title: Mineralocorticoid receptors modulate vascular endothelial function in human obesity.
abstract: Obesity increases linearly with age and is associated with impaired vascular endothelial function and increased risk of cardiovascular disease. MRs (mineralocorticoid receptors) contribute to impaired vascular endothelial function in cardiovascular disease; however, their role in uncomplicated human obesity is unknown. Because plasma aldosterone levels are elevated in obesity and adipocytes may be a source of aldosterone, we hypothesized that MRs modulate vascular endothelial function in older adults in an adiposity-dependent manner. To test this hypothesis, we administered MR blockade (eplerenone; 100 mg/day) for 1 month in a balanced randomized double-blind placebo-controlled cross-over study to 22 older adults (ten men, 55-79 years) varying widely in adiposity [BMI (body mass index): 20-45 kg/m²], but who were free from overt cardiovascular disease. We evaluated vascular endothelial function [brachial artery FMD (flow-mediated dilation)] via ultrasonography) and oxidative stress (plasma F2-isoprostanes and vascular endothelial cell protein expression of nitrotyrosine and NADPH oxidase p47phox) during placebo and MR blockade. In the whole group, oxidative stress (P>0.05) and FMD did not change with MR blockade (6.39 ± 0.67 compared with 6.23 ± 0.73%; P=0.7). However, individual improvements in FMD in response to eplerenone were associated with higher total body fat (BMI: r=0.45, P=0.02; and dual-energy X-ray absorptiometry-derived percentage body fat: r=0.50, P=0.009) and abdominal fat (total: r=0.61, P=0.005; visceral: r=0.67, P=0.002; and subcutaneous: r=0.48, P=0.03). In addition, greater improvements in FMD with eplerenone were related to higher baseline fasting glucose (r=0.53, P=0.01). MRs influence vascular endothelial function in an adiposity-dependent manner in healthy older adults.
authors.affiliation: Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA.
authors.forename: Moon-Hyon
authors.initials: MH
authors.lastname: Hwang
authors.forename: Jeung-Ki
authors.initials: JK
authors.lastname: Yoo
authors.forename: Meredith
authors.initials: M
authors.lastname: Luttrell
authors.forename: Han-Kyul
authors.initials: HK
authors.lastname: Kim
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Meade
authors.forename: Mark
authors.initials: M
authors.lastname: English
authors.forename: Mark S
authors.initials: MS
authors.lastname: Segal
authors.forename: Demetra D
authors.initials: DD
authors.lastname: Christou
mesh_terms: D050153:Abdominal Fat / Q000378:metabolism / Q000503:physiopathology; D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D042783:Endothelial Cells / Q000378:metabolism; D000077545:Eplerenone; D028441:F2-Isoprostanes / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000494:pharmacology*; D019255:NADPH Oxidases / Q000378:metabolism; D009765:Obesity / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology*; D018384:Oxidative Stress / Q000187:drug effects; D018161:Receptors, Mineralocorticoid / Q000502:physiology*; D013148:Spironolactone / Q000031:analogs & derivatives* / Q000494:pharmacology; D014443:Tyrosine / Q000031:analogs & derivatives / Q000378:metabolism; D014463:Ultrasonography
chemical_list: D028441:F2-Isoprostanes; D000451:Mineralocorticoid Receptor Antagonists; D018161:Receptors, Mineralocorticoid; D013148:Spironolactone; C002744:3-nitrotyrosine; D014443:Tyrosine; D000077545:Eplerenone; D019255:NADPH Oxidases