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Effect of different alpha-receptor antagonists on metabolic parameters: a head-to-head comparison

  • Urology - Original Paper
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Abstract

Purpose

Although it is known that alpha-adrenergic receptor antagonists have positive effects on metabolic parameters such as glucose metabolism, lipid profile, and insulin sensitivity, it is unclear whether this is a class effect. Tamsulosin is reported to have adverse effects on glucose metabolism and insulin resistance, and this may be because of its lack of glycolysis-enhancing effect compared with other alpha-adrenergic receptor antagonists with glycolysis-enhancing effects such as doxazosin, terazosin, and alfuzosin. The aim of this study was to compare the effect of tamsulosin on metabolic parameters with another alpha-1 adrenergic receptor antagonist, doxazosin.

Methods

In this prospective, observational, controlled, 12-week clinical study, a total of 60 male patients aged ≥ 40 years who were first started on tamsulosin (n = 30; 0.4 mg/day, oral; mean age, 59.20 ± 8.97 years) or doxazosin (n = 30; 4 or 8 mg/day, oral; mean age, 58.50 ± 8.93 years) for benign prostatic hyperplasia (BPH) or lower urinary tract symptoms (LUTS) were enrolled. The groups were compared according to the changes in anthropometric and biochemical parameters (glycemia, lipid profile, and insulin sensitivity) at the end of treatment.

Results

In intragroup analyses, systolic blood pressure, diastolic blood pressure, total cholesterol, and HbA1c levels decreased significantly in the doxazosin group compared with baseline (p < 0.05 for all), while no significant change was observed in the tamsulosin group. In comparisons between groups, systolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol levels showed a significant decrease in the doxazosin group compared with the tamsulosin group (percent change: − 6.68 ± 13.08 vs. 0.53 ± 11.02, p = 0.025; − 3.63 ± 9.56 vs. 4.02 ± 10.86, p = 0.005; and − 5.62 ± 18.18 vs. 5.24 ± 15.42, p = 0.015, respectively).

Conclusion

Although these results do not support previous findings that tamsulosin has adverse effects on metabolic parameters, they suggest that doxazosin treatment may be a reason for preference in patients with BPH or LUTS accompanied by metabolic disorder.

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Data availability

All clinical data were obtained from the official hospital (İstanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital) information management system (name: nucleus) and collected from physical patient files and forms.

References

  1. Lithell HO (1991) Effect of antihypertensive drugs on insulin, glucose, and lipid metabolism. DiabetesCare 14:203–209

    CAS  Google Scholar 

  2. Jacop S, Rett K, Henriksen EJ (1998) Antihypertensive therapy and insulin sensitivity: do we have to redefine the role of β-blocking agents? AJH 11:1258–1265

    Google Scholar 

  3. Giordano M, Matsuda M, Sanders L, Canessa ML, DeFronzo RA (1995) Effects of angiotensin-converting enzyme inhibitors, Ca2+ channel antagonists, and alpha-adrenergic blockers on glucose and lipid metabolism in NIDDM patients with hypertension. Diabetes 44:665–671

    Article  CAS  PubMed  Google Scholar 

  4. Fragasso G, Margonato A, Spoladore R, Lopaschuk GD (2019) Metabolic effects of cardiovascular drugs. Trends Cardiovasc Med 29:176–187. https://doi.org/10.1016/j.tcm.2018.08.001

    Article  CAS  PubMed  Google Scholar 

  5. Simmering JE, Welsh MJ, Liu L, Narayanan NS, Pottegård A (2021) Association of glycolysis-enhancing α-1 blockers with risk of developing parkinson disease. JAMA Neurol 78(4):407–413. https://doi.org/10.1001/jamaneurol.2020.5157

    Article  PubMed  Google Scholar 

  6. Goto Y (1984) Effects of alpha- and beta-blocker antihypertensive therapy on blood lipids: a multicenter trial. Am J Med 76(2A):72–78. https://doi.org/10.1016/0002-9343(84)90959-8

    Article  CAS  PubMed  Google Scholar 

  7. Giorda C, Appendino M (1993) Effects of doxazosin, a selective alpha 1-inhibitor, on plasma insulin and blood glucose response to a glucose tolerance test in essential hypertension. Metabolism 42(11):1440–1442. https://doi.org/10.1016/0026-0495(93)90196-u

    Article  CAS  PubMed  Google Scholar 

  8. Giorda C, Appendino M, Mason MG, Imperiale E, Pagano G (1995) Alpha 1-blocker doxazosin improves peripheral insulin sensitivity in diabetic hypertensive patients. Metabolism 44(5):673–676. https://doi.org/10.1016/0026-0495(95)90127-2

    Article  CAS  PubMed  Google Scholar 

  9. Huupponen R, Lehtonen A, Vähätalo M (1992) Effect of doxazosin on insulin sensitivity in hypertensive non-insulin dependent diabetic patients. Eur J ClinPharmacol 43(4):365–368. https://doi.org/10.1007/BF02220610

    Article  CAS  Google Scholar 

  10. Borgsteede S, Bruggeman R, Hoefnagel R, Huiskes M, vanPuijenbroek E (2010) Tamsulosin and hyperglycaemia in patients with diabetes. Neth J Med 68(3):141–143

    CAS  PubMed  Google Scholar 

  11. Dikko M, Sarkingobir Y, Umar AI (2020) Effect of tamsulosin administration on oral glucose tolerance (OGT) in normal wistar rats. Niger J PhysiolSci 35(2):187–190

    Google Scholar 

  12. Satpute S, Nerurkar R, Kokne M (2018) Effect of tamsulosin on blood glucose levels in euglycemic and all oxan induced diabetic rats and its interaction with glibenclamide. Int J Basic ClinPharmacol 7(8):1599–1605. https://doi.org/10.18203/2319-2003.ijbcp20183030

    Article  Google Scholar 

  13. Dikko M, Bello SO, Chika A, Mungadi IA, Sarkingobir Y, Umar AI (2020) Effect of tamsulosin use on plasma insulin status in benign prostatic hyperplasia patients in sokoto. Nigeria J ApplSciEnvironManage 24:543–548. https://doi.org/10.4314/jasem.v24i4.1

    Article  Google Scholar 

  14. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419

    Article  CAS  PubMed  Google Scholar 

  15. Saxena U (2012) Bioenergetics failure in neurodegenerative diseases: back to the future. ExpertOpinTherTargets 16(4):351–354. https://doi.org/10.1517/14728222.2012.664135

    Article  CAS  Google Scholar 

  16. Surmeier DJ (2018) Determinants of dopaminergic neuron loss in Parkinson’s disease. FEBSJ 285(19):3657–3668. https://doi.org/10.1111/febs.14607

    Article  CAS  Google Scholar 

  17. Singleton AB, Farrer M, Johnson J et al (2003) alpha-Synuclein locus triplication causes Parkinson’s disease. Science 302(5646):841. https://doi.org/10.1126/science.1090278

    Article  CAS  PubMed  Google Scholar 

  18. Patel A, Malinovska L, Saha S et al (2017) ATP as a biological hydrotrope. Science 356(6339):753–756. https://doi.org/10.1126/science.aaf6846

    Article  ADS  CAS  PubMed  Google Scholar 

  19. Cai R, Zhang Y, Simmering JE et al (2019) Enhancing glycolysis attenuates Parkinson’s disease progression in models and clinical databases. J ClinInvest 129(10):4539–4549. https://doi.org/10.1172/JCI129987

    Article  Google Scholar 

  20. Hirano T, Yoshino G, Kashiwazaki K, Adachi M (2001) Doxazosin reduces prevalence of small dense low density lipoprotein and remnant-like particle cholesterol levels in nondiabetic and diabetic hypertensive patients. Am J Hypertens 14:908–913

    Article  CAS  PubMed  Google Scholar 

  21. Daae LN, Westlie L (1998) A 5-year comparison of doxazosin and atenolol in patients with mild-to-moderate hypertension: effects on blood pressure, serum lipids, and coronary heart disease risk. Blood Press 7(1):39–45. https://doi.org/10.1080/080370598437556

    Article  CAS  PubMed  Google Scholar 

  22. Chapman N, Chen CY, Fujita T et al (2010) Time to re-appraise the role of alpha-1 adrenoceptor antagonists in the management of hypertension? JHypertens 28(9):1796–1803. https://doi.org/10.1097/HJH.0b013e32833b912c

    Article  CAS  Google Scholar 

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Acknowledgements

We thank Enago—https://www.enago.com.tr/ceviri/ for their assistance in manuscript translation and editing.

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Authors and Affiliations

  1. Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Department of İnternal Medicine, Istanbul, Turkey

    Lütfullah Caştur

  2. Department of İnternal Medicine, Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey

    Mehmet Uzunlulu & Erhan Eken

  3. Department of Urology, Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey

    Muhammed Çiçek, Ahmet Tahra, Özgür Efiloğlu, Bekir Demirtaş & Asıf Yıldırım

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  1. Lütfullah Caştur
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Correspondence to Erhan Eken.

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Caştur, L., Uzunlulu, M., Eken, E. et al. Effect of different alpha-receptor antagonists on metabolic parameters: a head-to-head comparison. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-03968-z

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