Impact of chronic diuretic treatment on glucose homeostasis

Diabetology & Metabolic Syndrome

Giovam B Rini³  Delia Sprini³  Alice Bonura³  Emanuele Amodio¹  Fatima M Massenti¹  Giuseppe Grosso²  Fabio Galvano²  Giuseppe Lucisano⁴  Antonio Nicolucci⁴  Silvio Buscemi³ 

[1]Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, University of Palermo, Via del Vespro, 129, Palermo 90128, Italy

[2]Dipartimento di Scienze del Farmaco, University of Catania, viale Andrea Doria,6, Catania 95124, Italy

[3]Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS) – Laboratorio di Nutrizione Clinica, University of Palermo, Via del Vespro, 129, Palermo 90127, Italy

[4]Dipartimento di Farmacologia Clinica ed Epidemiologia, Consorzio Mario Negri Sud, Via Nazionale per Lanciano, 8, S. Maria Imbaro, Chieti, Italy

关键词: Uric acid;    Type 2 diabetes;    Insulin resistance;    Hypertension;    Diuretics;   

Others  :  812312
DOI  :  10.1186/1758-5996-5-80

 received in 2013-10-16, accepted in 2013-12-10,  发布年份 2013

【 摘 要 】

Background

The use of diuretics for hypertension has been associated with unfavorable changes in cardiovascular risk factors, such as uric acid and glucose tolerance, though the findings in the literature are contradictory.

Methods

This study investigated whether diuretic use is associated with markers of metabolic and cardiovascular risk, such as insulin-resistance and uric acid, in a cohort of adults without known diabetes and/or atherosclerotic cardiovascular disease. Nine hundred sixty-nine randomly selected participants answered a questionnaire on clinical history and dietary habits. Laboratory blood measurements were obtained in 507 participants.

Results

Previously undiagnosed type 2 diabetes was recognized in 4.2% of participants who were on diuretics (n = 71), and in 2% of those who were not (n = 890; P = 0.53). Pre-diabetes was diagnosed in 38% of patients who were on diuretics, and in 17.4% (P < 0.001) of those who were not. Multivariate analysis showed that insulin-resistance (HOMA-IR) was associated with the use of diuretics (P = 0.002) independent of other well-known predisposing factors, such as diet, physical activity, body mass index, and waist circumference. The use of diuretics was also independently associated with fasting plasma glucose concentrations (P = 0.001) and uric acid concentrations (P = 0.01).

Conclusions

The use of diuretics is associated with insulin-resistance and serum uric acid levels and may contribute to abnormal glucose tolerance.

【 授权许可】

   
2013 Buscemi et al.; licensee BioMed Central Ltd.

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