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This version published online on March 1, 2005
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2004-1995
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Submitted on October 11, 2004
Accepted on February 18, 2005

Sympathetic modulation by carvedilol and losartan reduces angiotensin II-mediated lipolysis in subcutaneous and visceral fat

Aderville Cabassi*, Pietro Coghi, Paolo Govoni, Elisa Barouhiel, Ester Speroni, Stefania Cavazzini, Anna Maria Cantoni, Renato Scandroglio, and Enrico Fiaccadori

Laboratory of Clinical Physiology, Hypertension Unit (A.C.,P.C.,E.B.,E.F.) and Toxicology Unit (S.C.), Department of Internal Medicine, Nephrology and Health Sciences; Section of Histology and Embryology, Department of Experimental Medicine (P.G.,R.S.), University of Parma Faculty of Medicine, Via Gramsci 14, 43100 Parma, Veterinary Pathology Unit (A.M.C.), Department of Animal Health, University of Parma Faculty of Veterinary Medicine Via del Taglio 10, 43100 Parma Italy; Department of Pharmacology (E.S.), Faculty of Pharmacy, University of Bologna, Via Irnerio 48, Bologna, Italy

* To whom correspondence should be addressed. E-mail: cabassia{at}unipr.it.

Advanced heart failure is characterized by increased activation of the renin-angiotensin system and the development of cachexia. Angiotensin II has been proposed as a lipid metabolism regulator. The effects of exogenous angiotensin II (osmotic mini-pump, 525 ng/kg/min for 12 days) on interstitial sc glycerol and norepinephrine levels, indexes of lipolysis and sympathetic activation respectively, were measured in Sprague Dawley rats by consecutive microdialysis performed in vivo in white adipose tissue. Higher sustained interstitial glycerol and norepinephrine levels were found after 7 and 12 days of Ang II infusion. Triglyceride/DNA content ratio and adipocyte diameter were reduced in sc and visceral (retroperitoneal and epididymal) fat tissues of angiotensin II-infused rats, whose body weight was lower and blood pressure higher. Losartan, an angiotensin II-receptor1 blocker, and carvedilol, an alpha1-non-selective-beta1,2,3-adrenergic blocker, but not doxazosin, an alpha1-selective-adrenergic blocker, lowered glycerol and norepinephrine levels, preventing lipolysis and weight loss. Our results indicate that angiotensin II stimulates lipolysis in sc and visceral adipocytes by sympathetic activation and {beta}-adrenergic-receptor stimulation. Non-selective-{beta}-adrenergic and angiotensin II-receptor1 blockade markedly attenuated the rise of norepinephrine, preventing catabolic effects. The metabolic benefits of carvedilol and losartan, in addition to recognized protective cardiovascular effects, may be relevant in cachectic patients with advanced heart failure.


Key words: Angiotensin II • sympathetic activity • norepinephrine • glycerol • hormone sensitive lipase • subcutaneous and visceral fat • microdialysis • cachexia • alpha-adrenergic • beta-adrenergic blockade




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