Microvascular dysfunction as a link between obesity, insulin resistance and hypertension.
Impaired microvascular dilatation from any cause and impaired insulin-mediated capillary recruitment in particular result in suboptimal delivery of glucose and insulin to skeletal muscle, and subsequently impairment of glucose disposal (insulin resistance). In addition, microvascular dysfunction, through functional and/or structural arteriolar and capillary drop-out, and arteriolar constriction, increases peripheral resistance and thus blood pressure. Microvascular dysfunction may thus constitute a pathway that links insulin resistance and hypertension. Overweight and obesity may be an important cause of microvascular dysfunction. Mechanisms linking overweight and obesity to microvascular dysfunction include changes in the secretion of adipokines leading to increased levels of free fatty acids and inflammatory mediators, and decreased levels of adiponectin all of which may impair endothelial insulin signaling. Microvascular dysfunction may thus constitute a new treatment target in the prevention of type 2 diabetes mellitus and hypertension.
Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.
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Ü
Karaca
Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.
M T
MT
Schram
Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands. Electronic address: b.houben@maastrichtuniversity.nl.
A J H M
AJ
Houben
Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.
D M J
DM
Muris
Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.
C D A
CD
Stehouwer
D000818:Animals; D004730:Endothelium, Vascular / Q000378:metabolism / Q000473:pathology*; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D009765:Obesity / Q000503:physiopathology*; D014652:Vascular Diseases / Q000503:physiopathology*
D007328:Insulin; D005947:Glucose
Hypertension; Insulin resistance; Microvascular dysfunction; Obesity