Addition of Losartan to Angiotensin-Converting Enzyme Inhibitors Improves Insulin Resistance in Patients With Chronic Heart Failure Treated Without β-Blockers
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概要
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Background: Angiotensin II and insulin resistance (IR) have clinical implications in the pathophysiology of chronic heart failure (CHF). However, it is still unclear whether the combination of an angiotensin-receptor blocker and angiotensin-converting enzyme inhibitor (ACEI) improves IR in CHF patients who do not receive β-blockers. Thus, the aim of the present study was to evaluate the effects of losartan on glucose metabolism and inflammatory cytokines in CHF patients treated with ACEI but not β-blockers. Methods and Results: The effect of losartan treatment for 16 weeks on IR was analyzed in 16 CHF patients in a randomized crossover trial. Insulin level and homeostasis model IR index (HOMA-IR) decreased significantly (P<0.05), but fasting plasma glucose did not change significantly. Serum tumor necrosis factor (TNF)-α, interleukin (IL)-6, and monocyte chemoattractant protein (MCP)-1 levels were significantly decreased with losartan (P<0.05). Furthermore, the changes in IL-6 and MCP-1 levels were significantly correlated with the reduction in HOMA-IR (P<0.05), but the change in TNF-α levels was not significantly correlated. Conclusions: The addition of losartan to ACEI therapy improved IR and decreased inflammatory cytokines in CHF patients who did not receive β-blockers. (Circ J 2010; 74: 2346-2352)
- 2010-10-25
著者
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Ogino Kazuhide
Center for Clinical Residency Program, Tottori University Hospital
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Kato Masahiko
Department of Cardiovascular Medicine, Faculty of Medicine, Tottori University
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Furuse Yoshiyuki
Department of Cardiovascular Medicine, Faculty of Medicine, Tottori University
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Kinugasa Yoshiharu
Department of Cardiovascular Medicine, Faculty of Medicine, Tottori University
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Kaetsu Yasuhiro
Department of Cardiovascular Medicine, Faculty of Medicine, Tottori University
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Mizuta Einosuke
Department of Cardiovascular Medicine, Faculty of Medicine, Tottori University
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Sugihara Shinobu
Department of Cardiovascular Medicine, Faculty of Medicine, Tottori University
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Ishida Katsunori
Department of Cardiovascular Medicine, Faculty of Medicine, Tottori University
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Yanagihara Kiyotaka
Department of Cardiovascular Medicine, Faculty of Medicine, Tottori University
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Hisatome Ichiro
Department of Genetic Medicine and Regenerative Therapeutics, Tottori University Graduate School of
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Shigemasa Chiaki
Department of Cardiovascular Medicine, Faculty of Medicine, Tottori University
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喜多 義邦
Division Of Preventive Cardiology National Cardiovascular Center
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Shigemasa Chiaki
Department Of Cardiovascular Medicine Faculty Of Medicine Tottori University
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Shigemasa Chiaki
鳥取大学 医学部循環器内科
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Shigemasa Chiaki
鳥取大学 医学部病院薬剤部
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Itoh Hiroaki
Osaka City University
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Itoh Hiroshi
First Pathology Faculty Of Medical Sciences University Of Fukui
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Itoh Hiroshi
Division Of Surgical Pathology Department Of Biomedical Informatics Kobe University Graduate School
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Itoh Hiroshi
宮崎大学 医学部病理学第2
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Itoh Hiroshi
Division 1 Department Of Pathology Kobe University School Of Medicine
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Kotani Yasushi
国立循環器病センター 予防検診
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Kosakai Yoshio
Department Of Cardiovascular Surgery National Cardiovascular Center
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Kawano Yuhei
国立循環器病センター 高血圧腎臓内科
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Hisatome Ichiro
Department Of Regenerative Medicine And Therapeutics Tottori University Graduate School Of Medical S
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Kaneko Yoshihiro
Second Department Of Internal Medicine Yokohama City University Hospital
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Yoshida K
Furukawa City Hospital
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Yoshinaga Kaoru
The Second Department Of Internal Medicine Tohoku University School Of Medicine
-
Kokubo Yoshihiro
国立循環器病センター研究所 疫学部
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Sugihara Shinobu
Department Of Cardiovascular Medicine Faculty Of Medicine Tottori University
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Ogino Kazuhide
Center For Clinical Residency Program Tottori University Hospital
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Ito H
Osaka City University
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Hisatome Ichiro
Division Of Regenerative Therapeutics Department Of Genetic Medicine And Regenerative Therapeutics G
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Kaneko Yoshihiro
Department Of Internal Medicine Jikei University School Of Medicine
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Yanagihara Kiyotaka
Department Of Cardiovascular Medicine Faculty Of Medicine Tottori University
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Katanosaka Yuki
国立循環器病センター
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Itakura Hiroshige
Department Of Internal Medicine Keio University School Of Medicine
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Hisatome Ichiro
First Department Of Internal Medicine Faculty Of Medicine Tottori University
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Kato Masahiko
Department Of Cardiovascular Medicine Faculty Of Medicine Tottori University
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Kosakai Yoshio
Department Of Cardiovascldar Surgery National Cardiovascudar Center
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Mizuta Einosuke
Department Of Multidisciplinary Internal Medicine Tottori University Faculty Of Medicine
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Mizuta Einosuke
Department Of Bioscience National Cardiovascular Center Research Institute
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Kokubo Yoshihiro
Department Of Preventive Cardiology National Cardiovascular Center
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Kokubo Yoshihiro
Cardiovascular Division National Cardiovascular Center
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Kawagoe Yasuhiro
HIJC Investigators
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Ishida Katsunori
Department Of Cardiovascular Medicine Faculty Of Medicine Tottori University
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Sugihara Shinobu
Department Of Cardiovascular Medicine Tottori University Faculty Of Medicine
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Kakeji Yosihiro
九州大学 医学研究院消化器･総合外科
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Yoshita Katsushi
Project For The National Health And Nutrition Survey National Institute Of Health And Nutrition
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Kadoshima Yoko
Department Of Public Health Kanazawa Medical University
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Kinugasa Yoshiharu
Department Of Cardiovascular Medicine Faculty Of Medicine Tottori University
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Kato Masahiko
Department Of Allergy And Immunology Gunma Children's Medical Center
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Kosakai Yoshio
National Cardiovascular Center
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Imura H
Kyoto Univ. Kyoto Jpn
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Kaneda Yoshio
The 1st Dept. Of Pathology Tokyo Women's Medical College
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Kokubo Yoshihiro
国立循環器病センター 予防検診部
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Yoshihiro Kanako
Second Department Of Internal Medicine Yokohama City University Hospital
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Kaneko Y
Second Department Of Internal Medicine Yokohama City University School Of Medicine
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Ito Hisao
Division Of Organ Pathology Department Of Microbiology And Pathology Tottori University
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Kakizawa Yoshiko
Department Of Cardiology Tokyo Women's Medical University
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Hamanaka Ichiro
Departments Of Medicine And Clinical Science
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Furuse Yoshiyuki
Department Of Cardiovascular Medicine Faculty Of Medicine Tottori University
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Kato Masako
The Second Department Of Pathology Faculty Of Medicine Tottori University
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Shigemasa Chiaki
Division Of Regenerative Medicine And Therapeutics Department Of Genetic Medicine And Regenerative M
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Hisatome Ichiro
Division Of Molecular Medicine And Therapeutics Department Of Multidisciplinary Internal Medicine To
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Ito Hisao
Division Of Organ Pathology Department Of Microbiology And Pathology Faculty Of Medicine Tottori Uni
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Kaetsu Yasuhiro
Department Of Cardiovascular Medicine Faculty Of Medicine Tottori University
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Kaetsu Yasuhiro
Division Of Molecular Medicine And Therapeutics Department Of Multidisciplinary Internal Medicine To
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Yoshinaga Keiichiro
Department Of Photobiology Division Of Molecular Cellular Imaging Hokkaido University Graduate Schoo
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Ito Hisao
Division Of Organ Pathology Department Of Microbiology And Pathology Faculty Of Medicine Tottori Uni
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Hisatome Ichiro
Division Of Molecular Medicine And Therapeutics Department Of Multidisciplinary Internal Medicine To
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Hisatome Ichiro
Division Of Molecular Medicine And Therapeutics Department Of Multidisciplinary Internal Medicine Tottori University Faculty Of Medicine
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Shigemasa Chiaki
Division Of Regenerative Medicine And Therapeutics Department Of Genetic Medicine And Regenerative Medicine And Therapeutics Institute Of Regenerative Medicine And Biofunction Tottori University Graduate School Of Medical Science
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Hisatome Ichiro
Department Of Cardiology Kitano Hospital Medical Research Institute
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