Indapamide decreases plasma adiponectin concentration in patients with essential hypertension.
OBJECTIVE
Adiponectin is an adipose tissue-specific protein with antiatherogenic and insulin-sensitizing properties. In patients with essential hypertension, plasma adiponectin concentrations are lower than in healthy subjects. Antihypertensive drugs do not uniformly influence components of the metabolic syndrome. Therefore, the aim of this study was to evaluate the influence of 6 months' monotherapy with different antihypertensive drugs on plasma adiponectin concentration in essential hypertension patients.


METHODS
Forty essential hypertension patients were randomized to receive enalapril, metoprolol, amlodipine or indapamide. Plasma concentrations of adiponectin, insulin, glucose and body fat content were estimated twice: before and after 6 months of antihypertensive monotherapy.


RESULTS
Plasma adiponectin concentration did not change significantly after enalapril (11.5 +/- 4.8 vs. 11.1 +/- 4.1 mg/l), metoprolol (10.2 +/- 4.2 vs. 9.8 +/- 4.5 mg/l), and amlodipine (9.0 +/- 6.0 vs. 8.5 +/- 5.4 mg/l) treatment. However, a significant decrease of plasma adiponectin concentration (from 11.6 +/- 4.6 to 10.2 +/- 4.2 mg/l, p = 0.047) was observed in patients treated with indapamide. Additionally in these patients, a significant increase of the HOMA-IR index was found (p = 0.021).


CONCLUSIONS
Treatment with indapamide was followed by a significant decrease of plasma adiponectin concentration. This may participate in the pathogenesis of carbohydrate metabolism disturbances often found in patients treated with thiazide-type diuretics.
Piecha
Grzegorz
G
Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Poland.
Adamczak
Marcin
M
Chudek
Jerzy
J
Wiecek
Andrzej
A
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D017311:Amlodipine / Q000008:administration & dosage; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D004656:Enalapril / Q000008:administration & dosage; D005260:Female; D005919:Glomerular Filtration Rate; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D006977:Hypertension, Renal / Q000097:blood* / Q000188:drug therapy*; D007190:Indapamide / Q000008:administration & dosage*; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D008790:Metoprolol / Q000008:administration & dosage; D008875:Middle Aged
D052242:Adiponectin; D000959:Antihypertensive Agents; D008055:Lipids; D017311:Amlodipine; D004656:Enalapril; D007190:Indapamide; D008790:Metoprolol