The mineralocorticoid system, cardiometabolic health and its interplay with adipose tissue

in Journal of Endocrinology
Authors:
Moe Thuzar Endocrine Hypertension Research Centre, University of Queensland Frazer Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia
Department of Endocrinology & Diabetes, Princess Alexandra Hospital, Brisbane, Queensland, Australia

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https://orcid.org/0000-0001-6052-6096
,
Muthanna Abdul Halim Endocrine Hypertension Research Centre, University of Queensland Frazer Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia

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Michael Stowasser Endocrine Hypertension Research Centre, University of Queensland Frazer Institute and Princess Alexandra Hospital, Brisbane, Queensland, Australia

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Correspondence should be addressed to M Thuzar: m.thuzar@uq.edu.au

This paper forms part of a special collection on the theme of corticosteroids and cardiovascular disease. The guest editors for this collection were Massimiliano Caprio and Morag Young.

DOI:
https://doi.org/10.1530/JOE-24-0119
Volume/Issue:
Volume 263: Issue 2
Article Type:
Review Article
Article ID:
e240119
Online Publication Date:
16 Oct 2024
Copyright:
© the author(s) 2024
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The mineralocorticoid system, comprising the renin-angiotensin-aldosterone system (RAAS) and associated receptors, is traditionally viewed as a regulator of sodium and fluid balance and blood pressure (BP), with the main mineralocorticoid hormone aldosterone acting via the mineralocorticoid receptor (MR) in distal renal tubules. Over the past few decades, there has been a wider understanding of the role of the mineralocorticoid system in regulating both classical BP-dependent and non-BP-dependent systemic effects. Mounting evidence indicates the novel role of the mineralocorticoid system in cardiometabolic health, with excess mineralocorticoid system activity being associated with adiposity, diabetes, insulin resistance and cardiovascular diseases independent of its effect on BP, and RAAS blockade and MR antagonists offering protection against cardiometabolic dysfunction. The metabolic manifestations of mineralocorticoid system overactivation are mainly mediated by their interactions with adipose tissue, which orchestrates energy, lipids, and glucose homeostasis via effects on the functions of brown and white adipocytes and immune cells. Adipose tissue can, in turn, influence mineralocorticoid system activity by harboring its own RAAS system and by releasing mineralocorticoid-secretory factors/adipokines, resulting in further progression of cardiometabolic dysfunction. This article discusses the interplay between the mineralocorticoid system and adipose tissue in the pathophysiology of cardiometabolic diseases.

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Print ISSN:
0022-0795
Online ISSN:
1479-6805
Copyright:
© the author(s) 2024
Article ID:
e240119
Article Type:
Review Article
Received Date:
21 Apr 2024
Accepted Date:
16 Sep 2024
Print Publication Date:
01 Nov 2024
Online Publication Date:
16 Oct 2024
Keywords:
adipose tissue; aldosterone; angiotensin; cardiometabolic health; metabolic syndrome; metabolism; mineralocorticoid; mineralocorticoid receptor

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