The impact of mineralocorticoid receptor antagonists on fat mass and fat metabolism

INTRODUCTION: Obesity is a chronic, multifactorial condition which is a global health challenge. In general, obesity is defined by excessive fat accumulation and associated with the risk of numerous conditions, including type 2 diabetes mellitus (T2DM), cardiovascular disease, heart failure, and metabolic dysfunction-associated steatotic liver disease, and some types of cancer contributing to increased morbidity and mortality. Mineralocorticoid receptor antagonists (MRAs) are used for a long time for management of cardiovascular disease and non-steroidal MRAs also showed kidney protection. Apart from these, there is growing literature showing that MRAs effecting fat mass and fat metabolism. In this review, we summarised the effects of MRAs on fat mass and fat metabolism. RESULTS: In general, studies showed that MRAs reduced fat mass in various organs which is associated decreased oxidative stress, inflammation, and insulin resistance. Importantly, MRAs increased adipose tissue browning and decrease white adipose tissue mass. Up to now, the studies showed no safety signals and these favorable effects are independent of blood pressure reduction. Discussion A part from hemodynamic effects, MRAs have beneficial impacts on fat mass and fat metabolism. Currently, the underlying mechanisms for these effects are not clear Conclusions: Preliminary studies have shown that MRAs have favorable impact on fat metabolism and fat mass. Studies needed to highlight underlying mechanisms..