title: Effects of telmisartan on adiponectin levels and body weight in hypertensive patients with glucose intolerance.
abstract: Few studies have analyzed intraclass differences in angiotensin II receptor blockers (ARBs) with respect to antidiabetic or metabolic effects. We designed a prospective randomized study to compare a peroxisome proliferator-activated receptor-gamma (PPARgamma)-activating ARB with a nonactivating ARB to delineate the effects on metabolic factors associated with cardiovascular disease. Subjects initially comprised 153 hypertensive patients (72 men, 81 women; mean age, 67.9 +/- 7.8 years) with diagnosed glucose intolerance on the glucose loading test. Patients were randomly assigned to receive 6-month administration of telmisartan 47.0 mg/d (TEL) or candesartan 8.4 mg/d (CAN), or to have no change in drug regimen (control group, CTL). Fasting plasma glucose level was significantly reduced in TEL (n = 46) compared with CTL (n = 47) (percentage of change from baseline, -1.7% vs +2.2%; P = .045). Percentage of increase in adiponectin was significantly larger in TEL than in CTL (+10.5% vs +2.2%, P = .025), but not significantly larger in CAN (n = 44) than in CTL (+4.9% vs +2.2%; P = .13). Percentage of decrease in body weight from baseline was significantly enhanced in TEL compared with CTL (-2.2% vs -0.8%, P = .023) and CAN (-2.2% vs -0.3%, P = .007). Telmisartan decreased body weight while increasing serum adiponectin levels in hypertensive patients with glucose intolerance. Candesartan did not achieve similar improvements in these patients. Among ARBs, telmisartan may have a larger impact on obesity-related diseases that can lead to cardiovascular disorders.
authors.affiliation: Department of Internal Medicine II and Memorial Heart Center, Iwate Medical University School of Medicine, Morioka 0208505, Japan. makitas@seagreen.ocn.ne.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Makita
authors.forename: Akihiko
authors.initials: A
authors.lastname: Abiko
authors.forename: Yujirou
authors.initials: Y
authors.lastname: Naganuma
authors.forename: Yoshiteru
authors.initials: Y
authors.lastname: Moriai
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001565:Benzoates / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D005260:Female; D018149:Glucose Intolerance / Q000188:drug therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy*; D007328:Insulin / Q000097:blood; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000077333:Telmisartan; D013777:Tetrazoles / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood
chemical_list: D052242:Adiponectin; D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001565:Benzoates; D001713:Biphenyl Compounds; D002097:C-Reactive Protein; D002784:Cholesterol; D006442:Glycated Hemoglobin; D007328:Insulin; D000077333:Telmisartan; D013777:Tetrazoles; D014280:Triglycerides; C499918:ADIPOQ protein, human; C081643:candesartan