scholarly journals Renin–angiotensin–aldosterone system in insulin resistance and metabolic syndrome

2016 ◽  
Vol 4 (2) ◽  
pp. 66-72 ◽  
Author(s):  
Undurti N. Das

AbstractObesity and its consequent complications such as hypertension and metabolic syndrome are increasing in incidence in almost all countries. Insulin resistance is common in obesity. Renin– angiotensin system (RAS) is an important target in the treatment of hypertension and drugs that act on RAS improve insulin resistance and decrease the incidence of type 2 diabetes mellitus, explaining the close association between hypertension and type 2 diabetes mellitus. RAS influences food intake by modulating the hypothalamic expression of neuropeptide Y and orexins via AMPK dephosphorylation. Estrogen reduces appetite by its action on the brain in a way similar to leptin, an anorexigenic action that seems to be mediated via hypothalamic pro-opiomelanocortin (POMC) neurons in the arcuate nucleus and synaptic plasticity in the arcuate nucleus similar to leptin. Estrogen stimulates lipoxin A4, a potent vasodilator and platelet anti-aggregator. Since both RAS and estrogen act on the hypothalamic neuropeptides and regulate food intake and obesity, it is likely that RAS modulates LXA4 synthesis. Thus, it is proposed that Angiotensin-II receptor blockers and angiotensin-converting enzymes and angiotensin-II antagonists may have the ability to augment LXA4 synthesis and thus bring about their beneficial actions.

Author(s):  
Patricio López-Jaramillo ◽  
Diego Gómez-Arbeláez ◽  
Jose López-López ◽  
Cristina López-López ◽  
Javier Martínez-Ortega ◽  
...  

AbstractThe metabolic syndrome comprises a cluster of cardiometabolic risk factors, with insulin resistance and adiposity as its central features. Identifying individuals with metabolic syndrome is important due to its association with an increased risk of coronary heart disease and type 2 diabetes mellitus. Attention has focused on the visceral adipose tissue production of cytokines (adipokines) in metabolic syndrome and type 2 diabetes mellitus, as the levels of the anti-inflammatory adipokine adiponectin are decreased, while proinflammatory cytokines are elevated, creating a proinflammatory state associated with insulin resistance and endothelial dysfunction. In this review, we will give special attention to the role of the leptin/adiponectin ratio. We have previously demonstrated that in individuals with severe coronary artery disease, abdominal obesity was uniquely related to decreased plasma concentrations of adiponectin and increased leptin levels. Leptin/adiponectin imbalance was associated with increased waist circumference and a decreased vascular response to acetylcholine and increased vasoconstriction due to angiotensin II. Leptin and adiponectin have opposite effects on subclinical inflammation and insulin resistance. Leptin upregulates proinflammatory cytokines such as tumor necrosis factor-α and interleukin-6; these are associated with insulin resistance and type 2 diabetes mellitus. In contrast, adiponectin has anti-inflammatory properties and downregulates the expression and release of a number of proinflammatory immune mediators. Therefore, it appears that interactions between angiotensin II and leptin/adiponectin imbalance may be important mediators of the elevated risk of developing type 2 diabetes mellitus and cardiovascular diseases associated with abdominal obesity.


2011 ◽  
Vol 1 (3) ◽  
pp. 193-210 ◽  
Author(s):  
Melvin R. Hayden ◽  
Kurt M. Sowers ◽  
Lakshmi Pulakat ◽  
Tejaswini Joginpally ◽  
Bennett Krueger ◽  
...  

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1249
Author(s):  
Oana Irina Gavril ◽  
Lidia Iuliana Arhire ◽  
Radu Sebastian Gavril ◽  
Madalina Ioana Zota ◽  
Andreea Gherasim ◽  
...  

Background and Objectives: Non-alcoholic fatty liver disease is a worldwide significant public health problem, particularly in patients with type 2 diabetes mellitus. Identifying possible risk factors for the disease is mandatory for a better understandingand management of this condition. Patatin-like phospholipase domain-containing protein 3 (PNPLA3) has been linked to the development and evolution of fatty liver but not to insulin resistance. The aim of this study isto evaluate the relationships between PNPLA3 and fatty liver, metabolic syndrome and subclinical atherosclerosis. Materials and Methods: The study group consisted of patients with type 2 diabetes mellitus without insulin treatment. The degree of liver fat loading was assessed by ultrasonography, and subclinical atherosclerosis was assessed using carotid intima-media thickness (CIMT). PNPLA3 rs738409 genotype determination was performed by high-resolution melting analysis that allowed three standard genotypes: CC, CG, and GG. Results: Among the 92 patients, more than 90% showed various degrees of hepatic steatosis, almost 62% presented values over the normal limit for the CIMT. The majority of the included subjects met the criteria for metabolic syndrome. Genotyping of PNPLA3 in 68 patients showed that the difference between subjects without steatosis and subjects with hepatic steatosis was due to the higher frequency of genotype GG. The CC genotype was the most common in the group we studied and was significantly more frequent in the group of subjects with severe steatosis; the GG genotype was significantly more frequent in subjects with moderate steatosis; the frequency of the CG genotype was not significantly different among the groups.When we divided the group of subjects into two groups: those with no or mild steatosis and those with moderate or severe steatosis it was shown that the frequency of the GG genotype was significantly higher in the group of subjects with moderate or severe steatosis. PNPLA3 genotypes were not associated with metabolic syndrome, subclinical atherosclerosis, or insulin resistance. Conclusions: Our results suggest that PNPLA3 does not independently influence cardiovascular risk in patients with type 2 diabetes mellitus. The hypothesis that PNPLA3 may have a cardioprotective effect requires future confirmation.


2020 ◽  
Vol 52 (10) ◽  
pp. 695-707
Author(s):  
Emilio Antonio Francischetti ◽  
Rômulo Sperduto Dezonne ◽  
Cláudia Maria Pereira ◽  
Cyro José de Moraes Martins ◽  
Bruno Miguel Jorge Celoria ◽  
...  

AbstractIn 2016, the World Health Organization estimated that more than 1.9 billion adults were overweight or obese. This impressive number shows that weight excess is pandemic. Overweight and obesity are closely associated with a high risk of comorbidities, such as insulin resistance and its most important outcomes, including metabolic syndrome, type 2 diabetes mellitus, and cardiovascular disease. Adiponectin has emerged as a salutary adipocytokine, with insulin-sensitizing, anti-inflammatory, and cardiovascular protective properties. However, under metabolically unfavorable conditions, visceral adipose tissue-derived inflammatory cytokines might reduce the transcription of the adiponectin gene and consequently its circulating levels. Low circulating levels of adiponectin are negatively associated with various conditions, such as insulin resistance, type 2 diabetes mellitus, metabolic syndrome, and cardiovascular disease. In contrast, several recent clinical trials and meta-analyses have reported high circulating adiponectin levels positively associated with cardiovascular mortality and all-cause mortality. These results are biologically intriguing and counterintuitive, and came to be termed “the adiponectin paradox”. Adiponectin paradox is frequently associated with adiponectin resistance, a concept related with the downregulation of adiponectin receptors in insulin-resistant states. We review this contradiction between the apparent role of adiponectin as a health promoter and the recent evidence from Mendelian randomization studies indicating that circulating adiponectin levels are an unexpected predictor of increased morbidity and mortality rates in several clinical conditions. We also critically review the therapeutic perspective of synthetic peptide adiponectin receptors agonist that has been postulated as a promising alternative for the treatment of metabolic syndrome and type 2 diabetes mellitus.


Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 2499-PUB
Author(s):  
AYLA TOURKMANI ◽  
ABDULAZIZ BIN RSHEED ◽  
HEBA ANSARA ◽  
TURKI ALHARBI ◽  
MOSTAFA FOUAD

Author(s):  
Kh. I. Kurylo ◽  
A. S. Volska ◽  
I. M. Klishch ◽  
B. V. Zablotskyi

Diabetes mellitus is caused by one of the largest medical and social problems in Ukraine, because it causes a high risk of invasive disease. According to the WHO data, the number of patients is rising and people of varying age groups become ill, which causes an increase in the incidence of 3 to 4 pauses and the overall life expectancy of 20-30%. Pathogenesis of diabetes mellitus and enclosure, require the extraction of drugs for prophylaxis and treatment with late pharmacological effects. One of these is a herbal remedy. Analysis and systematization of the literature on metabolitotropic effects and substantiation of the use of new goat's-rue, blueberry and taurine phytocompositions for the correction of metabolic changes in diabetes type 2 were carried out. The methods of information search, analysis of literature on the medicinal plants with hypoglycemic action were used. The literary resources on pharmacological correction of metabolic changes in diabetes type 2 deal with natural herbs and amino acids that possess hypoglycemic action and can be used with therapeutic and prophylactic measure in patients with type 2 diabetes. In type 2 diabetes mellitus significant anticytolytic, detoxifying and antioxidant properties of phytocompositions were confirmed. It is known that in hyperglycemia and insulin resistance that occur at type 2 diabetes mellitus end products of glycosylation and glucose autooxidation are formed, which is accompanied by the activation of lipid peroxidation and the formation of a large number of free radicals. It is known that one of the basic mechanisms for the development of insulin resistance, diabetes mellitus and specific diabetic angiopathies is oxidative stress. One of the major pathogenetic factors in the development and course of type 2 diabetes mellitus is metabolic syndrome. It has been established that correction using both investigated phytocompositions and reference phytopreparation with different efficiency prevented the development of metabolic changes in metabolic syndrome. Biologically active components of medicinal plants, may show hypoglycemic effect which will influence the activity of the enzymes, glucose transcription and the function of the peptide to the incyline, the processes which play an important role in the pathogenesis of diabetes.


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