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About
The purpose of this study is to determine whether telmisartan and/or a low-glycemic index diet are effective in reducing intra-myocellular lipid (muscle fat) content.
Full description
The metabolic syndrome currently affects over 20% of the adult population in Canada. Patients with abdominal obesity are at markedly increased risk for diabetes and heart disease. Recent studies have shown that decreased sensitivity to insulin (insulin resistance), a hallmark of the metabolic syndrome, is related to increased storage of fat in muscle cells (muscle fat). Several recent studies indicate that blocking the renin-angiotensin system (RAS) may improve insulin sensitivity and prevent the development of type 2 diabetes. Other data suggests that this effect may be due to the effect of RAS blockade on the recruitment and growth of adipose tissue. The primary aim of this study is therefore to explore the role of angiotensin II in the development of insulin resistance. Specifically, we will examine the mechanisms underlying the putative anti-diabetic effect of RAS blockade by examining the effect of angiotensin receptor blockade on muscle fat content in individuals with the abdominal obesity. This study will therefore test the hypothesis that treatment with the angiotensin receptor blocker telmisartan (Micardis®) will reduce muscle fat, thereby improving insulin sensitivity in people with abdominal obesity, with or without additional features of the metabolic syndrome. A number of dietary factors can also affect insulin sensitivity and may influence muscle fat. Recent studies suggest that increasing the content of low-glycemic foods (carbohydrates which are less easily digested), can improve insulin sensitivity and lipid profile in patients with insulin resistance. A second aim of this study is therefore to test the hypothesis that a low-glycemic diet will reduce muscle fat, thereby improving insulin sensitivity in this population.
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Inclusion criteria
Exclusion criteria
Participant has taken ACE inhibitor or ARB in the last 3 months, or in the opinion of the study physician currently has indication for either of these medications
Concurrent antidiabetic medication
Use of systemic glucocorticosteroids (topical and inhaled are acceptable)
On lipid-lowering medication and NOT on stable dose for the last three months
If the participant has any one or more of the following medical disorders:
If the participant has any contraindications to MRI
Pre-menopausal women (last menstruation >=1 year prior to consent) who:
Intention to go on weight - reducing medications or weight-loss diets during the study period
Significant fluctuations in weight over past 3 months(e.g. >10%)
Household member currently in study
Any investigational drug therapy within one month of signing the informed consent form.
Participant has knowledge that he/she will be unable to consume study foods for >2 weeks during treatment phase of study
<70% compliant during run-in
Unable to reduce total fat consumption to <40% and/or reduce saturated fat consumption to <15% during run-in
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Data sourced from clinicaltrials.gov
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