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on October 7, 2002

Hypertension. 2002
Published online before print October 7, 2002, doi: 10.1161/01.HYP.0000036448.44066.53
A more recent version of this article appeared on November 1, 2002
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Submitted on July 15, 2002
Revised on August 8, 2002

Angiotensin Blockade Prevents Type 2 Diabetes by Formation of Fat Cells

Arya M. Sharma*; Jürgen Janke; Kerstin Gorzelniak; Stefan Engeli; and Friedrich C. Luft

From HELIOS Klinikum Berlin, Franz Volhard Clinic-Charité, Humboldt University of Berlin, and Max Delbrück Center for Molecular Medicine, Berlin, Germany.

* To whom correspondence should be addressed. E-mail: sharma{at}ccc.mcmaster.ca.

Abstract—Obesity is the prime risk factor for the development of type 2 diabetes. Recent clinical trials have shown that blockade of the renin-angiotensin system, either by inhibiting the angiotensin-converting enzyme or blocking the angiotensin type 1 receptor, may substantially lower the risk for type 2 diabetes. The mechanism underlying this effect is unknown. Based on our recent observation that angiotensin II markedly inhibits adipogenic differentiation of human adipocytes via the angiotensin type I receptor and that expression of angiotensin II-forming enzymes in adipose tissue is inversely correlated with insulin sensitivity, we propose the hypothesis that blockade of the renin-angiotensin system prevents diabetes by promoting the recruitment and differentiation of adipocytes. Increased formation of adipocytes would counteract the ectopic deposition of lipids in other tissues (muscle, liver, pancreas), thereby improving insulin sensitivity and preventing the development of type 2 diabetes.


Key words: angiotensin • diabetes • adipose tissue • insulin resistance • obesity




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