The risk of heart failure and cardiometabolic complications in obesity may be masked by an apparent healthy status of normal blood glucose

Oxid Med Cell Longev. 2013:2013:253657. doi: 10.1155/2013/253657. Epub 2013 Dec 14.

Abstract

Although many obese individuals are normoglycemic and asymptomatic of cardiometabolic complications, this apparent healthy state may be a misnomer. Since heart failure is a major cause of mortality in obesity, we investigated the effects of heme-oxygenase (HO) on heart failure and cardiometabolic complications in obese normoglycemic Zucker-fatty rats (ZFs). Treatment with the HO-inducer, hemin, reduced markers of heart failure, such as osteopontin and osteoprotegerin, abated left-ventricular (LV) hypertrophy/fibrosis, extracellular matrix/profibrotic proteins including collagen IV, fibronectin, TGF-β1, and reduced cardiac lesions. Furthermore, hemin suppressed inflammation by abating macrophage chemoattractant protein-1, macrophage-inflammatory protein-1 alpha, TNF-α, IL-6, and IL-1β but enhanced adiponectin, atrial-natriuretic peptide (ANP), HO activity, insulin sensitivity, and glucose metabolism. Correspondingly, hemin improved several hemodynamic/echocardiographic parameters including LV-diastolic wall thickness, LV-systolic wall thickness, mean-arterial pressure, arterial-systolic pressure, arterial-diastolic pressure, LV-developed pressure, +dP/dt, and cardiac output. Contrarily, the HO-inhibitor, stannous mesoporphyrin nullified the hemin effect, exacerbating inflammatory/oxidative insults and aggravated insulin resistance (HOMA-index). We conclude that perturbations in insulin signaling and cardiac function may be forerunners to overt hyperglycemia and heart failure in obesity. Importantly, hemin improves cardiac function by suppressing markers of heart failure, LV hypertrophy, cardiac lesions, extracellular matrix/profibrotic proteins, and inflammatory/oxidative mediators, while concomitantly enhancing the HO-adiponectin-ANP axis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiponectin / metabolism
  • Animals
  • Atrial Natriuretic Factor / metabolism
  • Blood Glucose / metabolism*
  • Chemokine CCL2 / metabolism
  • Dinoprost / analogs & derivatives
  • Dinoprost / metabolism
  • Endothelin-1 / metabolism
  • Heart Failure / complications*
  • Heart Failure / diagnostic imaging
  • Heart Failure / enzymology
  • Heart Failure / physiopathology
  • Heart Function Tests
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / drug effects
  • Heart Ventricles / pathology
  • Heart Ventricles / physiopathology
  • Heme Oxygenase (Decyclizing) / metabolism
  • Hemin / pharmacology
  • Hemodynamics / drug effects
  • Inflammation / pathology
  • Insulin / metabolism
  • Insulin Resistance
  • Macrophage Inflammatory Proteins / metabolism
  • Macrophages / drug effects
  • Macrophages / metabolism
  • Macrophages / pathology
  • Metalloporphyrins / pharmacology
  • Myocytes, Cardiac / drug effects
  • Myocytes, Cardiac / metabolism
  • Myocytes, Cardiac / pathology
  • Obesity / complications*
  • Obesity / metabolism*
  • Obesity / physiopathology
  • Rats
  • Rats, Zucker
  • Risk Factors
  • Tumor Necrosis Factor-alpha / metabolism
  • Ultrasonography
  • Up-Regulation / drug effects

Substances

  • Adiponectin
  • Blood Glucose
  • Ccl2 protein, rat
  • Chemokine CCL2
  • Endothelin-1
  • Insulin
  • Macrophage Inflammatory Proteins
  • Metalloporphyrins
  • Tumor Necrosis Factor-alpha
  • tin mesoporphyrin
  • 8-epi-prostaglandin F2alpha
  • Hemin
  • Atrial Natriuretic Factor
  • Dinoprost
  • Heme Oxygenase (Decyclizing)