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The renin-angiotensin system and insulin resistance

Zhenqi Liu1

  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Virginia Health System, PO Box 801410, Charlottesville, VA 22908-1410, USA. zl3e@virginia.edu

Current Diabetes Reports
|January 27, 2007
PubMed

Insights

Insulin resistance worsens cardiovascular disease by activating the renin-angiotensin system (RAS). Inhibiting the RAS can reduce cardiovascular and kidney problems and prevent type 2 diabetes.

Area of Science:

  • Cardiovascular Science
  • Endocrinology
  • Nephrology

Background:

  • Insulin resistance is linked to the renin-angiotensin system (RAS), contributing to hypertension, heart failure, and atherosclerosis.
  • The RAS plays a critical role in cardiovascular and renal health.

Purpose of the Study:

  • To explore the intricate relationship between insulin resistance, the renin-angiotensin system (RAS), and cardiovascular pathology.
  • To highlight the therapeutic potential of RAS inhibition in managing metabolic and cardiovascular diseases.

Main Methods:

  • Literature review and synthesis of existing research on the interplay between insulin resistance, RAS, and endothelial function.
  • Analysis of molecular pathways including nuclear factor-kappaB and nitric oxide signaling.

Main Results:

  • Insulin resistance upregulates the RAS, promoting conditions like hypertension and atherosclerosis.
  • Angiotensin II impairs insulin signaling, induces inflammation, and causes vasoconstriction, exacerbating insulin resistance and endothelial dysfunction.
  • RAS inhibition demonstrates benefits in reducing cardiovascular and renal events and preventing type 2 diabetes.

Conclusions:

  • The RAS, insulin resistance, and inflammation form a detrimental cycle contributing to endothelial dysfunction, vascular injury, and atherosclerosis.
  • Targeting the RAS offers a promising strategy for mitigating the progression of these interconnected conditions.

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