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Impaired mitochondrial metabolism reduces ATP synthesis, thereby impairing cardiac and renal function ( 2.3 Endoplasmic reticulum and oxidative stress modulation Endoplasmic reticulum stress (ERS), triggered by hypoxia, calcium dyshomeostasis, or autophagic impairment, disrupts the nitric oxide/reactive oxygen species (NO/ROS) balance, thereby activating cascades implicated in cardiovascular disease and diabetes

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GPx-1 acts in the intracellular environment and maintains the physiological level of hydrogen peroxide, which is important in mitochondrial function, thiol redox homeostasis, and signal transduction (Brigelius-Flohé and Maiorino 2013)