EFFECTS OF BENAZEPRIL ON INSULIN-RESISTANCE AND GLUCOSE-TOLERANCE IN UREMIA

This study tested whether the angiotensin-converting enzyme inhibitor (ACEI) benazepril can improve the insulin resistance and glucose toler ance in uremia. Fifteen uremic hypertensive patients were treated with benazepril in a dose of 10-20 mg per day for ten weeks, and ten healt hy subjects, matched in age, sex ratio and body mass index (BMI), serv ed as the control group. Before and after the treatment, an oral 75 g glucose tolerance test (OGTT) and insulin release test (IRT) were perf ormed in two groups above, and the blood glucose and serum insulin con centrations at 0, 60, 120 and 180 minutes after glucose load were exam ined, and the insulin glycoregulatory activity, including insulin sens itivity index (ISI), glucose uptake rate (M), total areas under the gl ucose and insulin curves during OGTTs (AUCG AUCINS), was calculated. T he changes of serum potassium and renal function before and after trea tment were observed. It showed that (1) benazepril could reduce blood pressure significantly (SBP decreased from 174.8 +/- 12.0 mmHg to 151. 5 +/- 9.0 mmHg, p < 0.001; DBP decreased from 108.0 +/- 8.2 mmHg to 95 .3 +/- 9.0 mmHg, p <0.001). The total response rate was 86.7%. (2) Aft er treatment with benazepril for ten weeks, the blood glucose and seru m insulin concentrations after glucose load and AUCG, AUCINS values in the uremic patients were significantly lower than before treatment, b ut were still significantly higher than in the controls. The values of ISI and M in the uremic patients after treatment were much higher tha n before treatment, but were still significantly lower than in the con trol subjects. (3) The differences of serum potassium and creatinine l evels before and after treatment were not significant. These findings indicate that benazepril can not only reduce blood pressure effectivel y and safely, but also partly improve insulin resistance, hyperinsulin emia and glucose intolerance in uremia.