Chronic administration of an angiotensin II receptor antagonist resets the hypothalamic–pituitary–adrenal (HPA) axis and improves the affect of patients with diabetes mellitus type 2: Preliminary results

Figures & data

Table I.  Anthropometric, clinical and biochemical characteristics before and after candesartan administration (BMI, body mass index; UFC, urine free cortisol; CBG, cortisol-binding globulin; Glu, glucose; HOMA, the homeostasis model assessment; HbA1c, glycosylated Hb A1c; QUICKI, quantitative insulin sensitivity check index; SEM, standard error of the mean).

	Before candesartan (n = 17)		After candesartan (n = 17)
	Mean	SEM	Mean	SEM
Height (m)	1.69	0.02
Weight (kg)	78.54	4.18	78.88	4.51
BMI (kg/m^2)	27.50	1.09	27.62	1.11
Waist/Hip ratio	0.946	0.945	0.021	0.011
Heart rate (pulses/min)	62.9	1.88	57.7	1.63
UFC (μg/24 h)	81.74	5.58	88.15	9.75
CBG (μg/ml)	55.87	7.52	50.46	6.39
Cholesterol (mg/dl)	175.0	7.60	179.4	9.70
LDL (mg/dl)	107.2	5.50	111.1	6.10
HDL (mg/dl)	43.40	1.70	43.70	1.90
Triglycerides (mg/dl)	121.7	14.50	126.2	17.50
Fasting insulin (mU/l)	13.15	3.68	9.63	2.00
Fasting Glu (mg/dl)	142.6	3.10	123.8	2.92
Albumin/creatine (μg/mg)	18	0.84	17.8	0.89
HbA1C (%)	6.5	0.26	6.42	0.31
HOMA	5.20	1.45	2.95	0.58
QUICKI	0.324	0.009	0.340	0.007

Figure 1 (A) Mean ± SEM plasama ACTH (pg/mL) response to hCRH in DM type 2 patients before (closed squares) and after (open squares) candesartan administration. Asterisks indicate statistically significant difference at the indicated time-point. P = 0.0017, n = 17. (a) Mean ± SEM AUC values of plasma ACTH in DM type 2 patients before (black bars) does not differ from that after (white bars) candesartan administration. (n = 17). (B) Mean ± SEM serum cortisol (μg/dl) response to hCRH in DM type 2 patients before (closed squares) and after (open squares) candesartan administration. Asterisks indicate statistically significant difference at the indicated time-point. − 1 min: P = 0.031; 5 min: P = 0.021; 15 min: P = 0.022; 30 min: P = 0.034; 90 min: P = 0.041; n = 17. (b) Mean ± SEM AUC values of serum cortisol in DM type 2 patients before (black bars) and after (white bars) candesartan administration. Asterisks indicate statistically significant difference at the indicated time-point. P = 0.005, n = 17. (C) Mean ± SEM plasma ACTH (expressed in pg/ml)/serum cortisol (expressed in μg/dl) ratios at the different time-points of the hCRH test in DM type 2 patients before (closed squares) and after (open squares) candesartan administration. Asterisks indicate statistically significant difference at the indicated time-point. − 1 min: P = 0.045; 5 min: P = 0.01; 90 min: P = 0.034; 120 min: P = 0.021; n = 17. (c) Mean ± SEM AUC values of plasma ACTH (expressed in pg/ml)/serum cortisol (expressed in μg/dl) ratios in DM type 2 patients before (black bars) and after (white bars) candesartan administration. Asterisks indicate statistically significant difference at the indicated time-point. P = 0.017, n = 17.