Although advances in medical technology and health care have improved the early diagnosis and management for cardiorenal metabolic disorders, the prevalence of obesity, insulin resistance, diabetes, hypertension, dyslipidemia, and kidney disease remains high. Findings from numerous population-based studies, clinical trials, and experimental evidence have consolidated a number of theories for the pathogenesis of cardiorenal metabolic anomalies including resistance to the metabolic action of insulin, abnormal glucose and lipid metabolism, oxidative and nitrosative stress, endoplasmic reticulum (ER) stress, apoptosis, mitochondrial damage, and inflammation. Accumulating evidence has recently suggested a pivotal role for proteotoxicity, the unfavorable effects of poor protein quality control, in the pathophysiology of metabolic dysregulation and related cardiovascular complications. The ubiquitin-proteasome system (UPS) and autophagy-lysosomal pathways, two major although distinct cellular clearance machineries, govern protein quality control by degradation and clearance of long-lived or damaged proteins and organelles. Ample evidence has depicted an important role for protein quality control, particularly autophagy, in the maintenance of metabolic homeostasis. To this end, autophagy offers promising targets for novel strategies to prevent and treat cardiorenal metabolic diseases. Targeting autophagy using pharmacological or natural agents exhibits exciting new strategies for the growing problem of cardiorenal metabolic disorders.

尽管医疗技术和卫生保健的进步改善了心肾代谢紊乱的早期诊断和治疗，但肥胖、胰岛素抵抗、糖尿病、高血压、血脂异常和肾脏疾病的患病率仍然很高。大量基于人群的研究、临床试验和实验证据的发现巩固了心肾代谢异常发病机制的多种理论，包括胰岛素代谢作用抵抗、葡萄糖和脂质代谢异常、氧化和亚硝化应激、内质网。 ER）应激、细胞凋亡、线粒体损伤和炎症。最近越来越多的证据表明，蛋白质毒性（蛋白质质量控​​制不良的不利影响）在代谢失调和相关心血管并发症的病理生理学中发挥着关键作用。泛素-蛋白酶体系统 (UPS) 和自噬-溶酶体途径是两种主要但不同的细胞清除机制，通过降解和清除长寿命或受损的蛋白质和细胞器来控制蛋白质质量。充足的证据表明蛋白质质量控​​制，特别是自噬，在维持代谢稳态中发挥着重要作用。为此，自噬为预防和治疗心肾代谢疾病的新策略提供了有前景的靶标。使用药物或天然药物靶向自噬为解决日益严重的心肾代谢紊乱问题提供了令人兴奋的新策略。