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Submitted on June 1, 2005
Accepted on December 1, 2005
Bispebjerg Hospital, Copenhagen, Denmark; Albert Einstein College of Medicine, NY, USA; Joslin Diabetes Center, MS, USA; Gentofte University Hospital, Gentofte, Denmark; Rigshospitalet Heart Center, Copenhagen, Denmark
* To whom correspondence should be addressed. E-mail: th{at}heart.dk.
Objective: Angiotensin converting enzyme (ACE) inhibitors reduce cardiovascular mortality and improve endothelial function in type 2 diabetic patients. We hypothesized that 2 months of quinapril treatment would improve insulin-stimulated endothelial function and glucose uptake in type 2 diabetic subjects, and simultaneously increase the expression of genes that are pertinent for endothelial function and metabolism.
Methods: Twenty-four type 2 diabetic subjects were randomized to receive 2 months of quinapril 20 mg daily or no treatment in an open parallel study. Endothelium-dependent and -independent vasodilation was studied during serotonin or sodium nitroprusside infusion in the diabetic patients and in fifteen healthy subjects. Endothelial function, insulin-stimulated endothelial function and insulin-stimulated glucose uptake were measured before and after quinapril treatment. Blood flow was measured by venous occlusion plethysmography. Gene expression was measured by real-time PCR.
Results: Quinapril treatment increased insulin-stimulated endothelial function in the type 2 diabetic subjects, P = 0.005, whereas forearm glucose uptake was unchanged. Endothelial function was also increased by quinapril, P = 0.001. Systolic and diastolic blood pressure were reduced by quinapril, P < 0.001. Quinapril increased adiponectin gene expression in vascular tissue obtained from sc adipose biopsies.
Conclusions: Quinapril treatment increases insulin-stimulated endothelial function in patients with type 2 diabetes. Increased vascular adiponectin gene expression may contribute to this beneficial effect.
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