Oxidative aspects of metabolic syndrome and atherosclerosis

  • Sandra Maria Barbalho Faculdade de Medicina de Marília - UNIMAR e FATEC - Marília
  • Karina Quesada Departamento de Bioquímica e Biologia Celular da Universidade de Marília - UNIMAR, Marília, SP, Brasil.
  • Ricardo de Alvares Goulart Médico da Associação Beneficente Hospital Universitário (ABHU). E-mail: [email protected]
  • Marcelo Dib Bechara Departamento de Bioquímica e Biologia Celular da Universidade de Marília - UNIMAR, Marília, SP, Brasil. E-mail: [email protected]
  • Márcia Rocha Gabaldi Departamento de Bioquímica e Biologia Celular da Universidade de Marília - UNIMAR, Marília, SP, Brasil. E-mail: [email protected]
  • Gabriela L. dos Santos Almeida Graduanda em Medicina pela Faculdade de Medicina da Universidade de Mogi das Cruzes AB de Cândido Xavier de Almeida e Souza. E-mail: [email protected]
  • Rodrigo Galhardi Gasparini Médico da Associação Beneficente Hospital Universitário (ABHU). Mestrando em Bases Gerais da Cirurgia pela UNESP - Universidade Estadual Paulista “Julio de Mesquita Filho”, campus Botucatu-SP, Brasil. E-mail: [email protected]
Keywords: metabolic syndrome x, oxidative stress, atherosclerosis.


Aims: To review the literature on the current aspects of oxidative stress and its role in metabolic syndrome and in atherosclerosis.

Methods: The study was performed in April and May 2015 and the following databases were used: PubMed, SciELO, and LILACS, including articles published from 2011 onwards. The following keywords were used: oxidative stress and atherosclerosis or oxidative stress and metabolic syndrome. Meta-analyses and clinical trials with a large sample size were preferred.

Results: A total of 3,934 articles were available in the databases (PubMed 3,292; SciELO 588; and LILACS 54). Fifty-three articles were included in the review after eliminating double references and using the inclusion criteria.

Conclusions: Biochemical and anthropometric findings characteristic of the metabolic syndrome are related to inflammatory processes and to oxidative stress which, in turn, are closely related to atherosclerosis. A better understanding of how the conditions that underlie metabolic syndrome predispose to oxidative stress may significantly contribute to the treatment of patients with cardiovascular disease in the future.


Download data is not yet available.


Jew S, AbuMweis SS, Jones PJ. Evolution of the human diet: linking our ancestral diet to modern functional foods as a means of chronic disease prevention. J Med Food. 2009 Oct;12(5):925-34. http://dx.doi.org/10.1089/jmf.2008.0268

Rigby N. Eating and obesity--the new world disorder. Nutrients. 2013 Oct 21;5(10):4206-10. doi: 10.3390/nu5104206. http://dx.doi.org/10.3390/nu5104206

Bonomini F, Rodella LF, Rezzani R. Metabolic syndrome, aging and involvement of oxidative stress. Aging Dis. 2015 Mar 10;6(2):109-20. http://dx.doi.org/10.14336/AD.2014.0305

McGill AT. Causes of metabolic syndrome and obesity-related co-morbidities Part 1: A composite unifying theory review of human-specific co-adaptations to brain energy consumption. Arch Public Health. 2014 Sep 1;72(1):30. http://dx.doi.org/10.1186/2049-3258-72-30

Kawada T, Otsuka T, Inagaki H, Wakayama Y, Katsumata M. Biological markers, lifestyles and metabolic syndrome in workers. Diabetes Metab Syndr. 2015 Apr-Jun;9(2):71-3 http://dx.doi.org/10.1016/j.dsx.2015.02.009

Kaya E, Sikka SC, Gur S. A Comprehensive Review of Metabolic Syndrome Affecting Erectile Dysfunction. J Sex Med. 2015 Apr;12(4):856-75. http://dx.doi.org/10.1111/jsm.12828

Won KB, Chang HJ, Niinuma H, Niwa K, Jeon K, Cho IJ, Shim CY, Hong GR, Chung N. Inverse association between central obesity and arterial stiffness in Korean subjects with metabolic syndrome: a cross-sectional cohort study. Diabetol Metab Syndr. 2015 Jan 27;7:3. http://dx.doi.org/10.1186/1758-5996-7-3

Bhatt H, Safford M, Glasser S. Coronary Heart Disease Risk Factors and Outcomes in the Twenty-First Century: Findings from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Curr Hypertens Rep. 2015 Apr;17(4):541. http://dx.doi.org/10.1007/s11906-015-0541-5

Coffman E, Richmond-Bryant J. Multiple biomarker models for improved risk estimation of specific cardiovascular diseases related to metabolic syndrome: a cross-sectional study. Popul Health Metr. 2015 Mar 14;13:7. http://dx.doi.org/10.1186/s12963-015-0041-5

Sociedade Brasileira de Hipertensão, Sociedade Brasileira de Cardiologia. I Diretriz brasileira de diagnóstico e tratamento da síndrome metabólica. Arq Bras Cardiol. 2005; 84(Supl 1):1-28.

Johnson KM, Dowe DA. Accuracy of statin assignment using the 2013 AHA/ACC Cholesterol Guideline versus the 2001NCEP ATP III guideline: correlation with atherosclerotic plaque imaging. J Am Coll Cardiol. 2014 Sep 2;64(9):910-9. http://dx.doi.org/10.1016/j.jacc.2014.05.056

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F; American Heart Association; National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005 Oct 25;112(17):2735-52. http://dx.doi.org/10.1161/CIRCULATIONAHA.105.169404

Martocchia A, Stefanelli M, Falaschi GM, Toussan L, Ferri C, Falaschi P. Recent advances in the role of cortisol and metabolic syndrome in age-related degenerative diseases. Aging Clin Exp Res. 2015 Mar 27. http://dx.doi.org/10.1007/s40520-015-0353-0

Abella V, Scotece M, Conde J, López V, Lazzaro V, Pino J, Gómez-Reino JJ, Gualillo O. Adipokines, metabolic syndrome and rheumatic diseases. J Immunol Res. 2014;2014:343746. http://dx.doi.org/10.1155/2014/343746

Beckman KB, Ames BN. The free radical theory of aging matures. Physiol Rev. 1998 Apr;78(2):547-81.

Jung T, Catalgol B, Grune T. The proteasomal system. Mol Aspects Med. 2009 Aug;30(4):191-296. http://dx.doi.org/10.1016/j.mam.2009.04.001

Stocker R, Keaney JF Jr. Role of oxidative modifications in atherosclerosis. Physiol Rev. 2004 Oct;84(4):1381-478. http://dx.doi.org/10.1152/physrev.00047.2003

Paradies G, Petrosillo G, Paradies V, Ruggiero FM. Oxidative stress, mitochondrial bioenergetics, and cardiolipin in aging. Free Radic Biol Med. 2010 May 15;48(10):1286-95. http://dx.doi.org/10.1016/j.freeradbiomed.2010.02.020

Sies H. Oxidative stress: A concept in redox biology and medicine Redox Biol. 2015;4:180-3. http://dx.doi.org/10.1016/j.redox.2015.01.002

Nowotny K, Jung T, Höhn A, Weber D, Grune T. Advanced Glycation End Products and Oxidative Stress in Type 2 Diabetes Mellitus. Biomolecules. 2015 Mar 16;5(1):194-222. http://dx.doi.org/10.3390/biom5010194

Furukawa S, Fujita T, Shimabukuro M, Iwaki M, Yamada Y, Nakajima Y, Nakayama O, Makishima M, Matsuda M, Shimomura I. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest. 2004 Dec;114(12):1752-61. http://dx.doi.org/10.1172/JCI21625

Vella RK, Pullen C, Coulson FR, Fenning AS. Resveratrol Prevents Cardiovascular Complications in the SHR/STZ Rat by Reductions in Oxidative Stress and Inflammation. Biomed Res Int. 2015;2015:918123. http://dx.doi.org/10.1155/2015/918123

Henriksen EJ, Diamond-Stanic MK, Marchionne EM. Oxidative stress and the etiology of insulin resistance and type 2 diabetes. Free Radic Biol Med. 2011 Sep 1;51(5):993-9. http://dx.doi.org/10.1016/j.freeradbiomed.2010.12.005

Libermann TA; Baltimore D. Activation of interleukin-6 gene expression through the NF-B transcription factor. Mol Cell Biol. 1990 May;10(5):2327-34. http://dx.doi.org/10.1128/MCB.10.5.2327

Li D, Zhang Y, Liu Y, Sun R, Xia M. Purified anthocyanin supplementation reduces dyslipidemia, enhances antioxidant capacity, and prevents insulin resistance in diabetic patients. J Nutr. 2015 Apr;145(4):742-8. http://dx.doi.org/10.3945/jn.114.205674

Roberts CK, Sindhu KK. Oxidative stress and metabolic syndrome. Life Sci. 2009 May 22;84(21-22):705-12. http://dx.doi.org/10.1016/j.lfs.2009.02.026

Schaffer SW, Jong CJ, Mozaffari M. Role of oxidative stress in diabetes-mediated vascular dysfunction: Unifying hypothesis of diabetes revisited. Vascul Pharmacol. 2012 Nov-Dec;57(5-6):139-49. http://dx.doi.org/10.1016/j.vph.2012.03.005

Gelaleti RB, Damasceno DC, Lima PH, Salvadori DM, Calderon Ide M, Peraçoli JC, Rudge MV. Oxidative DNA damage in diabetic and mild gestational hyperglycemic pregnant women. Diabetol Metab Syndr. 2015 Jan 15;7:1. http://dx.doi.org/10.1186/1758-5996-7-1

Oliveira J, Hort MA, Moreira EL, Glaser V, Ribeiro-do-Valle RM, Prediger RD, Farina M, Latini A, de Bem AF. Positive correlation between elevated plasma cholesterol level sand cognitive impairments in LDL receptor knockout mice: relevance of cortico-cerebral mitochondrial dysfunction and oxidative stress. Neuroscience. 2011;197:99-106. http://dx.doi.org/10.1016/j.neuroscience.2011.09.009

Zelzer S, Fuchs N, Almer G, Raggam RB, Prüller F, Truschnig-Wilders M, Schnedl W, Horejsi R, Möller R, Weghuber D, Ille R, Mangge H. High density lipoprotein cholesterol level is a robust predictor of lipid peroxidation irrespective of gender, age, obesity, and inflammatory or metabolic biomarkers. Clin Chim Acta. 2011 Jul 15;412(15-16):1345-9. http://dx.doi.org/10.1016/j.cca.2011.03.031

Marques de Mattos A, Marino LV, Ovidio PP, Jordão AA, Almeida CC, Chiarello PG. Protein, oxidative stress and dyslipidemia in dialysis patients. Ther Apher Dial. 2012 Feb;16(1):68-74. http://dx.doi.org/10.1111/j.1744-9987.2011.01009.x

Li D, Zhang Y, Liu Y, Sun R, Xia M. Purified anthocyanin supplementation reduces dyslipidemia, enhances antioxidant capacity, and prevents insulin resistance in diabetic patients. J Nutr. 2015 Apr;145(4):742-8. http://dx.doi.org/10.3945/jn.114.205674

Zhang J, Zhang Y, Liu H, Bai H, Wang Y, Jiang C, Fan P. Antioxidant properties of high-density lipoproteins are impaired in women with polycystic ovary syndrome. Fertil Steril. 2015 May;103(5):1346-54. http://dx.doi.org/10.1016/j.fertnstert.2015.02.024

Tangvarasittichai S. Oxidative stress, insulin resistance, dyslipidemia and type 2 diabetes mellitus. World J Diabetes. 2015 Apr 15;6(3):456-80. http://dx.doi.org/10.4239/wjd.v6.i3.456

Hutcheson R, Rocic P. The metabolic syndrome, oxidative stress, environment, and cardiovascular disease: the great exploration. Exp Diabetes Res. 2012;2012:271028. http://dx.doi.org/10.1155/2012/271028

Schmidt FM, Weschenfelder J, Sander C, Minkwitz J, Thormann J, Chittka T, Mergl R, Kirkby KC, Faßhauer M, Stumvoll M, Holdt LM, Teupser D, Hegerl U, Himmerich H. Inflammatory cytokines in general and central obesity and modulating effects of physical activity. PLoS One. 2015 Mar 17;10(3):e0121971. http://dx.doi.org/10.1371/journal.pone.0121971

Habich C, Sell H. Heat shock proteins in obesity: links to cardiovascular disease. Horm Mol Biol Clin Investig. 2015 Feb;21(2):117-24. http://dx.doi.org/10.1515/hmbci-2014-0040

Ringseis R, Eder K, Mooren FC, Krüger K. Metabolic signals and innate immune activation in obesity and exercise. Exerc Immunol Rev. 2015;21:58-68.

Wu B, Fukuo K, Suzuki K, Yoshino G, Kazumi T. Relationships of systemic oxidative stress to body fat distribution, adipokines and inflammatory markers in healthy middle-aged women Endocr J. 2009;56(6):773-82. http://dx.doi.org/10.1507/endocrj.K08E-332

Vincent HK, Bourguignon CM, Taylor AG. Relationship of the dietary phytochemical index to weight gain, oxidative stress and inflammation in overweight young adults. J Hum Nutr Diet. 2010 Feb;23(1):20-9. http://dx.doi.org/10.1111/j.1365-277X.2009.00987.x

Karaman S, Hollmén M, Robciuc MR, Alitalo A, Nurmi H, Morf B, Buschle D, Alkan HF, Ochsenbein AM, Alitalo K, Wolfrum C, Detmar M. Blockade of VEGF-C and VEGF-D modulates adipose tissue inflammation and improves metabolic parameters under high-fat diet. Mol Metab. 2014 Dec 4;4(2):93-105. http://dx.doi.org/10.1016/j.molmet.2014.11.006

Guimarães Filho GC, Sousa AL, Jardim TS, Souza WS, Jardim PC. Progression of Blood Pressure and Cardiovascular Outcomes in Hypertensive Patients in a Reference Center. Arq Bras Cardiol. 2015 Apr;104(4):292-8. http://dx.doi.org/10.5935/abc.20150001

Touyz RM. Reactive oxygen species, vascular oxidative stress, and redox signaling in hypertension: what is the clinical significance? Hypertension. 2004 Sep;44(3):248-52. http://dx.doi.org/10.1161/01.HYP.0000138070.47616.9d

Kizhakekuttu TJ, Widlansky ME. Natural antioxidants and hypertension: promise and challenges. Cardiovasc Ther. 2010 Aug;28(4):e20-32. http://dx.doi.org/10.1111/j.1755-5922.2010.00137.x

Li Y, Anand-Srivastava MB. Regulation of Giα protein expression by vasoactive peptides in hypertension: molecular mechanisms. Indian J Biochem Biophys. 2014 Dec;51(6):467-75.

Mozafari M, Nekooeian AA, Panjeshahin MR, Zare HR. The effects of resveratrol in rats with simultaneous type 2 diabetes and renal hypertension: a study of antihypertensive mechanisms. Iran J Med Sci. 2015 Mar;40(2):152-60.

Testai L, D'Antongiovanni V, Piano I, Martelli A, Citi V, Duranti E, Virdis A, Blandizzi C, Gargini C, Breschi MC, Calderone V. Different patterns of H2S/NO activity and cross-talk in the control of the coronary vascular bed under normotensive or hypertensive conditions. Nitric Oxide. 2015 May 1;47:25-33. http://dx.doi.org/10.1016/j.niox.2015.03.003

Mansego ML1, Solar Gde M, Alonso MP, Martínez F, Sáez GT, Escudero JC, Redón J, Chaves FJ. Polymorphisms of antioxidant enzymes, blood pressure and risk of hypertension. J Hypertens. 2011 Mar;29(3):492-500. http://dx.doi.org/10.1097/HJH.0b013e328341f1b2

Nishihara M, Hirooka Y, Matsukawa R, Kishi T, Sunagawa K. Oxidative stress in the rostral ventrolateral medulla modulates excitatory and inhibitory inputs in spontaneously hypertensive rats. J Hypertens. 2012 Jan;30(1):97-106. http://dx.doi.org/10.1097/HJH.0b013e32834e1df4

Cloonan L, Fitzpatrick KM, Kanakis AS, Furie KL, Rosand J, Rost NS. Metabolic determinants of white matter hyperintensity burden in patients with ischemic stroke. Atherosclerosis. 2015 May;240(1):149-53. doi: 10.1016/j.atherosclerosis.2015.02.052. http://dx.doi.org/10.1016/j.atherosclerosis.2015.02.052

Gargiulo S, Gamba P, Testa G, Rossin D, Biasi F, Poli G, Leonarduzzi G. Relation between TLR4/NF-κB signaling pathway activation by 27-hydroxycholesterol and 4-hydroxynonenal, and atherosclerotic plaque instability. Aging Cell. 2015 Aug;14(4):569-81. http://dx.doi.org/10.1111/acel.12322

Sinha N, Dabla PK Oxidative stress and antioxidants in hypertension-a current review. Curr Hypertens Rev. 2015;11(2):132-42. http://dx.doi.org/10.2174/1573402111666150529130922

Kamigaki M, Sakaue S, Tsujino I, Ohira H, Ikeda D, Itoh N, Ishimaru S, Ohtsuka Y, Nishimura M. Oxidative stress provokes atherogenic changes in adipokine gene expression in 3T3-L1 adipocytes. Biochem Biophys Res Commun. 2006 Jan 13;339(2):624-32. http://dx.doi.org/10.1016/j.bbrc.2005.11.059

How to Cite
Barbalho, S. M., Quesada, K., Goulart, R. de A., Bechara, M. D., Gabaldi, M. R., Almeida, G. L. dos S., & Gasparini, R. G. (2015). Oxidative aspects of metabolic syndrome and atherosclerosis. Scientia Medica, 25(3), ID21092. https://doi.org/10.15448/1980-6108.2015.3.21092
Review Articles