related Disease Center, Tomishiro Chuo Hospital, Okinawa, Japan. mshimabukuro-ur@umin.ac.jp
Tanaka
Hideaki
H
Shimabukuro
Takeshi
T
D052436:Adipose Tissue, White / Q000187:drug effects*; D000328:Adult; D000368:Aged; D017311:Amlodipine / Q000627:therapeutic use; D000704:Analysis of Variance; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001011:Aorta / Q000187:drug effects / Q000503:physiopathology; D001562:Benzimidazoles / Q000627:therapeutic use*; D001565:Benzoates / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D050218:Body Fat Distribution; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000187:drug effects; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008875:Middle Aged; D011446:Prospective Studies; D012107:Research Design; D000077333:Telmisartan; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014655:Vascular Resistance / Q000187:drug effects
D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001565:Benzoates; D015415:Biomarkers; D001786:Blood Glucose; D002121:Calcium Channel Blockers; D007328:Insulin; D017311:Amlodipine; D000077333:Telmisartan