Abstract

Objective: The study investigated the effect of angiotensin-receptor blockers (ARB) on glucose homeostasis and inflammatory parameters in patients with impaired glucose tolerance (IGT).

Research Design and Methods: We prospectively studied the insulin sensitivity index (ISI) and homeostasis model of insulin resistance (HOMA-IR) in 13 obese males with IGT and in 13 matched controls with normal glucose tolerance (NGT) during hyperglycemic testing over 90 minutes. Adiponectin, retinol-binding protein 4 (RBP4), and high-sensitive C-reactive protein (hs-CRP) were analyzed. Measurements were performed at baseline and after a four-week treatment with valsartan 160 mg/day. The results of the IGT and NGT groups were compared.

Results: At baseline, HOMA-IR (IGT 4.1±3 vs. NGT 2.3± 1.0, p<0.01), hsCRP (IGT 3.9±1.9 vs. NGT 1.8±1mg/l, p<0.05), and RBP4 (IGT 27.1±2.1 vs. NGT 24.0± 2.0 ng/ml, p<0.05) were significantly higher, whereas ISI (IGT 1.5±0.9 vs. NGT 1.8±1.2, p<0.05) and plasma adiponectin (IGT 3.2±0.9, NGT 5.2±2.4 μg/ml, p<0.05) were significantly lower in the IGT group compared to the NGT group.

Under ARB, there was an increase in both groups of adiponectin (IGT 4.1±1.9 μg/ml, NGT 6.3±2.9 μg/ml, p <0.05), and an increase in ISI (IGT 1.5±0.9 μg/ml to 2.3 ± 1, NGT 1.8±1 to 2.5±2, p <0.05). Homa-IR (4.1±3 to 2.6±2; p<0.01), hsCRP (3.9±1.9 to 1.8±1mg/l, p<0.05) and RBP4 (27.1±2.1 to 22.1±1.8 ng/ml, p<0.01) decreased significantly in the IGT group.

Conclusion: Insulin sensitivity and associated inflammatory factors improve under ARB in IGT patients. International Standard Randomized Controlled Trial Number07427212.