The Role of Aldosterone in the Metabolic Syndrome
The Role of Aldosterone in the Metabolic Syndrome
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DOI：
10.1007/s11906-011-0182-2
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发表时间：
2011-04-01
影响因子：
5.6
通讯作者：
Schiffrin, Ernesto L.
中科院分区：
文献类型：
--
作者：
Briet, Marie;Schiffrin, Ernesto L.
代谢综合征将代谢异常如胰岛素抵抗和血脂异常与腰围增加和高血压相关联。它是一个主要的公共卫生问题，因为其流行率在发达国家可能很快达到30%至50%。醛固酮是一种典型的参与钠平衡调节的盐皮质激素，在代谢综合征患者中升高。除了其经典作用外，醛固酮和盐皮质激素受体（MR）活化影响葡萄糖代谢，通过涉及氧化应激、炎症和参与胰岛素信号传导途径的蛋白质下调的各种机制诱导胰岛素抵抗。醛固酮和MR信号对心血管系统和肾脏产生有害作用，影响与代谢综合征相关的心血管风险。盐负荷在醛固酮和MR信号介导的心血管损伤中起重要作用。需要进行大型多中心、随机临床试验，测试MR拮抗剂对代谢综合征患者心血管事件和死亡率的有益作用。
The metabolic syndrome associates metabolic abnormalities such as insulin resistance and dyslipidemia with increased waist circumference and hypertension. It is a major public health concern, as its prevalence could soon reach 30% to 50% in developed countries. Aldosterone, a mineralocorticoid hormone classically involved in sodium balance regulation, is increased in patients with metabolic syndrome. Besides its classic actions, aldosterone and mineralocorticoid receptor (MR) activation affect glucose metabolism, inducing insulin resistance through various mechanisms that involve oxidative stress, inflammation, and downregulation of proteins involved in insulin signaling pathways. Aldosterone and MR signaling exert deleterious effects on the cardiovascular system and the kidney that influence the cardiovascular risk associated with metabolic syndrome. Salt load plays a major role in cardiovascular injury induced by aldosterone and MR signaling. Large multicenter, randomized clinical trials testing the beneficial effects of MR antagonists on cardiovascular events and mortality in patients with metabolic syndrome are needed.