Effects of losartan on insulin sensitivity in hypertensive subjects
Effects of losartan on insulin sensitivity in hypertensive subjects
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DOI：
10.1161/01.hyp.28.3.392
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发表时间：
1996-09-01
期刊：
影响因子：
8.3
通讯作者：
LempiainenKuosa, P
中科院分区：
文献类型：
--
作者：
Laakso, M;Karjalainen, L;LempiainenKuosa, P
氯沙坦是第一个特效的口服血管紧张素受体拮抗剂，是一种有效的降压药物，在人类中副作用发生率低。然而，氯沙坦对胰岛素敏感性和糖代谢的影响还没有详细的研究。因此，我们开展了一项随机双盲研究，以比较氯沙坦(50 Mg Qd)和美托洛尔(95 Mg Qd)对20例高胰岛素血症高血压患者的胰岛素敏感性、胰岛素分泌、糖耐量以及血脂和脂蛋白的影响。氯沙坦的血压下降幅度大于美托洛尔。正常血糖钳夹技术评估的胰岛素敏感性在治疗12周后在两组中都没有改变。同样，葡萄糖氧化(洛沙坦：17.0+/-0.9vs16.9+/-1.0mU/kg[治疗前与治疗后，P=NS]：美托洛尔：17.9+/-1.3vs16.8+/-1.6[P=NS])和非氧化(氯沙坦：2.2.3+/-4.0 vs23.5+/-3.4mU/kg[P=NS]；美托洛尔：23.3+/-3.2比25.6+/-4.7[P=NS])在正常血糖钳夹3小时的最后30分钟内保持不变。氯沙坦和美托洛尔对胰岛素分泌、糖耐量或血脂和脂蛋白没有任何显著的不良影响。总而言之。氯沙坦在代谢上是中性的，对糖脂代谢没有任何明显的不良影响。
Losartan, the first specific and orally available angiotensin LI receptor antagonist, is a potent antihypertensive drug with a low incidence of side effects in humans. However, the effects of losartan on insulin sensitivity and glucose metabolism have not been investigated in detail. Therefore, we carried out a randomized, double-blind study to compare the effects of losartan (50 mg QD) and metoprolol (95 mg QD) on insulin sensitivity, insulin secretion, glucose tolerance, and lipids and lipoproteins in 20 hyperinsulinemic subjects with essential hypertension. The fall in blood pressure was greater with losartan than with metoprolol. Insulin sensitivity evaluated by the euglycemic clamp technique did not change in either group after 12 weeks of treatment. Similarly, glucose oxidation (losartan: 17.0+/-0.9 versus 16.9+/-1.0 mu mol/kg per minute [before versus after, P=NS]: metoprolol: 17.9+/-1.3 versus 16.8+/-1.6 [P=NS]) and nonoxidation (losartan: 2.2.3+/-4.0 versus 23.5+/-3.4 mu mol/kg per minute [P=NS]; metoprolol: 23.3+/-3.2 versus 25.6+/-4.7 [P=NS]) remained unchanged during the last 30 minutes of the 3-hour euglycemic clamp. Losartan and metoprolol did not have any significant adverse effects on insulin secretion, glucose tolerance, or lipids and lipoproteins. In conclusion. losartan is metabolically neutral, without any significant adverse effect on glucose and lipid metabolism.