Arginine vasopressin: A promising therapeutic target for metabolic syndrome

Globally, the prevalence of metabolic syndrome (MetS) among adults is around 20%-25%. MetS is associated with an increased risk of cardiovascular morbidity and mortality. The pathogenesis of MetS is multifactorial, with no single factor being an obvious target for treatment. Rather, complex genetic and environmental factors result in visceral obesity, insulin resistance, hyperglycemia, dyslipidemia, and hypertension. A growing body of epidemiological evidence is indicative of an association between arginine vasopressin (AVP) and MetS and its components. Indeed, the clinical marker of AVP, copeptin, has been proposed as a biomarker of MetS. Moreover, experimental studies support a causal relationship between AVP and MetS. This suggests that AVP should be considered in the management of MetS. However, there is lack of clinical trials. This review summarizes the accumulating literature describing the roles of AVP in the pathophysiology of MetS and discusses its role as a possible therapeutic target. SIGNIFICANCE STATEMENT: This review highlights the emerging role of arginine vasopressin (AVP) as a central regulator linking hydration, energy balance, and cardiometabolic risk in metabolic syndrome. By integrating mechanistic, epidemiological, and therapeutic evidence, AVP signaling was identified as a promising yet complex target in the prevention and management of metabolic syndrome.