© 2002 European Society of Cardiology
Carvedilol does not alter the insulin sensitivity in patients with congestive heart failure
a Department of Cardiology and Medicine, Aarhus Amtssygehus Aarhus University Hospital, Tage Hansensgade 2, DK-8000 Aarhus C, Denmark
b Center of Clinical Pharmacology University of Aarhus, DK-8000 Aarhus C, Denmark
c Department of Endocrinology Aarhus Amtssygehus, Aarhus University Hospital, DK-8000 Aarhus C, Denmark
* Corresponding author. Department of Cardiology and Medicine, Aarhus Amtssygehus, Aarhus University Hospital, Tage Hansensgade 2, DK-8000 Aarhus C, Denmark. Tel.: +45-8949-7601; fax: +45-8949-7619 E-mail address: jensrefsgaard{at}post.tele.dk
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Abstract |
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Background: Congestive heart failure (CHF) has previously been shown to be associated with insulin resistance and hyperinsulinemia. A beneficial effect of the non-selective β-blocker carvedilol has been demonstrated in patients with CHF. However, whether the drug affects the insulin sensitivity (Si) is unknown.
Aims: To investigate whether treatment with carvedilol alters the Si in patients with CHF during a prospective, double-blinded, placebo-controlled study. Methods and results: The patients were randomized to receive either carvedilol (n=29) or matched placebo (n=17). Insulin and glucose responses were measured during a 0.3 g/kg intravenous glucose tolerance test, and Si was calculated according to Bergman's Minimal Model. Baseline Si values correlated significantly with body mass index (r=–0.42, P=0.002), plasma urate (r=–0.42, P=0.002), plasma HDL-cholesterol (r=0.39, P=0.003), maximal oxygen uptake (r=0.35, P=0.009), plasma triglycerides (r=–0.34, P=0.01) and weight (r=–0.29, P=0.03). During the study the insulin sensitivity was unchanged in the carvedilol group compared with placebo (2.63±1.45 to 2.38±1.64 vs. 2.81±2.36 to 2.48±1.84x10–4 min–1/mU1–1, P=0.83).
Conclusion: Additional treatment with carvedilol is neutral with regard to influence the insulin sensitivity in patients with mild to moderate CHF.
Key Words: Congestive heart failure • Insulin resistance • Beta-blockade • Minimal model
Received March 27, 2001; Revised November 9, 2001; Accepted February 4, 2002
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