Effect of Short-term Ace Inhibitor Treatment on Peripheral Insulin Sensitivity in Obese Insulin-resistant Subjects.
From: Department of Human Biology, Nutrition and Toxicology Research Institute Maastricht, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, MD, Maastricht, The Netherlands. g.goossens@hb.unimaas.nl
Diabetologia
- Publish Date: Dec 2006
- ISSN: 0012-186X
- Volume: 49
- Issue: 12
- Pages: 3009-16
- Medium: Print
- Language: English
- Citation (JAMA): Goossens G H, Blaak E E, Schiffers P M, et al. Effect of Short-term Ace Inhibitor Treatment on Peripheral Insulin Sensitivity in Obese Insulin-resistant Subjects.. Diabetologia Dec 2006;49:3009-16
Abstract
AIMS/HYPOTHESIS: This study was designed to investigate the effect of short-term ACE inhibitor treatment on insulin sensitivity and to examine possible underlying metabolic and haemodynamic effects in obese insulin-resistant subjects. METHODS: A randomised, double-blind placebo-controlled trial was performed in 18 obese insulin-resistant men (age, 53 +/- 2 years; BMI, 32.6 +/- 0.8 kg/m(2); homeostasis model assessment of insulin resistance, 5.6 +/- 0.5; systolic blood pressure [SBP], 140.8 +/- 3.2; diastolic blood pressure [DBP], 88.8 +/- 1.6 mmHg), who were free of any medication. The aim was to examine the effects of 2 weeks of ACE inhibitor treatment (ramipril, 5 mg/day) on insulin sensitivity, forearm blood flow, substrate fluxes across the forearm, whole-body substrate oxidation and intramuscular triacylglycerol (IMTG) content. RESULTS: Ramipril treatment decreased ACE activity compared with placebo (-22.0 +/- 1.7 vs 0.2 +/- 1.1 U/l, respectively, p < 0.001), resulting in a significantly reduced blood pressure (SBP, -10.8 +/- 2.1 vs -2.7 +/- 2.0 mmHg, respectively, p = 0.01; DBP, -10.1 +/- 1.3 vs -4.2 +/- 2.1 mmHg, respectively, p = 0.03). Ramipril treatment had no effect on whole-body insulin-mediated glucose disposal (before: 17.9 +/- 2.0, after: 19.1 +/- 2.4 micromol kg body weight(-1) min(-1), p = 0.44), insulin-mediated glucose uptake across the forearm (before: 1.82 +/- 0.39, after: 1.92 +/- 0.29 micromol 100 ml forearm tissue(-1) min(-1), p = 0.81) and IMTG content (before: 45.4 +/- 18.8, after: 48.8 +/- 27.5 micromol/mg dry muscle, p = 0.92). Furthermore, the increase in carbohydrate oxidation (p < 0.001) and forearm blood flow (p < 0.01), and the decrease in fat oxidation (p < 0.001) during insulin stimulation were not significantly different between treatments. CONCLUSIONS/INTERPRETATION: Short-term ramipril treatment adequately reduced ACE activity and blood pressure, but had no significant effects on insulin sensitivity, forearm blood flow, substrate fluxes across the forearm, whole-body substrate oxidation and IMTG content in obese insulin-resistant subjects.
Mesh Headings (Keywords): Angiotensin II, Angiotensin-Converting Enzyme Inhibitors, Blood Glucose, Blood Pressure, Double-Blind Method, Fatty Acids, Nonesterified, Glucose Clamp Technique, Humans, Hyperinsulinism, Insulin, Insulin Resistance, Middle Aged, Placebos, Ramipril
Check for Full Text / PubMed Unique Identifier (PMID): 17019594
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