Renin-angiotensin-aldosterone system and oxidative stress in cardiovascular insulin resistance.
Hypertension commonly occurs in conjunction with insulin resistance and other components of the cardiometabolic syndrome. Insulin resistance plays a significant role in the relationship between hypertension, Type 2 diabetes mellitus, chronic kidney disease, and cardiovascular disease. There is accumulating evidence that insulin resistance occurs in cardiovascular and renal tissue as well as in classical metabolic tissues (i.e., skeletal muscle, liver, and adipose tissue). Activation of the renin-angiotensin-aldosterone system and subsequent elevations in angiotensin II and aldosterone, as seen in cardiometabolic syndrome, contribute to altered insulin/IGF-1 signaling pathways and reactive oxygen species formation to induce endothelial dysfunction and cardiovascular disease. This review examines currently understood mechanisms underlying the development of resistance to the metabolic actions of insulin in cardiovascular as well as skeletal muscle tissue.
Cooper
Shawna A
SA
Department of Internal Medicine, University of Missouri School of Medicine, Columbia, Missouri 65212, USA.
Whaley-Connell
Adam
A
Habibi
Javad
J
Wei
Yongzhong
Y
Lastra
Guido
G
Manrique
Camila
C
Stas
Sameer
S
Sowers
James R
JR
D000804:Angiotensin II / Q000378:metabolism; D000818:Animals; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007674:Kidney Diseases / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D024821:Metabolic Syndrome / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D008901:Mineralocorticoids / Q000378:metabolism; D018482:Muscle, Skeletal / Q000378:metabolism / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism; D018384:Oxidative Stress; D017382:Reactive Oxygen Species / Q000378:metabolism; D044140:Receptor, Angiotensin, Type 1 / Q000378:metabolism; D012084:Renin-Angiotensin System; D012307:Risk Factors; D015398:Signal Transduction
D007328:Insulin; D008901:Mineralocorticoids; D017382:Reactive Oxygen Species; D044140:Receptor, Angiotensin, Type 1; D000804:Angiotensin II; D007334:Insulin-Like Growth Factor I