Startseite Obesity and cardiovascular disease: role of adipose tissue, inflammation, and the renin-angiotensin-aldosterone system
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Obesity and cardiovascular disease: role of adipose tissue, inflammation, and the renin-angiotensin-aldosterone system

  • Guido Lastra und James R. Sowers EMAIL logo
Veröffentlicht/Copyright: 6. August 2013
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Hormone Molecular Biology and Clinical Investigation
Aus der Zeitschrift Hormone Molecular Biology and Clinical Investigation Band 15 Heft 2

Abstract

Obesity is a leading contributor to morbidity and mortality worldwide. Chronic overnutrition and lack of physical activity result in excess deposition of adipose tissue and insulin resistance, which plays a key role in the pathophysiology of type 2 diabetes mellitus (DM2) and associated cardiovascular disease (CVD). Dysfunctional adipose tissue in obese individuals is characterized by chronic low-grade inflammation that spreads to several tissues as well as systemically and is able to impact the cardiovascular system, resulting in both functional and anatomical abnormalities. Inflammation is characterized by abnormalities in both innate and adaptive immunity including adipose tissue infiltration by CD4+ T lymphocytes, pro-inflammatory (M1) macrophages, and increased production of adipokines. The renin-angiotensin-aldosterone system (RAAS) is inappropriately activated in adipose tissue and contributes to originating and perpetuating inflammation and excessive oxidative stress by increasing production of reactive oxygen species (ROS). In turn, ROS and pro-inflammatory adipokines cause resistance to the metabolic actions of insulin in several tissues including cardiovascular and adipose tissue. Insulin resistance in cardiovascular tissues is characterized by impaired vascular reactivity and abnormal cardiac contractility as well as hypertrophy, fibrosis, and remodeling, which ultimately result in CVD. In this context, weight loss through caloric restriction, regular physical activity, and surgery as well as pharmacologic RAAS blockade all play a key role in reducing obesity-related cardiovascular morbidity and mortality.

Keywords: adipose tissue; cardiovascular disease; inflammation; insulin resistance; obesity; overnutrition; renin-angiotensin-aldosterone system
Corresponding author: James R. Sowers, MD, Division of Endocrinology, Diabetes and Metabolism, School of Medicine, University of Missouri-Columbia, D109 Diabetes Center UHC, One Hospital Drive, Columbia, MO 65212, USA, Phone: +1-573-882-2273

This research was supported by the National Institutes of Health (R01-HL73101 and R01-HL1079100) and Veterans Affairs Merit System 0018.

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Received: 2013-5-24
Accepted: 2013-7-11
Published Online: 2013-08-06
Published in Print: 2013-09-01

©2013 by Walter de Gruyter Berlin Boston

Artikel in diesem Heft

  1. Topic 2: Adipose Tissue and Corticosteroid Hormones
  2. Review Articles
  3. The role and regulation of 11β-hydroxysteroid dehydrogenase type 1 in obesity and the metabolic syndrome
  4. Obesity and cardiovascular disease: role of adipose tissue, inflammation, and the renin-angiotensin-aldosterone system
  5. The mineralocorticoid receptor: a new player controlling energy homeostasis
  6. Effects of energy restriction on activity of the hypothalamo-pituitary-adrenal axis in obese humans and rodents: implications for diet-induced changes in body composition
https://doi.org/10.1515/hmbci-2013-0025
Schlagwörter für diesen Artikel
adipose tissue; cardiovascular disease; inflammation; insulin resistance; obesity; overnutrition; renin-angiotensin-aldosterone system

Artikel in diesem Heft

  1. Topic 2: Adipose Tissue and Corticosteroid Hormones
  2. Review Articles
  3. The role and regulation of 11β-hydroxysteroid dehydrogenase type 1 in obesity and the metabolic syndrome
  4. Obesity and cardiovascular disease: role of adipose tissue, inflammation, and the renin-angiotensin-aldosterone system
  5. The mineralocorticoid receptor: a new player controlling energy homeostasis
  6. Effects of energy restriction on activity of the hypothalamo-pituitary-adrenal axis in obese humans and rodents: implications for diet-induced changes in body composition
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