Mineralocorticoids and Cardiovascular Disease in Females with Insulin Resistance and Obesity.
Mineralocorticoids and Cardiovascular Disease in Females with Insulin Resistance and Obesity.
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DOI：
10.1007/s11906-018-0887-6
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发表时间：
2018-08-14
影响因子：
5.6
通讯作者：
Acevedo CM
中科院分区：
文献类型：
--
作者：
Nayyar M;Lastra G;Acevedo CM
在本综述中，我们将讨论肥胖、盐皮质激素受体激活和心血管功能障碍之间复杂相互作用的证据和机制，特别强调肥胖和胰岛素抵抗女性心血管疾病（CVD）的发病机制。自 1953 年首次分离醛固酮以及几十年后克隆盐皮质激素受体 (MR) 以来，我们对其参与 CVD 发病机制的认识已大大扩展。临床前和临床研究的最新结果都支持肥胖增加与醛固酮生成增强（MR 激活）之间的密切相关性。重要的是，胰岛素抵抗和肥胖女性更容易受到 MR 激活的有害心血管影响，并且女性中 MR 激活的增强已成为糖尿病女性更严重 CVD 发生的重要致病事件。不同的临床试验已经完成，检验 MR 阻断对 CVD 受试者的影响。尽管它对死亡率有重要的有益影响，但副作用也很常见，目前正在大型临床试验中测试一种新型 MR 拮抗剂 Finerenone，其高钾血症风险较低。
In the present review, we will discuss the evidence and the mechanisms underlying the complex interplay between obesity, mineralocorticoid receptor activation, and cardiovascular dysfunction with special emphasis on the pathogenesis of cardiovascular disease (CVD) in obese and insulin-resistant females. Since the initial isolation of aldosterone in 1953 and the cloning of the mineralocorticoid receptor (MR) decades later, our understanding has expanded tremendously regarding their involvement in the pathogenesis of CVD. Recent results from both pre-clinical and clinical studies support a close correlation between increase adiposity and enhanced aldosterone production (MR activation). Importantly, insulin resistance and obese females are more prone to the deleterious cardiovascular effects of MR activation, and enhanced MR activation in females has emerged as an important causative event in the genesis of a more severe CVD in diabetic women. Different clinical trials have been completed examining the effect of MR blockade in subjects with CVD. Despite its important beneficial mortality impact, side effects are frequent and a newer MR antagonist, finerenone, with less risk of hyperkalemia is currently being tested in large clinical trials.
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影响因子：
2.9
作者：
Barrett KV;McCurley AT;Jaffe IZ
通讯作者：
Jaffe IZ
影响因子：
8.3
作者：
Engeli, S;Bohnke, J;Sharma, AM
通讯作者：
Sharma, AM
在心力衰竭和合并症糖尿病或慢性肾脏疾病的患者中使用矿物皮质受体拮抗剂。
影响因子：
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作者：
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影响因子：
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作者：
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通讯作者：
Touyz, Rhian M.