Abstract 3707: The Multiplier Effect of Telmisartan and Fenofibrate in Patients with Metabolic Syndrome

Abstract

Background: Telmisartan, a partial agonist of PPARγ, improve insulin resistance with increase adiponectin and especially high molecular weight adiponectin (HMW adipo) in patients with metabolic syndrome. Fenofibrate, an antihyperlipidemic drug, can function as an agonist of PPARα and is increased adiponectin receptors. In this study, we examined that telmisartan with fenofibrate influences multiplier effect of insulin resistance and anti-arteriosclerosis action in patients with metabolic syndrome. Methods: 25 patients with metabolic syndrome took telmisartan (40mg/day) for 6 months (stage 1), and they were measured HOMA-R, high sensitive CRP (hsCRP), adiponectin, HMW adipo, TNFα, both visceral fat (VF) area and subcutaneous fat (SF) area by CT scan and mean intima-media thickness (M-IMT) of common carotid artery. After stage 1 they took telmisartan (40mg/day) together with fenofibrate (100mg/day) for 6 months (stage 2), and they were measured them again. Results: We compared these parameters of stage 1 and stage 2. HOMA-R, hsCRP, and TNFα were decreased for both stage 1 and stage 2. HOMA-R especially was significant (from 3.97 to 3.09; p<0.05) for stage 2. Both adiponectin and HMW adipo were increased for stage 1, but they were decreased for stage 2. Both VF area and SF area were decreased between stage1 and stage2. SF area especially was significant (from 194.9 to 184.3 cm2; p<0.05) for stage 2. M-IMT of common carotid artery significantly was decreased (from 0.97 to 0.84 mm; p<0.01) between stage 1 and stage 2. Conclusion: Our findings indicate that although telmisartan with fenofibrate are decreased both fat area (especially SF area) and secretion of adiponectin, they influences multiplier effect of insulin resistance and anti-arteriosclerosis action through the improvement of adiponectin sensitivity.