The Role of Oxidative Stress Enhanced by Adiposity in Cardiometabolic Diseases

Abstract

Cardiometabolic diseases (CMDs), including cardiovascular disease (CVD), metabolic syndrome (MetS), and type 2 diabetes (T2D), are associated with increased morbidity and mortality. The growing prevalence of CVD is mostly attributed to the aging population and common occurrence of risk factors, such as high systolic blood pressure, elevated plasma glucose, and increased body mass index, which led to a global epidemic of obesity, MetS, and T2D. Oxidant-antioxidant balance disorders largely contribute to the pathogenesis and outcomes of CMDs, such as systemic essential hypertension, coronary artery disease, stroke, and MetS. Enhanced and disturbed generation of reactive oxygen species in excess adipose tissue during obesity may lead to increased oxidative stress. Understanding the interplay between adiposity, oxidative stress, and cardiometabolic risks can have translational impacts, leading to the identification of novel effective strategies for reducing the CMDs burden. The present review article is based on extant results from basic and clinical studies and specifically addresses the various aspects associated with oxidant-antioxidant balance disorders in the course of CMDs in subjects with excess adipose tissue accumulation. We aim at giving a comprehensive overview of existing knowledge, knowledge gaps, and future perspectives for further basic and clinical research. We provide insights into both the mechanisms and clinical implications of effects related to the interplay between adiposity and oxidative stress for treating and preventing CMDs. Future basic research and clinical trials are needed to further examine the mechanisms of adiposity-enhanced oxidative stress in CMDs and the efficacy of antioxidant therapies for reducing risk and improving outcome of patients with CMDs.

Keywords: cardiometabolic diseases; cardiovascular disease; coronary artery disease; metabolic syndrome; obesity; oxidative stress; type 2 diabetes.

Figure 1

Adipose tissue as a source of reactive oxygen species (ROS). The main sources are mitochondria and reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX). (ERO-1) endoplasmic reticular oxidoreductin 1, (COX) cyclooxygenase, (LOX) lipoxygenase, (WBC) white blood cells, (XDH) xanthine dehydrogenase, (XOR) xanthine oxidoreductase, (XO) xanthine oxidase, and (NOS) nitric oxide synthase.

Figure 2

Demonstrated and potential associations between adiposity, redox homeostasis disorders, and cardiometabolic diseases.