363
ment of lipid and carbohydrate metabolism and insulin sensitivity are the common
side effects of most β-blockers especially of the first generation. However, the
nebivolol and carvedilol; the third generation vasodilating β-blockers have shown
better metabolic profiles and are predominantly preferred for patients of hypertension with metabolic syndrome [28–30]. The side effects of β-blockers appear due to
disturbance in insulin secretion and impaired activities of lipid metabolizing
enzymes.
Some of the β-blockers cause abdominal fat deposition due to abnormal lipid and
carbohydrate metabolism. The adrenergic stimulation cause β-blockade which lead
to inhibition of lipolysis resultantly a condition of fatigue appears in patients under
β-blocker therapy. The β-receptor antagonist treatments reduce the metabolic rate
and energy consumption, thus cause weight gain [31].
Diuretics as Antihypertensive Agents
The diuretics promote diuresis by inhibiting the reabsorption of Na in renal tubular
system, thus cause an increased water excretion. The loop diuretics inhibit the reabsorption of about 25% Na by inhibiting the Na-K-Cl cotransporter proteins and
increase the urination. Such diuretics also induce the production of prostaglandins
to increase renal blood flow [32]. The thiazide diuretics also inhibit the Na reabsorption by blocking Na-K-Cl cotransporter in distal tubules. These diuretics
reduce blood volume and arterial pressure and activate the renin–angiotensin–aldosterone system [33]. These diuretics usually cause glucose intolerance and hyperglycemia due to their hypokalemia effect which reduces cardiac output, extracellular
fluid volume, and inhibition of insulin secretion. Further, the peripheral utilization
of glucose decreases due to the increase of catecholamines. The thiazide diuretics
also disturb the lipid and glucose metabolism mainly due to the effects of hypokalemia [34, 35]. Therefore, they are preferred for the patients of type 2 diabetes
mellitus and obesity as they cause dyslipidemia and insulin resistance in a dosedependent manner.
Conclusions
As we know the endocrine system with its hormone producing endocrine glands and
their receptors regulate a variety of essential physiological functions in human body.
The hormones, the chemical messengers which are secreted directly into circulatory
system regulate body’s growth and development, embryonic development, and primary sex characters, etc. The endocrine system also regulates glucose and lipid
metabolism, very crucial biological functions for the survival of life. However,
exogenous chemicals in the form of EDCs could interfere with the normal functioning of the endocrine system. They disrupt the hormonal-production, transportation
21 Role of Pharmaceuticals as EDCs in Metabolic Disorders
ment of lipid and carbohydrate metabolism and insulin sensitivity are the common
side effects of most β-blockers especially of the first generation. However, the
nebivolol and carvedilol; the third generation vasodilating β-blockers have shown
better metabolic profiles and are predominantly preferred for patients of hypertension with metabolic syndrome [28–30]. The side effects of β-blockers appear due to
disturbance in insulin secretion and impaired activities of lipid metabolizing
enzymes.
Some of the β-blockers cause abdominal fat deposition due to abnormal lipid and
carbohydrate metabolism. The adrenergic stimulation cause β-blockade which lead
to inhibition of lipolysis resultantly a condition of fatigue appears in patients under
β-blocker therapy. The β-receptor antagonist treatments reduce the metabolic rate
and energy consumption, thus cause weight gain [31].
Diuretics as Antihypertensive Agents
The diuretics promote diuresis by inhibiting the reabsorption of Na in renal tubular
system, thus cause an increased water excretion. The loop diuretics inhibit the reabsorption of about 25% Na by inhibiting the Na-K-Cl cotransporter proteins and
increase the urination. Such diuretics also induce the production of prostaglandins
to increase renal blood flow [32]. The thiazide diuretics also inhibit the Na reabsorption by blocking Na-K-Cl cotransporter in distal tubules. These diuretics
reduce blood volume and arterial pressure and activate the renin–angiotensin–aldosterone system [33]. These diuretics usually cause glucose intolerance and hyperglycemia due to their hypokalemia effect which reduces cardiac output, extracellular
fluid volume, and inhibition of insulin secretion. Further, the peripheral utilization
of glucose decreases due to the increase of catecholamines. The thiazide diuretics
also disturb the lipid and glucose metabolism mainly due to the effects of hypokalemia [34, 35]. Therefore, they are preferred for the patients of type 2 diabetes
mellitus and obesity as they cause dyslipidemia and insulin resistance in a dosedependent manner.
Conclusions
As we know the endocrine system with its hormone producing endocrine glands and
their receptors regulate a variety of essential physiological functions in human body.
The hormones, the chemical messengers which are secreted directly into circulatory
system regulate body’s growth and development, embryonic development, and primary sex characters, etc. The endocrine system also regulates glucose and lipid
metabolism, very crucial biological functions for the survival of life. However,
exogenous chemicals in the form of EDCs could interfere with the normal functioning of the endocrine system. They disrupt the hormonal-production, transportation
21 Role of Pharmaceuticals as EDCs in Metabolic Disorders