Role of metabolic factors: Lipids, glucose/insulin intolerance

Abstract

Overnutrition characterized by overconsumption of food rich in fat and carbohydrates is a significant contributor to hypertension, type 2 diabetes, and the cardiorenal syndrome (CRS). Obesity, insulin resistance, and diabetes mellitus are associated with a substantially increased prevalence of arterial disease (AD), which is involved in the risk of coronary, cerebral, and peripheral atherosclerosis and the clinical consequences of myocardial infarction, stroke, limb ischemia, and death. Although the underlying mechanisms and mediators of AD are not well understood, accumulating evidence supports the role of dysregulation of VSMCs, ECs, and vascular extracellular matrix in pathogenesis of AD. Risk factors related to CRS and misregulation of adaptive metabolic responses develop a complex network and contribute to the progression of AD. In this review, we will focus on the interaction of metabolic risk factors, adaptive metabolic response, and AD, highlighting pathophysiology and molecular mechanisms, as well as the contemporary understanding of potential therapeutic strategies.