Endothelial Dysfunction and Metabolic Syndrome

Abstract

Atherosclerotic cardiovascular disease (ASCVD) continues to be the leading cause of death worldwide. Metabolic syndrome is associated with an increased risk of ASCVD. With the prevalence of metabolic syndrome continuing to increase, it is important to understand the relationship between these risk factors and development of ASCVD. Endothelial dysfunction (ED), an early, essential step in atherosclerotic plaque formation, is the key link. Here we review diagnostic methods of ED and the mechanisms of each metabolic syndrome component contributing to ED. Finally, the effects of current treatments of metabolic syndrome on ED will also be discussed.

Ameliorative effects of ark clams (Scapharca subcrenata and Tegillarca granosa) on endothelial dysfunction induced by a high-fat diet

“…Endothelium normalizes vascular tone by balancing vasodilators and vasoconstrictors [1]. Failure of endothelial function is associated with a variety of metabolic syndrome including cardiovascular diseases [2], insulin resistance [3], and hypertension [4]. Nitric oxide (NO), the key regulator of the vasodilatory process, is generated from L-arginine through the catalyzation of endothelial NO synthase [2].…”

The modern view on the role of glyprolines by metabolic syndrome

“…25 Endothelial dysfunction is also the main sign of MS development. 29 In addition, adipokines are now considered to have a direct modulating effect on vascular and circulating cells. 32 Elevated platelet levels and their activating ability are well known as determining parameters for the physiological and pharmacological prediction of thrombotic events.…”

“…28 Endothelium-dependent vasodilation is impaired in MS, which is mainly mediated by reduced expression of vasodilators (i.e., nitric oxide and prostacyclin) with concomitant increases in vasoconstrictors (i.e., endothelin-1, angiotensin II, and thromboxane A2). 29 Crossinteraction between the activated endothelium and platelets leads to a prothrombotic vicious cycle. Increased coagulation along with impaired fibrinolysis is also present in MS.…”

“…Many metabolic changes that are closely related to the development of MS have an impact on blood clotting and vascular‐endothelial function, increasing the risk of both atherothrombotic cardiovascular events and venous thromboembolism 25 . The pathogenesis of atherothrombosis in MS is multifactorial, requiring a close relationship between the main components of MS, including not only insulin resistance, changes in the glycemic and lipid pattern, but also a violation of hemodynamics and the early appearance of endothelial dysfunction 28,29 . Hemostatic changes (i.e., coagulation balance, fibrinolysis, and platelet function), aimed at thrombogenicity of circulating blood, play an important role both in the progression of arterial wall damage and in acute vascular disorders.…”

“…Among hemostatic disorders, there is a significant increase in plasma levels of the type 1 plasminogen activator inhibitor (PAI‐1), which is a known anomaly associated with oxidative stress and an inflammatory condition 25 . Endothelial dysfunction is also the main sign of MS development 29 . In addition, adipokines are now considered to have a direct modulating effect on vascular and circulating cells 32 …”