EFFECTS OF 3-MONTH NIFEDIPINE TREATMENT ON ENDOCRINE-METABOLIC PARAMETERS IN PATIENTS WITH ABDOMINAL OBESITY AND MILD HYPERTENSION

It is widely accepted that abdominal obesity presents with exaggerated insulin secretion, insulin resistance and a trend toward glucose into lerance. Hypertension is frequently associated to abdominal obesity, a nd hyperinsulinism could play a role in its pathogenesis. Some studies reported that Ca-antagonists positively influence insulin sensitivity and glucose tolerance in obese patients with normal or elevated brood pressure. However, other studies reported worsening of metabolic bala nce during treatment with Ca-antagonists in hypertensive non-insulin-d ependent diabetes mellitus (NIDDM) patients and in normal subjects. We studied 19 patients with abdominal obesity, mild hypertension and ins ulin resistance on balanced, mild hypocaloric diet (1400 Kcal), to ver ify the effects of the Ca-antagonist nifedipine on both basal and oral glucose tolerance test (OGTT)-induced glucose and insulin levels as w ell as on IGF-I basal and DHEA-S levels and fat mass (FM). To achieve this goal, 10 hypertensive obese subjects (HOB-NIFE, 3 mates, 7 female s, mean age+/-SD 44.6+/-1.7 yr; body mass index (BMI) 37.1+/-2.5 Kg/m( 2), WHR 0.95+/-0.02) received 3-month treatment with nifedipine (Adala t Crono 30 Bayer, ? tab daily) while other 9 hypertensive obese (HOB, 3 males, 6 females, 42+/-2.4 yr, BMI 35.8+/-1.8 Kg/m(2), WHR 0.91+/-0. 03) were studied during diet only. The same parameters were studied al so in 8 normotensive obese patients (OB: 3 males, 5 females, 48.1+/-2. 1 yr, BMI 35.8+/-2.4 Kg/m(2), WHR 0.90+/-0.03) on the same balanced hy pocaloric diet. Basal systolic (SEP) and diastolic (DBP) blood pressur e levels in HOB-NIFE and HOB were similar. At baseline, ail groups had similar basal and OGTT-induced glucose, insulin and glucose insulin r atio (GIR) levels as well as IGF-I and DHEA-S levels. After 3 months B MI fell to the same extent in all groups (p<0.05 vs baseline) while WH R and FFM/FM ratio did not change. SEP and DBP decreased HOB-NIFE (p<0 .02) but also during diet alone in both HOB and OB, though to a lesser extent (p<0.05). Both basal and OGTT-stimulated glucose and insulin l evers as well as IGF-I and DHEA-S levels were not modified in HOB-NIFE as well as in HOB and OB. In conclusion, our data indicate that nifed ipine treatment does not modify glucose tolerance as well as insulin s ecretion and sensitivity, IGF-I and DHEA-S levels in hypertensive abdo minal obese patients. Thus, nifedipine treatment has no detrimental ef fects on endocrine-metabolic balance in hypertensive obese patients. ( C) 1998, Editrice Kurtis.