Department of Medicine, B-127, SMBD-Jewish General Hospital, 3755 Côte-Ste-Catherine Road, Montreal, QC H3T 1E2, Canada.
Curr Hypertens Rep. 2011 Apr;13(2):163-72. doi: 10.1007/s11906-011-0182-2.
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.
代谢综合征将胰岛素抵抗和血脂异常等代谢异常与腰围增加和高血压联系起来。这是一个主要的公共卫生关注点，因为在发达国家，其患病率可能很快会达到 30%至 50%。醛固酮是一种经典参与钠平衡调节的盐皮质激素，在代谢综合征患者中增加。除了其经典作用外，醛固酮和盐皮质激素受体 (MR) 的激活还会影响葡萄糖代谢，通过涉及氧化应激、炎症和胰岛素信号通路相关蛋白下调的各种机制引起胰岛素抵抗。醛固酮和 MR 信号对心血管系统和肾脏产生有害影响，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 信号诱导的心血管损伤中起主要作用。需要进行大型多中心、随机临床试验，以测试 MR 拮抗剂对代谢综合征患者心血管事件和死亡率的有益影响。
