Telmisartan reduced visceral fat area and improved insulin and glucose levels compared to amlodipine over 24 weeks in 53 patients with metabolic syndrome.
RCT (n=53)
Open-label
Does telmisartan improve fat distribution and insulin sensitivity compared to amlodipine in patients with metabolic syndrome?
Telmisartan provides metabolic benefits beyond blood pressure lowering by reducing visceral fat and improving insulin sensitivity in patients with metabolic syndrome.
BACKGROUND: Visceral fat obesity plays an essential role in the clustering of atherosclerotic multiple risk factors in the metabolic syndrome. Telmisartan, an angiotensin II type 1 receptor blocker, has partial agonistic properties for peroxisome proliferator-activated receptor gamma, which is a key regulator of adipocyte differentiation and function. METHODS: This study aimed to clarify the impact of telmisartan on fat distribution and insulin sensitivity in the metabolic syndrome. In this open-label, prospective, randomized study, patients with the metabolic syndrome (waist circumference: men >or= 85 cm, women >or= 90 cm) were treated either with amlodipine (n = 26) or with telmisartan (n = 27) for 24 weeks, and fat distribution and insulin sensitivity were determined. RESULTS: Systolic and diastolic blood pressure were decreased in both groups to a comparable level. However, insulin and glucose levels during an oral 75 g glucose loading were decreased only in the telmisartan group. The visceral fat area, determined by abdominal computed tomography scan, was reduced in the telmisartan group after 24 weeks' treatment, but the subcutaneous fat area did not change in either group. CONCLUSION: The results imply that telmisartan could treat both the hemodynamic and metabolic aberrations seen in patients with the metabolic syndrome, improving insulin resistance and glucose intolerance at least partly through visceral fat remodeling.
Shimabukuro et al. (Tue,) conducted a rct in Metabolic syndrome (n=53). Telmisartan vs. Amlodipine was evaluated on Fat distribution and insulin sensitivity. Telmisartan reduced visceral fat area and improved insulin and glucose levels compared to amlodipine over 24 weeks in 53 patients with metabolic syndrome.