title: Effects of telmisartan on fat distribution: a meta-analysis of randomized controlled trials.
abstract: Several meta-analyses have confirmed the positive metabolic effects of telmisartan, an angiotensin II receptor blocker that can also act as a partial peroxisome proliferator-activated receptor-γ agonist, compared to those of other angiotensin II receptor blockers. These effects include decreased fasting glucose, glycosylated hemoglobin, interleukin-6, and tumor necrosis factor-α levels. However, no systemic analysis of telmisartan's effects on body fat distribution has been performed. We performed a meta-analysis of randomized controlled telmisartan trials to investigate its effects on body weight, fat distribution, and visceral adipose reduction.
  
  
  
  A literature search was performed using Embase, MEDLINE, and the Cochrane Library between January 1966 and November 2013. Randomized controlled trials in English and meeting the following criterion were included: random assignment of hypertensive participants with overweight/obesity, metabolic syndrome, or glucose intolerance to telmisartan or control therapy group.
  
  
  
  Of 651 potentially relevant reports, 15 satisfied the inclusion criterion. While visceral fat area was significantly lower in the telmisartan group than in the control group (weighted mean difference = -18.13 cm(2), 95% C.I. = -27.16 to -9.11, Pχ(2) = 0.19, I(2) = 41%), subcutaneous fat area was similar (weighted mean difference =2.94 cm(2), 95% C.I. = -13.01 to 18.89, Pχ(2) = 0.30, I(2) = 17%). Total cholesterol levels were significantly different between the groups (standardized mean difference = -0.24, 95% C.I. = -0.45 to -0.03, Pχ(2) = 0.0002, I(2) = 67%).
  
  
  
  Limitations include: (1) limited number of studies, especially those evaluating fat distribution; (2) different imaging modalities to assess visceral fat area (V.F.A.) and subcutaneous fat area (S.F.A.); (3) observed heterogeneity.
  
  
  
  The findings suggest that telmisartan affected fat distribution, inducing visceral fat reduction, and thus could be useful in hypertensive patients with obesity/overweight, metabolic syndrome, or glucose intolerance.
authors.affiliation: a Department of Anesthesiology and Pain Medicine , Chung-Ang University College of Medicine , Seoul , Korea ;
authors.forename: Geun Joo
authors.initials: GJ
authors.lastname: Choi
authors.affiliation: b Division of Endocrinology and Metabolism, Department of Internal Medicine , Chung-Ang University College of Medicine , Seoul , Korea.
authors.forename: Hyun Min
authors.initials: HM
authors.lastname: Kim
authors.affiliation: a Department of Anesthesiology and Pain Medicine , Chung-Ang University College of Medicine , Seoul , Korea ;
authors.forename: Hyun
authors.initials: H
authors.lastname: Kang
authors.affiliation: b Division of Endocrinology and Metabolism, Department of Internal Medicine , Chung-Ang University College of Medicine , Seoul , Korea.
authors.forename: Jaetaek
authors.initials: J
authors.lastname: Kim
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects*; D001562:Benzimidazoles / Q000494:pharmacology / Q000627:therapeutic use; D001565:Benzoates / Q000494:pharmacology / Q000627:therapeutic use; D050218:Body Fat Distribution; D001835:Body Weight / Q000187:drug effects; D006801:Humans; D009765:Obesity / Q000188:drug therapy; D047495:PPAR gamma / Q000819:agonists*; D016032:Randomized Controlled Trials as Topic; D000077333:Telmisartan
chemical_list: D001562:Benzimidazoles; D001565:Benzoates; D047495:PPAR gamma; D000077333:Telmisartan
keywords: Body fat distribution; Hypertension; Obesity; Telmisartan