Adipocytes, aldosterone and obesity-related hypertension

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   Figure 1

   Synthesis of aldosterone and regulators. (A) Synthesis of the mineralocorticoid hormone aldosterone and cortisol from cholesterol. Aldosterone is synthesized in the zona glomerulosa of the adrenal cortex by a series of enzyme steps leading to the conversion of cholesterol to aldosterone. There are two critical enzyme steps: (1) the conversion of cholesterol to pregnenolone cholesterol side-chain cleavage enzyme (CYP11A1) and (2) the conversion of corticosterone to aldosterone by the aldosterone synthase (CYP11B2). However, cortisol is synthesized in the zona fasciculata of the adrenal glands. CYP11A1, cholesterol side-chain cleavage enzyme (P450c11); 3β-HSD, 3β-hydroxysteroid dehydrogenase; CYP1121A, 21-hydroxylase (P450c21); CYP11B1, 11β-hydroxylase; CYP11B2, aldosterone synthase. (B) Main regulators of aldosterone synthesis by the adrenals. A variety of factors modify the aldosterone secretion: the most important are the angiotensin II (AngII) and high concentrations of potassium (K+).
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   Figure 2

   Novel regulators of aldosterone production in adrenals. New regulators of the secretion of aldosterone by the adrenal glands have been identified such as leptin, adiponectin and complement-C1q TNF-related protein-1 (CTRP1).
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   Figure 3

   Regulation of aldosterone production in adipocytes. (A) Angiotensin II via its receptor type 1 (AT₁R) regulates the aldosterone synthase (CYP11B2) expression and the adipocyte-secreted aldosterone in a calcineurin/nuclear factor of activated T (NFAT)-dependent manner. (B) Cholesteryl ester-transfer protein (CETP) inhibitors regulates the aldosterone synthase (CYP11B2) expression through increase in ROS generation and activation of peroxisome proliferation-activated receptor-gamma (PPAR-G) and signal transducer and activator of transcription 3 (STAT3). AGT, angiotensinogen; Ang, angiotensin; ROS, reactive oxygen species; STAR, steroidogenic acute regulatory protein.
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   Figure 4

   Summary of the pathophysiological roles of adipose aldosterone/MR activation in obesity-related hypertension.

• © 2016 Society for Endocrinology