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Mitochondrial biogenesis in the metabolic syndrome and cardiovascular disease.

Abstract
The metabolic syndrome is a constellation of metabolic disorders including obesity, hypertension, and insulin resistance, components which are risk factors for the development of diabetes, hypertension, cardiovascular, and renal disease. Pathophysiological abnormalities that contribute to the development of the metabolic syndrome include impaired mitochondrial oxidative phosphorylation and mitochondrial biogenesis, dampened insulin metabolic signaling, endothelial dysfunction, and associated myocardial functional abnormalities. Recent evidence suggests that impaired myocardial mitochondrial biogenesis, fatty acid metabolism, and antioxidant defense mechanisms lead to diminished cardiac substrate flexibility, decreased cardiac energetic efficiency, and diastolic dysfunction. In addition, enhanced activation of the renin-angiotensin-aldosterone system and associated increases in oxidative stress can lead to mitochondrial apoptosis and degradation, altered bioenergetics, and accumulation of lipids in the heart. In addition to impairments in metabolic signaling and oxidative stress, genetic and environmental factors, aging, and hyperglycemia all contribute to reduced mitochondrial biogenesis and mitochondrial dysfunction. These mitochondrial abnormalities can predispose a metabolic cardiomyopathy characterized by diastolic dysfunction. Mitochondrial dysfunction and resulting lipid accumulation in skeletal muscle, liver, and pancreas also impede insulin metabolic signaling and glucose metabolism, ultimately leading to a further increase in mitochondrial dysfunction. Interventions to improve mitochondrial function have been shown to correct insulin metabolic signaling and other metabolic and cardiovascular abnormalities. This review explores mechanisms of mitochondrial dysfunction with a focus on impaired oxidative phosphorylation and mitochondrial biogenesis in the pathophysiology of metabolic heart disease.
AuthorsJun Ren, Lakshmi Pulakat, Adam Whaley-Connell, James R Sowers
JournalJournal of molecular medicine (Berlin, Germany) (J Mol Med (Berl)) Vol. 88 Issue 10 Pg. 993-1001 (Oct 2010) ISSN: 1432-1440 [Electronic] Germany
PMID20725711 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S., Review)
Chemical References
  • Nitric Oxide Synthase Type III
  • AMP-Activated Protein Kinases
Topics
  • AMP-Activated Protein Kinases (metabolism)
  • Animals
  • Cardiovascular Diseases (metabolism, physiopathology)
  • Humans
  • Metabolic Syndrome (metabolism, physiopathology)
  • Mitochondria (metabolism, physiology)
  • Myocardium (ultrastructure)
  • Nitric Oxide Synthase Type III (metabolism)
  • Oxidative Phosphorylation
  • Oxidative Stress
  • Risk Factors

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