Evidence map›Paper›PMID 41668130›Full record

ReviewCardiovascular diabetology2026

Causal demonstration of adiposity-induced adipose-specific signaling derangements in the pathogenesis of the clinical features of the cardiovascular-kidney metabolic syndrome.

Milton Packer

Abstract readReview
In one paragraph

Review in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author.

Milton PackerBaylor Heart and Vascular Institute, Baylor University Medical Center, 621 North Hall Street, Dallas, TX, USA. milton.packer@baylorhealth.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The American Heart Association has recognized that excess dysfunctional fat and its secretion of adipokines are upstream causal mechanisms that drive the clinical and pathophysiological features of the cardiovascular-kidney-metabolic (CKM) syndrome. The identity of these signaling molecules can be discerned by experimental adipose tissue-specific silencing studies showing that biological events induced by adiposity and occurring selectively in adipose tissue can promote each element of the CKM syndrome. Suppression of the renin-angiotensin system specifically and selectively only in adipose tissue alleviates hypertension and atherosclerosis, whereas overexpression of the mineralocorticoid receptor specifically and only in adipocytes promotes vascular injury. Silencing of autotaxin, platelet-derived growth factor D, resistin and microRNA-410-5P selectively and specifically only in adipose tissue ameliorates the development of cardiac hypertrophy and fibrosis, thus preventing experimental HFpEF. The suppression of cytoprotective adipokines (e.g., adiponectin) simultaneous with the activation of proinflammatory adipokines (e.g., leptin) promotes renal tubular sodium reabsorption and plasma volume expansion. Experimental aldosterone-induced kidney injury is accompanied by augmented expression of lipocalin-2 in visceral adipose tissue, and selective and specific deletion of lipocalin-2 only in adipose tissue—but not in the kidney—counteracts renal inflammation and fibrosis. Silencing of fatty acid binding protein 4 and 12/15-lipoxygenase selectively and specifically in adipose tissue prevents the development of insulin resistance. These observations support the conceptual framework that the accumulation of dysfunctional fat can promote each of the pathophysiological features of the CKM syndrome by altering the expression and/or secretion of signaling molecules in an adipose tissue-specific and -selective manner.

Indexed as

AdipokinesAdipose TissueAdiposityCardio-Renal SyndromeKidneyMetabolic SyndromeObesityAnimalsHumansRenin-Angiotensin SystemSignal TransductionAdipokinesAdipokinesCardiovascular-kidney-metabolicHeart failure

Identifiers

PMID41668130
PMCPMC12990487

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.