Fig. 3.

From redox physiology to redox medicine in obesity, metabolic syndrome, and type 2 diabetes. In physiological states, the production of reactive species, metabolic processes, antioxidant defense responses, and repair/removal of oxidatively damaged biomolecules are highly synchronized processes. In metabolic diseases, this homeostasis is disturbed. Nutrient overload disrupts redox/metabolic equilibrium. Gluco- and lipo-toxicity are an integrative part of the overproduction of reactive species, forming a vicious circle in which oxidative stress is central. Induction of secondary pathways of glucose and lipid metabolism strongly enhances these processes, leading to oxidative stress and oxidative modification of all biomolecules, further inducing alterations in redox-metabolic regulation. T2DM: type 2 diabetes mellitus; ETC: electron transport chain; GSH: glutathione; GSH-Px: glutathione peroxidase; GR: glutathione reductase; NOS: nitric oxide synthase; NOX: NADPH oxidase; PPP: pentose phosphate pathway; Prdx: peroxiredoxin; SOD: superoxide dismutase; TR: thioredoxin reductase; Trx: thioredoxin.