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Perturbed autonomic nervous system function in metabolic syndrome
Tentolouris, Nicholas
Argyrakopoulou, Georgia
Katsilambros,
Nicholas
The metabolic syndrome is characterized by the clustering of various
common metabolic abnormalities in an individual and it is associated
with increased risk for the development of type 2 diabetes and
cardiovascular diseases. Its prevalence in the general population is
approximately 25%. Central fat accumulation and insulin resistance are
considered as the common denominators of the abnormalities of the
metabolic syndrome. Subjects with metabolic syndrome have autonomic
nervous system dysfunction characterized by predominance of the
sympathetic nervous system in many organs, i.e. heart, kidneys,
vasculature, adipose tissue, and muscles. Sympathetic nervous system
activation in metabolic syndrome is detected as increased heart rate and
blood pressure, diminished heart rate variability, baroreceptor
dysfunction, enhanced lipolysis in visceral fat, increased muscle
sympathetic nerve activity, and high urine or plasma catecholamine
concentrations as well as turnover rates. The augmented sympathetic
activity in individuals with metabolic syndrome worsens prognosis of
this high-risk population. The mechanisms linking metabolic syndrome
with sympathetic activation are complex and not clearly understood.
Whether sympathetic overactivity is involved in the development of the
metabolic syndrome or is a consequence of it remains to be elucidated
since data from prospective studies are missing. Intervention studies
have demonstrated that the autonomic disturbances of the metabolic
syndrome may be reversible.
(EN)
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