Nebivolol treatment influence on carbohydrate and lipid metabolism in patients with metabolic syndrome

Abstract

Introductoin: Metabolic syndrome is a cluster of the most dangerous cardiovascular risk factors: diabetes mellitus, abdominal obesity, dyslipidemia and arterial hypertension. According to the International Diabetes Federation from 2006, about 25 % of the world's population presents the metabolic syndrome, with a two-fold higher risk of death, and three times more frequently myocardial infarction and/or cerebral stroke occurrence. Purpose of the study: To assess the influence of Nebivolol 5 mg, on carbohydrate and lipid metabolism in patients with metabolic syndrome. Material and methods: The metabolic syndrome diagnosis was established according to the criteria proposed in the recommendations of the International Diabetes Federation (2005). In our study were included 90 patients (divided into two groups: with metabolic syndrome - 45 patients and without metabolic syndrome - 45 patients), who received a third generation selective P-blocker with vasodilator action - Nebivolol, 5 mg/day. Indices of glucose metabolism, insulin resistance, lipids and apoproteins spectrum were evaluated initially and after 2 months of treatment with nebivolol. Results and discussions: Comparative analysis of studied indices in patients according to the presence of metabolic syndrome after treatment with Nebivol, revealed no changes in carbohydrates spectrum (basal glycemia, F. Caro index, H bA lc, glycated albumin, glycemic profile) in both groups. However, the monotherapy with Nebivolol 5 mg single dose daily for 2 months, was associated with significant reduction of total cholesterol in patients with metabolic syndrome (p < 0.01) and no reduction of it in patients without metabolic syndrome (p>0.05). Analysis of LDL cholesterol has proved essential reduction compared to the initial values in the group of metabolic syndrome patients (p<0.05) and their slight diminution in the group without metabolic syndrome (p>0.05). Similar changes were observed in the dynamics of triglycerides by important reducing of their level in patients with metabolic syndrome (p<0.001) and minor decrease in patients without metabolic syndrome (p>0.05). Regarding HDL cholesterol did not change significantly in both groups. The atherogenic indices presented the following modifications: CoAt diminished in patients with metabolic syndrome (p<0.001) and had an unimportant change in patients without metabolic syndrome (p>0.05). Some changes were noted in the dynamic of total cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol interaction. Thus, in patients with metabolic syndrome was observed the reduction of the ratio total cholesterol/HDL cholesterol (p<0.001), and of the ratio LDL cholesterol/HDL cholesterol (p<0.01), while in the group without metabolic syndrome was noted insignificant change in the ratio total cholesterol/HDL cholesterol (p>0.05) and the ratio LDL cholesterol/HDL cholesterol (p>0.05). Conclusions: In patients with metabolic syndrome Nebivolol improved lipid status by significantly reducing the total cholesterol, the LDL cholesterol, and the triglycerides. The treatment with Nebivolol had low influence on carbohydrates metabolism.