title: Intramyocellular lipid content in subjects with impaired fasting glucose after telmisartan treatment, a randomised cross-over trial.
abstract: Ectopic lipid accumulation in skeletal muscle is associated with insulin resistance. Telmisartan improves metabolic parameters in type 2 diabetic patients. The aim of our study was to evaluate the in vivo effect of telmisartan on intramyocellular lipid content (IMCL) in subjects with impaired fasting glucose (IFG) by magnetic resonance spectroscopy (MRS). We enrolled 10 subjects with IFG in a cross-over, placebo-controlled, randomized, double-blind trial, treated with 3 weeks of telmisartan (160 mg daily) or placebo. After completing each treatment, a hyperinsulinaemic euglycaemic clamp (1 mU/kg per min; 5 mmol/l; 120 min) to assess insulin action (metabolic clearance rate of glucose, MCR) and (1)H MRS of the m. tibialis anterior using a MR Scanner Siemens Vision operating at 1.5 T to evaluate IMCL content, were performed. Plasma adipokine levels were determined simultaneously. Telmisartan treatment resulted in a lower fasting plasma glucose (FPG) (p < 0.05), but insulin action was comparable to after placebo. Telmisartan did not affect IMCL content. After placebo, IMCL correlated negatively with total cholesterol (p < 0.001), MCR (p < 0.05) and adiponectin (p < 0.05) and positively with FPG (p < 0.05). After telmisartan treatment there was only a positive correlation between IMCL and TNFα (p < 0.05). IMCL content is related to parameters of glucose metabolism and insulin action in sedentary IFG subjects. A short telmisartan treatment did not affect the IMCL content despite its positive effect on FPG. The improvement in FPG was probably mediated through interference with other metabolic pathways.
authors.affiliation: Diabetes Center, Institute for Clinical and Experimental Medicine, Vídeňská 1958/4, Prague 140 21, Czech Republic.
authors.forename: Simona
authors.initials: S
authors.lastname: Kratochvílová
authors.affiliation: MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Vídeňská 1958/4, Prague 140 21, Czech Republic.
authors.forename: Antonín
authors.initials: A
authors.lastname: Škoch
authors.affiliation: Diabetes Center, Institute for Clinical and Experimental Medicine, Vídeňská 1958/4, Prague 140 21, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Wohl
authors.affiliation: Diabetes Center, Institute for Clinical and Experimental Medicine, Vídeňská 1958/4, Prague 140 21, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Švehlíková
authors.affiliation: MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Vídeňská 1958/4, Prague 140 21, Czech Republic.
authors.forename: Monika
authors.initials: M
authors.lastname: Dezortová
authors.affiliation: Institute of Endocrinology, Národní 8, Prague 116 94, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Hill
authors.affiliation: MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Vídeňská 1958/4, Prague 140 21, Czech Republic.
authors.forename: Milan
authors.initials: M
authors.lastname: Hájek
authors.affiliation: Diabetes Center, Institute for Clinical and Experimental Medicine, Vídeňská 1958/4, Prague 140 21, Czech Republic. Electronic address: terezie.pelikanova@ikem.cz.
authors.forename: Terezie
authors.initials: T
authors.lastname: Pelikánová
mesh_terms: D054392:Adipokines / Q000097:blood; D052242:Adiponectin / Q000097:blood / Q000737:chemistry; D000328:Adult; D001562:Benzimidazoles / Q000627:therapeutic use*; D001565:Benzoates / Q000627:therapeutic use*; D001786:Blood Glucose / Q000737:chemistry*; D002151:Calorimetry; D002784:Cholesterol / Q000737:chemistry; D018592:Cross-Over Studies; D003593:Cytoplasm / Q000378:metabolism; D004311:Double-Blind Method; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000737:chemistry; D007333:Insulin Resistance; D008055:Lipids / Q000737:chemistry*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood; D008875:Middle Aged; D009132:Muscles / Q000378:metabolism*; D000077333:Telmisartan
chemical_list: D054392:Adipokines; D052242:Adiponectin; D001562:Benzimidazoles; D001565:Benzoates; D001786:Blood Glucose; D007328:Insulin; D008055:Lipids; D002784:Cholesterol; D000077333:Telmisartan
keywords: (1)H MR Spectroscopy; Impaired fasting glucose; Insulin resistance; Intramyocellular lipid content; Telmisartan