title: Effect of selective and non-selective beta-blockers on body weight, insulin resistance and leptin concentration in chronic heart failure.
abstract: BACKGROUND
  Chronic heart failure (CHF) is characterized by increased insulin resistance and hyperleptinaemia. We aimed to study effects of selective and non-selective beta-blockers on body weight, insulin resistance, plasma concentrations of leptin and resistin in patients with CHF.
  
  
  METHODS
  Twenty-six non-cachectic beta-blocker-naive patients with CHF were randomized and treated with either carvedilol or bisoprolol. Body weight, plasma concentrations of leptin, resistin, fasting glucose and insulin were measured at baseline and after 6 months of therapy. Insulin resistance was estimated by homeostasis model assessment- estimated insulin resistance (HOMA-IR).
  
  
  RESULTS
  Body weight increased significantly in the carvedilol group (mean change + 2.30 kg, p = 0.023) while it did not change in the bisoprolol group (mean change -0.30 kg, p = 0.623) (ns between groups). Plasma leptin concentration increased only in the carvedilol group (mean change + 4.20 ng/ml, p = 0.019) (ns between groups). Fasting glucose and resistin remained unchanged in both groups. After 6 months, mean plasma insulin concentration changed significantly differently (p = 0.015) in the bisoprolol (mean change +3.1 microU/ml) compared to the carvedilol group (mean change -6.3 microU/ml) and HOMA-IR was consequently higher in the bisoprolol compared to the carvedilol group (5.2 +/- 4.2 vs 2.8 +/- 1.6, p = 0.046).
  
  
  CONCLUSIONS
  This study found different metabolic effects of carvedilol and bisoprolol in non-cachectic patients with CHF. With unchanged fasting plasma glucose concentration after 6 months of treatment, carvedilol significantly decreased plasma insulin concentration and insulin resistance compared to bisoprolol.
authors: Department of Cardiology, General and Teaching Hospital Celje, Celje, Slovenia.
authors: D
authors: D
authors: Kovacić
authors: M
authors: M
authors: Marinsek
authors: L
authors: L
authors: Gobec
authors: M
authors: M
authors: Lainscak
authors: M
authors: M
authors: Podbregar
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D000368:Aged; D017298:Bisoprolol / Q000494:pharmacology* / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D002227:Carbazoles / Q000494:pharmacology* / Q000627:therapeutic use; D000077261:Carvedilol; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011412:Propanolamines / Q000494:pharmacology* / Q000627:therapeutic use; D052243:Resistin / Q000097:blood
chemical_list: D000319:Adrenergic beta-Antagonists; D001786:Blood Glucose; D002227:Carbazoles; D007328:Insulin; D020738:Leptin; D011412:Propanolamines; D052243:Resistin; D000077261:Carvedilol; D017298:Bisoprolol
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