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      Increased Muscle Mass Protects Against Hypertension and Renal Injury in Obesity

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          Abstract

          Background

          Obesity compromises cardiometabolic function and is associated with hypertension and chronic kidney disease. Exercise ameliorates these conditions, even without weight loss. Although the mechanisms of exercise's benefits remain unclear, augmented lean body mass is a suspected mechanism. Myostatin is a potent negative regulator of skeletal muscle mass that is upregulated in obesity and downregulated with exercise. The current study tested the hypothesis that deletion of myostatin would increase muscle mass and reduce blood pressure and kidney injury in obesity.

          Methods and Results

          Myostatin knockout mice were crossed to db/db mice, and metabolic and cardiovascular functions were examined. Deletion of myostatin increased skeletal muscle mass by ≈50% to 60% without concomitant weight loss or reduction in fat mass. Increased blood pressure in obesity was prevented by the deletion of myostatin, but did not confer additional benefit against salt loading. Kidney injury was evident because of increased albuminuria, which was abolished in obese mice lacking myostatin. Glycosuria, total urine volume, and whole kidney NOX‐4 levels were increased in obesity and prevented by myostatin deletion, arguing that increased muscle mass provides a multipronged defense against renal dysfunction in obese mice.

          Conclusions

          These experimental observations suggest that loss of muscle mass is a novel risk factor in obesity‐derived cardiovascular dysfunction. Interventions that increase muscle mass, either through exercise or pharmacologically, may help limit cardiovascular disease in obese individuals.

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          Most cited references40

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          A PGC-1α isoform induced by resistance training regulates skeletal muscle hypertrophy.

          PGC-1α is a transcriptional coactivator induced by exercise that gives muscle many of the best known adaptations to endurance-type exercise but has no effects on muscle strength or hypertrophy. We have identified a form of PGC-1α (PGC-1α4) that results from alternative promoter usage and splicing of the primary transcript. PGC-1α4 is highly expressed in exercised muscle but does not regulate most known PGC-1α targets such as the mitochondrial OXPHOS genes. Rather, it specifically induces IGF1 and represses myostatin, and expression of PGC-1α4 in vitro and in vivo induces robust skeletal muscle hypertrophy. Importantly, mice with skeletal muscle-specific transgenic expression of PGC-1α4 show increased muscle mass and strength and dramatic resistance to the muscle wasting of cancer cachexia. Expression of PGC-1α4 is preferentially induced in mouse and human muscle during resistance exercise. These studies identify a PGC-1α protein that regulates and coordinates factors involved in skeletal muscle hypertrophy. Copyright © 2012 Elsevier Inc. All rights reserved.
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            Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. National Diabetes Data Group.

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              Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Synopsis of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline

              In November 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) released a clinical practice guideline for the prevention, detection, evaluation, and treatment of high blood pressure (BP) in adults. This article summarizes the major recommendations.
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                Author and article information

                Contributors
                dstepp@augusta.edu
                Journal
                J Am Heart Assoc
                J Am Heart Assoc
                10.1002/(ISSN)2047-9980
                JAH3
                ahaoa
                Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
                John Wiley and Sons Inc. (Hoboken )
                2047-9980
                14 August 2018
                21 August 2018
                : 7
                : 16 ( doiID: 10.1002/jah3.2018.7.issue-16 )
                : e009358
                Affiliations
                [ 1 ] Vascular Biology Center Medical College of Georgia at Augusta University Augusta GA
                [ 2 ] Department of Pharmacology Medical College of Georgia at Augusta University Augusta GA
                [ 3 ] Department of Physiology Medical College of Georgia at Augusta University Augusta GA
                Author notes
                [*] [* ] Correspondence to: David W. Stepp, PhD, Vascular Biology Center, 1459 Laney Walker Blvd, Augusta, GA 30912. E‐mail: dstepp@ 123456augusta.edu
                Article
                JAH33398
                10.1161/JAHA.118.009358
                6201396
                30369309
                3466b87e-db92-4ba4-89c5-e7e5b3e87851
                © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 05 May 2018
                : 20 June 2018
                Page count
                Figures: 5, Tables: 4, Pages: 12, Words: 7908
                Funding
                Funded by: National Institutes of Health
                Award ID: R01 HL124773
                Funded by: American Heart Association Postdoctoral Fellowship
                Award ID: 17POST33410322
                Categories
                Original Research
                Original Research
                Hypertension
                Custom metadata
                2.0
                jah33398
                21 August 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.4 mode:remove_FC converted:21.08.2018

                Cardiovascular Medicine
                hyperglycemia,hypertension,myostatin,nicotinamide‐adenine dinucleotide phosphate, reduced form, oxidase 4,skeletal muscle,high blood pressure,obesity,exercise

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