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