Article Text

Telmisartan Improves Insulin Resistance in Patients With Low Cytokine Levels
  1. Juan Francisco Sanchez Muñoz-Torrero, MD*,
  2. Maria D. Rivas, PhD,
  3. Alberto Costo, MD*,
  4. Leandro Crespo, MD*,
  5. Juana Fraile, MD,
  6. Carlos Doncel, MD§,
  7. Jose Maria Fernandez Toro, MD§,
  8. Jose Zamorano, PhD
  1. From the *Servicio de Medicina Interna, Hospital San Pedro de Alcántara; †Unidad de Investigación, Hospital San Pedro de Alcántara; ‡Servicio de Endocrinologia, Clínica San Francisco; and §Unidad Docente de Medicina Familiar, Cáceres, Spain.
  1. Received October 05, 2010, and in revised form November 16, 2010.
  2. Accepted for publication December 14, 2010.
  3. Reprints: Juan Francisco Sanchez Muñoz-Torrero, MD, Servicio de Medicina Interna, Hospital San Pedro de Alcántara, Avda Pablo Naranjo s/n, Cáceres, Spain. E-mail: juanf.sanchezm{at}
  4. This work has been partially funded by Boehringer Ingelheim. J.F. Sánchez received a grant from Pfizer.
  5. All authors have no conflicts of interest with this article.
  6. Author contributions: J.F.S. and J.Z. for design and conduct of this study; A.C., L.C., J.F., and J.M.F.T. for data collection; M.D.R. for analysis; and J.F.S. and J.Z. for data interpretation and writing.


Metabolic syndrome (MS) is a disease with an inflammatory component. Telmisartan improves insulin resistance in MS, but its relationship with the inflammatory state is unknown. We investigated the effect of 3-month telmisartan therapy on homeostatic model assessment-insulin resistance (HOMA-IR) in hypertensive subjects with MS with regard to the levels of circulating plasma cytokines.

Methods A total of 42 patients were included in this study; 30 were men (71%), aged 50 ± 8.2 years (mean ± SD). Cytokines and metabolic parameters were analyzed before and after treatment with telmisartan.

Results Twenty-eight patients showed low plasma levels of cytokines (group 1) similar to control subjects, and 14 showed high levels (group 2). Treatment with telmisartan diminished by 35% HOMA-IR in group 1 (4.5 ± 3.1 vs 2.9 ± 2.1), without improvement in group 2. In the multivariate analysis, the predictors of improvement of HOMA-IR in response to telmisartan treatment were low levels of cytokines, whereas systolic and diastolic blood pressure and the elevation of high-sensitivity C-reactive protein had a negative effect.

Conclusions Our study provides evidence of a more favorable effect of telmisartan on glucose homeostasis in patients with MS and low levels of serum cytokines.

Key Words
  • telmisartan
  • metabolic syndrome
  • cytokines

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