Effect Of Telmisartan On The Level Of Serum Adiponectin In Hypertensive Patients With Type 2 Diabetes Mellitus

Background and objects:Hypertension, the intensive predictor of diabetes, and type 2 diabetes mellitus are very common, which often coexists to accelerate the sclerosis of conducting arteries. They often share the same heredity and biochemical metabolism characteristics, which include hypertension, hyperglucose and arteriosclerosis. Insulin resistance (IR) may be a key role among them. It was reported that, compare with normal people, serum concentration of adiponectin decreased significantly in hypertensive patients with type 2 diabetes mellitus and the high adiponectin level has potentially beneficial effect on metabolic disorder and cardiovascular diseases. Whether ARBs have extra protection to cardiovascular system beyond their BP reduction has become the focus topics recently. Telmisartan, an angiotensin II type 1 receptor blocker and a drug which has partially agonistic properties for peroxisome Proliferators activated receptor gamma, may be more special as a perspective drug for its possible metabolic effect. Telmisartan has been widely used in hypertensive patients with DM. We designed this study to investigate the effect of telmisartan on adiponectin in hypertensive patients with type 2 diabetes mellitus in order to elucidate the underlied mechanism.Methods:In this prospective, randomized study, hypertensive patients with type 2 diabetes mellitus were treated either with telmisartan or with amlodipine for at least 8 weeks. The serum concentration of fasting adiponectin, glucose, lipid and CRP (C reactive protein) and blood pressure (BP) were measured at baseline and after treatment respectively. Data analyses were processed by using the SAS8.1.Results:The systolic and diastolic BP decreased significantly after the treatment both in telmisartan group and in amlodipine group. A significant improve was also detected in adiponectin(p<0.01) , blood glucose (p<0.01), insulin(p<0.01), CRP(p=0.04) in telmisartan group. But no notable difference was detected in adiponectin(p=0.87), blood glucose(p= 0.65), insulin (p=0.53) in amlodipine group except CRP(p=0.03).Conclusion:These data indicated the potential effect of telmisartan on the improvement of adiponectin and IR, which demonstrate the metabolic effect of telmisartan beyond its BP reduction. Our result also indicate that the decrease of CRP, at the same time, may be partially correlate to the increase of serum adiponectin.