Regulation of adipose tissue function and metabolism: role of mineralocorticoid receptor

Mineralocorticoid receptor has been recently identified in several extra-renal tissues, including adipose tissue, where its hyperactivation contributes to some metabolic derangements frequently observed in obesity and metabolic syndrome, such as adipocyte hypertrophy, increased macrophage infiltration, oxidative stress, insulin resistance and impaired browning of white adipose tissue. Moreover, recent evidence supports the existence of a detrimental crosstalk between adipose tissue and adrenal glands contributing to high aldosterone levels often observed in obesity. Importantly, several studies have demonstrated prevention of weight gain and significant metabolic benefits after the use of mineralocorticoid receptor antagonists in animal models of genetic or diet-induced obesity. Despite these encouraging data, there are still few studies showing significant beneficial metabolic effects derived from the use of mineralocorticoid receptor antagonists in clinical settings. Therefore, planning well-structured clinical trials will be necessary to better elucidate the role and effectiveness of these drugs in obesity and metabolic syndrome in humans.