Naslov
Obesity and aldosterone

Autori
Baretić, Maja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, neobjavljeni rad, znanstveni

Skup
41st symposium Hypertension Highlights in 2020

Mjesto i datum
Rijeka, Hrvatska, 19.11.2020. - 20.11.2020

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
obesity ; aldosterone ; hypertension ; renin-angiotensin-aldosterone system ; glucagon-like peptide-1

Sažetak
The lecture regarding Obesity and aldosterone is divided in two parts. The firs one argues the association among obesity and aldosterone, the second one presents a study explaining the pharmacological possibilities in treatment of obesity and suppression of aldosterone. The obesity epidemic brings with a number of health problems including increased risk of hypertension and associated cardiovascular disorders. Obese individuals frequently develop hypertension, which is for an important part attributable to renin- angiotensin-aldosterone system (RAAS) overactivity. Many studies suggest correlation between aldosterone levels and the metabolic syndrome, especially abdominal obesity and arterial hypertension. The background of obesity and hypertension it is connected to sympathetic nervous system overactivity, renal compression and dysfunctional adipose tissue. Adipose tissue is highly active endocrine organ involved in many physiological and pathological processes excreting both aldosterone-releasing factors and aldosterone itself, thereby contributing to high level of aldosterone independently. The classic role of aldosterone is to regulate water and electrolyte balance, though today it is well known that aldosterone induces structural and functional alterations in the heart, kidneys, and vessels with effects such as myocardial fibrosis, nephrosclerosis, vascular inflammation and remodeling, and disturbed fibrinolysis. If there is less aldosterone in obese subject, there is less cardiovascular risk. Weight loss studies demonstrated that following even moderate weight loss there was a significant reduction in aldosterone levels together with renin and angiotensin II, confirming involvement of an increased RAAS activity in the development of obesity hypertension. Glucagon-like peptide-1 (GLP-1), a peptide secreted form the gut after a meal, has many positive outcomes on the human body, but its glucose- lowering effect through its stimulation of insulin secretion is the most significant one. Therefore, GLP- 1 receptor agonists are indicated for the treatment of type 2 diabetes. Since weigh loss was noticed during treatment with GLP-1 receptor agonists, one of them, liraglutide, is indicated for the treatment of obesity too. A double-blind, placebo-controlled crossover study exploring the effect of native GLP-1 in healthy normal weight participants showed that following GLP-1 infusion, aldosterone had decreased by a statistically significant amount (p < 0.008) compared to the baseline level. The antihypertensive and renoprotective effects of GLP-1 receptor agonists are partly explained by their vasoactive effect and increased natriuresis, but their positive influences on blood pressure and the development and progression of kidney disease are attributed to many effects beyond glycaemic control, possible aldosterone suppression. The results of the study show that native GLP-1 can decrease aldosterone secretion in a group of healthy individuals, supporting the idea of beneficial outcomes of GLP-1-activating agents on blood pressure and the RAAS. It brings a new light to the treatment of obesity with GLP-1 receptor agonists, pointing to the possible benefits we were not aware of.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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