Clinical Research in Cardiology

, Volume 97, Issue 1, pp 24–31

Effect of selective and non-selective β-blockers on body weight, insulin resistance and leptin concentration in chronic heart failure

  • Dragan Kovačić
  • Matej Marinšek
  • Lidija Gobec
  • Mitja Lainščak
  • Matej Podbregar
ORIGINAL PAPER

DOI: 10.1007/s00392-007-0571-3

Cite this article as:
Kovačić, D., Marinšek, M., Gobec, L. et al. Clin Res Cardiol (2008) 97: 24. doi:10.1007/s00392-007-0571-3

Abstract

Background

Chronic heart failure (CHF) is characterized by increased insulin resistance and hyperleptinaemia. We aimed to study effects of selective and non-selective β-blockers on body weight, insulin resistance, plasma concentrations of leptin and resistin in patients with CHF.

Methods

Twenty-six non-cachectic β-blocker-naive patients with CHF were randomized and treated with either carvedilol or bisoprolol. Body weight, plasma concentrations of leptin, resistin, fasting glucose and insulin were measured at baseline and after 6 months of therapy. Insulin resistance was estimated by homeostasis model assessment- estimated insulin resistance (HOMA-IR).

Results

Body weight increased significantly in the carvedilol group (mean change + 2.30 kg, p = 0.023) while it did not change in the bisoprolol group (mean change –0.30 kg, p = 0.623) (ns between groups). Plasma leptin concentration increased only in the carvedilol group (mean change + 4.20 ng/ml, p = 0.019) (ns between groups). Fasting glucose and resistin remained unchanged in both groups. After 6 months, mean plasma insulin concentration changed significantly differently (p = 0.015) in the bisoprolol (mean change +3.1 µU/ml) compared to the carvedilol group (mean change –6.3 µU/ml) and HOMA-IR was consequently higher in the bisoprolol compared to the carvedilol group (5.2 ± 4.2 vs 2.8 ± 1.6, p = 0.046).

Conclusion

This study found different metabolic effects of carvedilol and bisoprolol in non-cachectic patients with CHF. With unchanged fasting plasma glucose concentration after 6 months of treatment, carvedilol significantly decreased plasma insulin concentration and insulin resistance compared to bisoprolol.

Key words

bisoprololcarvedilolchronic heart failureinsulin resistanceleptinresistin

Copyright information

© Steinkopff-Verlag 2008

Authors and Affiliations

  • Dragan Kovačić
    • 2
  • Matej Marinšek
    • 2
  • Lidija Gobec
    • 3
  • Mitja Lainščak
    • 4
  • Matej Podbregar
    • 1
  1. 1.Center for intensive care medicineUniversity Clinical Center LjubljanaLjubljanaSlovenia
  2. 2.Department of CardiologyGeneral and Teaching Hospital CeljeCeljeSlovenia
  3. 3.Central LaboratoryGeneral and Teaching Hospital CeljeCeljeSlovenia
  4. 4.Department of Internal MedicineGeneral Hospital Murska SobotaMurska SobotaSlovenia