Insulin Resistance the Hinge Between Hypertension and Type 2 Diabetes

作者：Costantino Mancusi, Raffaele Izzo, Giuseppe Di Gioia, Maria Angela Losi, Emanuele Barbato, Carmine Morisco · 发表于：High Blood Pressure & Cardiovascular Prevention · 年份：2020 · DOI：10.1007/s40292-020-00408-8 · 被引用次数：222 · 研究领域：Adipokines, Inflammation, and Metabolic Diseases、Atherosclerosis and Cardiovascular Diseases、Diet, Metabolism, and Disease

Epidemiological studies have documented a high incidence of diabetes in hypertensive patients.Insulin resistance is defined as a less than expected biologic response to a given concentration of the hormone and plays a pivotal role in the pathogenesis of diabetes. However, over the last decades, it became evident that insulin resistance is not merely a metabolic abnormality, but is a complex and multifaceted syndrome that can also affect blood pressure homeostasis. The dysregulation of neuro-humoral and neuro-immune systems is involved in the pathophysiology of both insulin resistance and hypertension. These mechanisms induce a chronic low grade of inflammation that interferes with insulin signalling transduction. Molecular abnormalities associated with insulin resistance include the defects of insulin receptor structure, number, binding affinity, and/or signalling capacity. For instance, hyperglycaemia impairs insulin signalling through the generation of reactive oxygen species, which abrogate insulin-induced tyrosine autophosphorylation of the insulin receptor. Additional mechanisms have been described as responsible for the inhibition of insulin signalling, including proteasome-mediated degradation of insulin receptor substrate 1/2, phosphatase-mediated dephosphorylation and kinase-mediated serine/threonine phosphorylation of both insulin receptor and insulin receptor substrates. Insulin resistance plays a key role also in the pathogenesis and progression of hypertension-in...