Effects of Telmisartan on Insulin Resistance in Japanese Type 2 Diabetic Patients
Objective PPARγ agonists are widely used in type 2 diabetic patients to reduce insulin resistance. Recently, telmisartan, an AT1 receptor antagonist, was reported to function as a partial agonist of PPARγ based on in vitro experiments. The aim of the present study was to investigate whether the PPAR...
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Veröffentlicht in: | Internal Medicine 2010, Vol.49(17), pp.1843-1847 |
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description | Objective PPARγ agonists are widely used in type 2 diabetic patients to reduce insulin resistance. Recently, telmisartan, an AT1 receptor antagonist, was reported to function as a partial agonist of PPARγ based on in vitro experiments. The aim of the present study was to investigate whether the PPARγ enhancing activity of telmisartan is exerted clinically in diabetic patients. Methods We compared the effects of telmisartan with those of candesartan, on insulin sensitivity, the serum levels of various adipocytokines and oxidative stress. Patients In total, 85 Japanese type 2 diabetic patients with hypertension, maintained on 8 mg per day of candesartan, were randomly assigned to the TM group (candesartan switched to 40 mg of telmisartan, n=38) or the CD group (no treatment change, n=47). Results After 3 months, oxidized lipids were significantly decreased only in the TM group. Although the homeostasis assessment model of insulin resistance (HOMA-R) tended to be improved and serum concentrations of HDL-cholesterol and HMW adiponectin tended to be increased only in the TM group, these alterations were too small to be significant by unpaired t-test. Interestingly, in subgroup analysis, the alterations of HOMA-R, serum concentrations of oxidized lipids, and HMW adiponectin were more apparent in obese TM group subjects and the changes reached statistical significance. Conclusion Switching from candesartan to telmisartan in obese subjects increases serum adiponectin and improves both insulin resistance and oxidative stress, while these effects were not statistically apparent in the total patient population. These results support the idea that telmisartan exerts its PPARγ enhancing activity clinically in obese type 2 diabetic patients. |
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Recently, telmisartan, an AT1 receptor antagonist, was reported to function as a partial agonist of PPARγ based on in vitro experiments. The aim of the present study was to investigate whether the PPARγ enhancing activity of telmisartan is exerted clinically in diabetic patients. Methods We compared the effects of telmisartan with those of candesartan, on insulin sensitivity, the serum levels of various adipocytokines and oxidative stress. Patients In total, 85 Japanese type 2 diabetic patients with hypertension, maintained on 8 mg per day of candesartan, were randomly assigned to the TM group (candesartan switched to 40 mg of telmisartan, n=38) or the CD group (no treatment change, n=47). Results After 3 months, oxidized lipids were significantly decreased only in the TM group. Although the homeostasis assessment model of insulin resistance (HOMA-R) tended to be improved and serum concentrations of HDL-cholesterol and HMW adiponectin tended to be increased only in the TM group, these alterations were too small to be significant by unpaired t-test. Interestingly, in subgroup analysis, the alterations of HOMA-R, serum concentrations of oxidized lipids, and HMW adiponectin were more apparent in obese TM group subjects and the changes reached statistical significance. Conclusion Switching from candesartan to telmisartan in obese subjects increases serum adiponectin and improves both insulin resistance and oxidative stress, while these effects were not statistically apparent in the total patient population. These results support the idea that telmisartan exerts its PPARγ enhancing activity clinically in obese type 2 diabetic patients.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.49.3189</identifier><identifier>PMID: 20823643</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>adiponectin ; Adiponectin - blood ; Aged ; Angiotensin II Type 1 Receptor Blockers - pharmacology ; Angiotensin II Type 1 Receptor Blockers - therapeutic use ; Antihypertensive Agents - pharmacology ; Antihypertensive Agents - therapeutic use ; Benzimidazoles - pharmacology ; Benzimidazoles - therapeutic use ; Benzoates - pharmacology ; Benzoates - therapeutic use ; Cholesterol, HDL - blood ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - physiopathology ; Female ; Homeostasis ; Humans ; Hypertension - complications ; Hypertension - drug therapy ; insulin resistance ; Insulin Resistance - physiology ; Japan ; Lipoproteins, LDL - analysis ; Male ; Metabolic Syndrome - drug therapy ; Metabolic Syndrome - physiopathology ; Middle Aged ; Obesity - complications ; Oxidative Stress ; PPAR gamma - agonists ; PPARγ ; Telmisartan ; Tetrazoles - pharmacology ; Tetrazoles - therapeutic use</subject><ispartof>Internal Medicine, 2010, Vol.49(17), pp.1843-1847</ispartof><rights>2010 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c583t-3f9e881d9b039a3c6693f9ee94e270300e038f39fbb3b86535ac552f3c26eb263</citedby><cites>FETCH-LOGICAL-c583t-3f9e881d9b039a3c6693f9ee94e270300e038f39fbb3b86535ac552f3c26eb263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1883,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20823643$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Watanabe, Masaki</creatorcontrib><creatorcontrib>Inukai, Kouichi</creatorcontrib><creatorcontrib>Sumita, Takashi</creatorcontrib><creatorcontrib>Ikebukuro, Kaori</creatorcontrib><creatorcontrib>Ito, Daisuke</creatorcontrib><creatorcontrib>Kurihara, Susumu</creatorcontrib><creatorcontrib>Ono, Hiraku</creatorcontrib><creatorcontrib>Awata, Takuya</creatorcontrib><creatorcontrib>Katayama, Shigehiro</creatorcontrib><title>Effects of Telmisartan on Insulin Resistance in Japanese Type 2 Diabetic Patients</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>Objective PPARγ agonists are widely used in type 2 diabetic patients to reduce insulin resistance. Recently, telmisartan, an AT1 receptor antagonist, was reported to function as a partial agonist of PPARγ based on in vitro experiments. The aim of the present study was to investigate whether the PPARγ enhancing activity of telmisartan is exerted clinically in diabetic patients. Methods We compared the effects of telmisartan with those of candesartan, on insulin sensitivity, the serum levels of various adipocytokines and oxidative stress. Patients In total, 85 Japanese type 2 diabetic patients with hypertension, maintained on 8 mg per day of candesartan, were randomly assigned to the TM group (candesartan switched to 40 mg of telmisartan, n=38) or the CD group (no treatment change, n=47). Results After 3 months, oxidized lipids were significantly decreased only in the TM group. Although the homeostasis assessment model of insulin resistance (HOMA-R) tended to be improved and serum concentrations of HDL-cholesterol and HMW adiponectin tended to be increased only in the TM group, these alterations were too small to be significant by unpaired t-test. Interestingly, in subgroup analysis, the alterations of HOMA-R, serum concentrations of oxidized lipids, and HMW adiponectin were more apparent in obese TM group subjects and the changes reached statistical significance. Conclusion Switching from candesartan to telmisartan in obese subjects increases serum adiponectin and improves both insulin resistance and oxidative stress, while these effects were not statistically apparent in the total patient population. These results support the idea that telmisartan exerts its PPARγ enhancing activity clinically in obese type 2 diabetic patients.</description><subject>adiponectin</subject><subject>Adiponectin - blood</subject><subject>Aged</subject><subject>Angiotensin II Type 1 Receptor Blockers - pharmacology</subject><subject>Angiotensin II Type 1 Receptor Blockers - therapeutic use</subject><subject>Antihypertensive Agents - pharmacology</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Benzimidazoles - pharmacology</subject><subject>Benzimidazoles - therapeutic use</subject><subject>Benzoates - pharmacology</subject><subject>Benzoates - therapeutic use</subject><subject>Cholesterol, HDL - blood</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Female</subject><subject>Homeostasis</subject><subject>Humans</subject><subject>Hypertension - complications</subject><subject>Hypertension - drug therapy</subject><subject>insulin resistance</subject><subject>Insulin Resistance - physiology</subject><subject>Japan</subject><subject>Lipoproteins, LDL - analysis</subject><subject>Male</subject><subject>Metabolic Syndrome - drug therapy</subject><subject>Metabolic Syndrome - physiopathology</subject><subject>Middle Aged</subject><subject>Obesity - complications</subject><subject>Oxidative Stress</subject><subject>PPAR gamma - agonists</subject><subject>PPARγ</subject><subject>Telmisartan</subject><subject>Tetrazoles - pharmacology</subject><subject>Tetrazoles - therapeutic use</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkE1PAjEQhhujUUT_gunN02Lb2Y_2aPALQ4IaPDfdMtWapYvb5cC_twTkYLxM05l3Zt55CKGcjQQv1Y0PPXbBNEtceOsDjnI1Ai7VERlwyFVWCSiOyYApLjORwhk5j_GLMZCVEqfkTDApoMxhQF7vnUPbR9o6Osdm6aPpehNoG-gkxHXjA33D6GPKWaTp92xWJmBEOt-skAp6502Nvbf0xfQeQx8vyIkzTcTL_Tsk7w_38_FTNp09Tsa308wWEvoMnEIp-ULVDJQBW5Zqm0KVo6gYMIbJrQPl6hpqWRZQGFsUwoEVJdaihCG53s1dde33GmOvk3mLTZPsteuoqyJnIpfpyiGRO6Xt2hg7dHrV-aXpNpozveWp__LUudJbnqn1ar9kXafiofEXYBLMdoKvhOgDD4JE0dsG_53Mq33kMoeD0n6aTmOAH5xkk3k</recordid><startdate>20100101</startdate><enddate>20100101</enddate><creator>Watanabe, Masaki</creator><creator>Inukai, Kouichi</creator><creator>Sumita, Takashi</creator><creator>Ikebukuro, Kaori</creator><creator>Ito, Daisuke</creator><creator>Kurihara, Susumu</creator><creator>Ono, Hiraku</creator><creator>Awata, Takuya</creator><creator>Katayama, Shigehiro</creator><general>The Japanese Society of Internal Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100101</creationdate><title>Effects of Telmisartan on Insulin Resistance in Japanese Type 2 Diabetic Patients</title><author>Watanabe, Masaki ; Inukai, Kouichi ; Sumita, Takashi ; Ikebukuro, Kaori ; Ito, Daisuke ; Kurihara, Susumu ; Ono, Hiraku ; Awata, Takuya ; Katayama, Shigehiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c583t-3f9e881d9b039a3c6693f9ee94e270300e038f39fbb3b86535ac552f3c26eb263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>adiponectin</topic><topic>Adiponectin - blood</topic><topic>Aged</topic><topic>Angiotensin II Type 1 Receptor Blockers - pharmacology</topic><topic>Angiotensin II Type 1 Receptor Blockers - therapeutic use</topic><topic>Antihypertensive Agents - pharmacology</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Benzimidazoles - pharmacology</topic><topic>Benzimidazoles - therapeutic use</topic><topic>Benzoates - pharmacology</topic><topic>Benzoates - therapeutic use</topic><topic>Cholesterol, HDL - blood</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Female</topic><topic>Homeostasis</topic><topic>Humans</topic><topic>Hypertension - complications</topic><topic>Hypertension - drug therapy</topic><topic>insulin resistance</topic><topic>Insulin Resistance - physiology</topic><topic>Japan</topic><topic>Lipoproteins, LDL - analysis</topic><topic>Male</topic><topic>Metabolic Syndrome - drug therapy</topic><topic>Metabolic Syndrome - physiopathology</topic><topic>Middle Aged</topic><topic>Obesity - complications</topic><topic>Oxidative Stress</topic><topic>PPAR gamma - agonists</topic><topic>PPARγ</topic><topic>Telmisartan</topic><topic>Tetrazoles - pharmacology</topic><topic>Tetrazoles - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Watanabe, Masaki</creatorcontrib><creatorcontrib>Inukai, Kouichi</creatorcontrib><creatorcontrib>Sumita, Takashi</creatorcontrib><creatorcontrib>Ikebukuro, Kaori</creatorcontrib><creatorcontrib>Ito, Daisuke</creatorcontrib><creatorcontrib>Kurihara, Susumu</creatorcontrib><creatorcontrib>Ono, Hiraku</creatorcontrib><creatorcontrib>Awata, Takuya</creatorcontrib><creatorcontrib>Katayama, Shigehiro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Watanabe, Masaki</au><au>Inukai, Kouichi</au><au>Sumita, Takashi</au><au>Ikebukuro, Kaori</au><au>Ito, Daisuke</au><au>Kurihara, Susumu</au><au>Ono, Hiraku</au><au>Awata, Takuya</au><au>Katayama, Shigehiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of Telmisartan on Insulin Resistance in Japanese Type 2 Diabetic Patients</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2010-01-01</date><risdate>2010</risdate><volume>49</volume><issue>17</issue><spage>1843</spage><epage>1847</epage><pages>1843-1847</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>Objective PPARγ agonists are widely used in type 2 diabetic patients to reduce insulin resistance. Recently, telmisartan, an AT1 receptor antagonist, was reported to function as a partial agonist of PPARγ based on in vitro experiments. The aim of the present study was to investigate whether the PPARγ enhancing activity of telmisartan is exerted clinically in diabetic patients. Methods We compared the effects of telmisartan with those of candesartan, on insulin sensitivity, the serum levels of various adipocytokines and oxidative stress. Patients In total, 85 Japanese type 2 diabetic patients with hypertension, maintained on 8 mg per day of candesartan, were randomly assigned to the TM group (candesartan switched to 40 mg of telmisartan, n=38) or the CD group (no treatment change, n=47). Results After 3 months, oxidized lipids were significantly decreased only in the TM group. Although the homeostasis assessment model of insulin resistance (HOMA-R) tended to be improved and serum concentrations of HDL-cholesterol and HMW adiponectin tended to be increased only in the TM group, these alterations were too small to be significant by unpaired t-test. Interestingly, in subgroup analysis, the alterations of HOMA-R, serum concentrations of oxidized lipids, and HMW adiponectin were more apparent in obese TM group subjects and the changes reached statistical significance. Conclusion Switching from candesartan to telmisartan in obese subjects increases serum adiponectin and improves both insulin resistance and oxidative stress, while these effects were not statistically apparent in the total patient population. These results support the idea that telmisartan exerts its PPARγ enhancing activity clinically in obese type 2 diabetic patients.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>20823643</pmid><doi>10.2169/internalmedicine.49.3189</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | adiponectin Adiponectin - blood Aged Angiotensin II Type 1 Receptor Blockers - pharmacology Angiotensin II Type 1 Receptor Blockers - therapeutic use Antihypertensive Agents - pharmacology Antihypertensive Agents - therapeutic use Benzimidazoles - pharmacology Benzimidazoles - therapeutic use Benzoates - pharmacology Benzoates - therapeutic use Cholesterol, HDL - blood Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - physiopathology Female Homeostasis Humans Hypertension - complications Hypertension - drug therapy insulin resistance Insulin Resistance - physiology Japan Lipoproteins, LDL - analysis Male Metabolic Syndrome - drug therapy Metabolic Syndrome - physiopathology Middle Aged Obesity - complications Oxidative Stress PPAR gamma - agonists PPARγ Telmisartan Tetrazoles - pharmacology Tetrazoles - therapeutic use |
title | Effects of Telmisartan on Insulin Resistance in Japanese Type 2 Diabetic Patients |
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