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

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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.

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Authors and Affiliations

  1. Center for intensive care medicine, University Clinical Center Ljubljana, Ljubljana, Slovenia

    Matej Podbregar MD PhD

  2. Department of Cardiology, General and Teaching Hospital Celje, Celje, Slovenia

    Dragan Kovačić & Matej Marinšek

  3. Central Laboratory, General and Teaching Hospital Celje, Celje, Slovenia

    Lidija Gobec

  4. Department of Internal Medicine, General Hospital Murska Sobota, Murska Sobota, Slovenia

    Mitja Lainščak

Authors
  1. Dragan Kovačić
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  2. Matej Marinšek
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  3. Lidija Gobec
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  4. Mitja Lainščak
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  5. Matej Podbregar MD PhD
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Correspondence to Matej Podbregar MD PhD.

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Kovačić, D., Marinšek, M., Gobec, L. et al. Effect of selective and non-selective β-blockers on body weight, insulin resistance and leptin concentration in chronic heart failure. Clin Res Cardiol 97, 24–31 (2008). https://doi.org/10.1007/s00392-007-0571-3

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  • DOI: https://doi.org/10.1007/s00392-007-0571-3

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