Telmisartan improves insulin resistance in patients with low cytokine levels.
Metabolic syndrome (MS) is a disease with an inflammatory component. Telmisartan improves insulin resistance in MS, but its relationship with the inflammatory state is unknown. We investigated the effect of 3-month telmisartan therapy on homeostatic model assessment-insulin resistance (HOMA-IR) in hypertensive subjects with MS with regard to the levels of circulating plasma cytokines.


METHODS
A total of 42 patients were included in this study; 30 were men (71%), aged 50 ± 8.2 years (mean ± SD). Cytokines and metabolic parameters were analyzed before and after treatment with telmisartan.


RESULTS
Twenty-eight patients showed low plasma levels of cytokines (group 1) similar to control subjects, and 14 showed high levels (group 2). Treatment with telmisartan diminished by 35% HOMA-IR in group 1 (4.5 ± 3.1 vs 2.9 ± 2.1), without improvement in group 2. In the multivariate analysis, the predictors of improvement of HOMA-IR in response to telmisartan treatment were low levels of cytokines, whereas systolic and diastolic blood pressure and the elevation of high-sensitivity C-reactive protein had a negative effect.


CONCLUSIONS
Our study provides evidence of a more favorable effect of telmisartan on glucose homeostasis in patients with MS and low levels of serum cytokines.
Servicio de Medicina Interna, Hospital San Pedro de Alcántara, Cáceres, Spain. juanf.sanchezm@gmail.com
Juan Francisco
JF
Sanchez Muñoz-Torrero
Maria D
MD
Rivas
Alberto
A
Costo
Leandro
L
Crespo
Juana
J
Fraile
Carlos
C
Doncel
Jose Maria
JM
Fernandez Toro
Jose
J
Zamorano
D000328:Adult; D001562:Benzimidazoles / Q000494:pharmacology / Q000627:therapeutic use*; D001565:Benzoates / Q000494:pharmacology / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000188:drug therapy; D008875:Middle Aged; D000077333:Telmisartan
D001562:Benzimidazoles; D001565:Benzoates; D015415:Biomarkers; D001786:Blood Glucose; D016207:Cytokines; D000077333:Telmisartan