Sexual dimorphism in the metabolic response to the calcium channel antagonists, diltiazem and clentiazem, by hyperlipidemic JCR:LA-cp rats

The JCR:LA-cp rat is obese, insulin resistant, and hypertriglyceridemic. The obese male rats spontaneously develop atherosclerosis and ischemic myocardial lesions that are prevented by treatment with the calcium channel antagonist, nifedipine. Male and female JCR:LA-cp rats were treated with the calcium channel antagonist, diltiazem, and a closely related compound, clentiazem (at 30 mg/kg). Clentiazem, but not diltiazem, caused a significant increase in body weight of both sexes in the presence of decreased food consumption. Serum triacylglycerols were decreased by half by both drugs in male rats only, reflecting decreased very-low-density lipoprotein (VLDL) secretion. Females did not respond with lower concentrations of triacylglycerol (although VLDL secretion rate was decreased) and showed increased concentrations of cholesterol in the high-density lipoprotein (HDL) fraction. Diltiazem-treated male rats showed decreased VLDL particle size, together with a shift to shorter-chain fatty acids in the triacylglycerols. This effect was not seen with clentiazem treatment. There was no effect on insulin and glucose metabolism in these insulin-resistant animals. Calcium channel antagonists have complex metabolic effects in the hypertriglyceridemic rats, with highly beneficial hypolipidemic effects in the males that are not seen in the females. The sexual dimorphism of these responses is sex linked, but appears not to be due to the steroid sex hormones. These results suggest caution in the chronic treatment of human females with these agents and the importance of detailed human studies in females and individuals with the insulin-resistant/hypertriglyceridemic/obese syndrome.