Natriuretic peptides are endogenous antagonists of vasoconstrictor and salt- and water-retaining systems in the body's defence against blood pressure elevation and plasma volume expansion, through direct vasodilator, diuretic and natriuretic properties. In addition, natriuretic peptides may play a role in the modulation of the molecular mechanisms involved in metabolic regulation and cardiovascular remodelling. The metabolic syndrome is characterized by visceral obesity, hyperlipidaemia, vascular inflammation and hypertension, which are linked by peripheral insulin resistance. Increased visceral adiposity may contribute to the reduction in the circulating levels of natriuretic peptides. The dysregulation of neurohormonal systems, including the renin–angiotensin and the natriuretic peptide systems, may in turn contribute to the development of insulin resistance in dysmetabolic patients. In obese subjects with the metabolic syndrome, reduced levels of natriuretic peptides may be involved in the development of hypertension, vascular inflammation and cardio vascular remodelling, and this may predispose to the development of cardiovascular disease. The present review summarizes the regulation and function of the natriuretic peptide system in obese patients with the metabolic syndrome and the involvement of altered bioactive levels of natriuretic peptides in the pathophysiology of cardiovascular disease in patients with metabolic abnormalities.
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Review Article|
November 09 2009
Natriuretic peptides and cardiovascular damage in the metabolic syndrome: molecular mechanisms and clinical implications
Carmine Savoia;
*Cardiology Unit, Second Faculty of Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
†Research Center, Fatebenefratelli San Pietro Hospital, Rome, Italy
Correspondence: Dr Carmine Savoia (email [email protected]).
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Massimo Volpe;
Massimo Volpe
*Cardiology Unit, Second Faculty of Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
‡IRCCS Neuromed, Polo Molisano University of Rome La Sapienza, Pozzilli (Is), Italy
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Alessandro Alonzo;
Alessandro Alonzo
*Cardiology Unit, Second Faculty of Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Chiara Rossi;
Chiara Rossi
*Cardiology Unit, Second Faculty of Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Speranza Rubattu
Speranza Rubattu
*Cardiology Unit, Second Faculty of Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
‡IRCCS Neuromed, Polo Molisano University of Rome La Sapienza, Pozzilli (Is), Italy
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Publisher: Portland Press Ltd
Received:
April 15 2009
Revision Received:
July 06 2009
Accepted:
July 28 2009
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© The Authors Journal compilation © 2010 Biochemical Society
2010
Clin Sci (Lond) (2010) 118 (4): 231–240.
Article history
Received:
April 15 2009
Revision Received:
July 06 2009
Accepted:
July 28 2009
Citation
Carmine Savoia, Massimo Volpe, Alessandro Alonzo, Chiara Rossi, Speranza Rubattu; Natriuretic peptides and cardiovascular damage in the metabolic syndrome: molecular mechanisms and clinical implications. Clin Sci (Lond) 1 February 2010; 118 (4): 231–240. doi: https://doi.org/10.1042/CS20090204
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