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Choi WS, Heo NJ, Son H. The Influence of Dietary Habits on Male Lower Urinary Tract Symptoms: Differential Influence of Water Intake on Voiding Symptoms and Storage Symptoms. World J Mens Health 2024; 42:42.e100. [PMID: 39743216 DOI: 10.5534/wjmh.230361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 07/06/2024] [Accepted: 07/08/2024] [Indexed: 01/04/2025] Open
Abstract
PURPOSE To investigate the dietary factors affecting male lower urinary tract symptoms (LUTS). MATERIALS AND METHODS This retrospective study analyzed men who underwent health check-ups. The men who completed the International Prostate Symptom Score (IPSS) and a dietary questionnaire with 19 items were included in the study. Men with a history of medication for LUTS were excluded from the study. The influences of each dietary habit on total IPSS, voiding symptoms, storage symptoms and quality of life were evaluated separately. Dietary risk group was defined by the number of significant dietary risk factors. RESULTS The mean age of 28,463 men was 52.2±8.7 years. After adjusting for age and other conditions, 13 dietary habits (for examples; overeating, preference for salty food, frequently eating sweets, and infrequently eating vegetables, etc.) were the significant risk factors related to worse total IPSS scores. For voiding symptoms, storage symptoms, and quality of life scores, 14, 12, and 12 dietary habits were identified as independent risk factors, respectively. Drinking four or more cups of water per day was related to worse storage symptoms (odds ratio [OR]=1.12, 95% confidence interval [95% CI]=1.09-1.22), but better voiding symptoms (OR=0.90, 95% CI=0.86-0.95). The newly developed dietary risk group showed that total and subtotal IPSS scores increased by the number of bad dietary habits in all age groups, respectively. CONCLUSIONS This study showed that dietary habits had a significant impact on LUTS. The amount of water consumed had a differential influence on each subdomain symptom.
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Affiliation(s)
- Woo Suk Choi
- Department of Urology, Konkuk University School of Medicine, Seoul, Korea
| | - Nam Ju Heo
- Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Hwancheol Son
- Department of Urology, SMG-SNU Boramae Medical Center, Seoul National University Collegy of Medicine, Seoul, Korea
- Institute for Peace and Unification Studies, Seoul National University, Seoul, Korea.
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Afzal S, Sattar MA, Albokhadaim I, Attiq A, Kandeel M, Manap ASA, Alhojaily SM. Interaction between Nuclear Receptor and Alpha-Adrenergic Agonist Subtypes in Metabolism and Systemic Hemodynamics of Spontaneously Hypertensive Rats. PPAR Res 2024; 2024:5868010. [PMID: 38899161 PMCID: PMC11186691 DOI: 10.1155/2024/5868010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/22/2023] [Accepted: 05/03/2024] [Indexed: 06/21/2024] Open
Abstract
Partial and full PPAR-γ agonists have shown promising effects and antihypertensive and antidiabetic agents through increased plasma adiponectin concentration. This study is aimed at examining the role of PPAR-γ, alpha-adrenoceptors, and adiponectin receptors in the modulation of vasopressor responses to angiotensin II (Ang II) and adrenergic agonists, after a subset treatment of partial and full PPAR-γ agonists, each individually, and also when coupled with adiponectin in SHRs. The antioxidant potential and metabolic indices for these animals were also determined. Group I (WKY) and group II (SHR) were designated as normotensive control and hypertensive control, respectively. Groups III (SHR) and IV (SHR) received irbesartan (30 mg/kg) and pioglitazone (10 mg/kg) orally for 28 days, and groups V (SHR), VI (SHR), and VII (SHR) were treated with adiponectin (2.5 μg/kg) intraperitoneally alone, in combination with irbesartan, and in combination with pioglitazone, respectively, from days 21 to 28 only. On day 29, sodium pentobarbitone (60 mg/kg) was used to anesthetize all test animals, and systemic hemodynamic and plasma adiponectin concentrations and in vitro and in vivo antioxidant potential were measured. As compared to the WKY control, the SHR control group's noninvasive blood pressure and basal mean arterial pressure were significantly greater, along with increased arterial stiffness, lower plasma nitric oxide, adiponectin concentration, and antioxidant enzyme levels (all P < 0.05). However, they were gradually normalized by single drug treatments in all groups, and to a greater extent in the SHR + Irb + Adp group (P < 0.05). In the acute study, the dose dependant mean arterial pressure responses to intravenously administered adrenergic agonists and angiotensin-II were significantly larger in SHRs as compared to WKY by 20-25%. Adiponectin alone and in combination significantly blunted vasopressor responses to these alpha-adrenergic agonists in the SHR + Pio + Adp group by 63%, whereas attenuated responses to ANG-II administration to 70% in SHR + Irb + Adp. In conclusion, the combined treatment of adiponectin with PPAR-agonists reduced the systemic vascular responses to adrenergic agonists and improved arterial stiffness. This an evidence of the interaction of adiponectin receptors, PPAR-γ, alpha-adrenoceptors, and ANG-II in the systemic vasculature of SHRs. A significant level of synergism has also been proved among full PPAR-γ agonists and adiponectin receptors.
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Affiliation(s)
- Sheryar Afzal
- Department of Biomedical ScienceCollege of Veterinary MedicineKing Faisal University, Al Hofuf, Saudi Arabia
- Discipline of PharmacologySchool of Pharmaceutical SciencesUniversiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
| | - Munavvar Abdul Sattar
- Discipline of PharmacologySchool of Pharmaceutical SciencesUniversiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
| | - Ibrahim Albokhadaim
- Department of Biomedical ScienceCollege of Veterinary MedicineKing Faisal University, Al Hofuf, Saudi Arabia
| | - Ali Attiq
- Discipline of PharmacologySchool of Pharmaceutical SciencesUniversiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
| | - Mahmoud Kandeel
- Department of Biomedical ScienceCollege of Veterinary MedicineKing Faisal University, Al Hofuf, Saudi Arabia
| | - Aimi Syamima Abdul Manap
- Department of Biomedical ScienceCollege of Veterinary MedicineKing Faisal University, Al Hofuf, Saudi Arabia
| | - Sameer M. Alhojaily
- Department of Biomedical ScienceCollege of Veterinary MedicineKing Faisal University, Al Hofuf, Saudi Arabia
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Gao D, Zhang C, Chen Q, Cao Z, Li P, Zhou G, Xu H, Xu B, Wang Z. Association between dietary fatty acids and urinary incontinence. Heliyon 2024; 10:e28595. [PMID: 38571581 PMCID: PMC10988052 DOI: 10.1016/j.heliyon.2024.e28595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
Background Dietary nutrient intake contributes to urination; however, the association between dietary nutrient intake, especially that of fat, and urinary incontinence (UI) is not well understood. The most common types of UI include stress UI (SUI) and urgency UI (UUI). Objective To investigate the potential effect(s) of dietary fat intake on UI and explore its mechanism of action in relation to body mass index (BMI). Methods A cross-sectional survey of data from 15,121 individuals (20-85 years of age) from the National Health and Nutrition Examination Survey (2001-2008), a random population-based sample, was performed. Data regarding dietary nutrient intake were collected through 24 h dietary recall interviews. UI and covariate data were collected through in-person interviews. UI was assessed according to the American Urological Association Symptom Index. The odds ratio (OR) for SUI and UUI were calculated using multivariate logistic regression analysis. The mediation effect was estimated using observational mediation analysis. Results Higher total fat intake was positively associated with increased odds for developing UI (OR 1.44 [95% confidence interval (CI) 1.08-1.93]). Females who consumed more saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), and polyunsaturated fatty acids (PUFA) were more likely to develop SUI. BMI partially explained the association between total fat, SFA, MUFA, and PUFA and SUI; the proportions of the mediation effect of BMI were 14.7%, 13.0%, 18.7%, and 16.3%, respectively. Conclusions Results of this study emphasize the key role of dietary fat intake in the prevalence of UI. Higher fat intake was positively associated with UI and BMI partially mediated the effect of fat intake on SUI.
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Affiliation(s)
- Dajun Gao
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai, 200011, China
| | - Caoxu Zhang
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostics and Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qi Chen
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai, 200011, China
| | - Zhi Cao
- Shanghai Changhai Hospital, Shanghai, China
| | - Peizhang Li
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai, 200011, China
| | | | - Huan Xu
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai, 200011, China
| | - Bin Xu
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai, 200011, China
| | - Zhong Wang
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai, 200011, China
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Gumede NAC, Khathi A. The Role of Pro-Opiomelanocortin Derivatives in the Development of Type 2 Diabetes-Associated Myocardial Infarction: Possible Links with Prediabetes. Biomedicines 2024; 12:314. [PMID: 38397916 PMCID: PMC10887103 DOI: 10.3390/biomedicines12020314] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/14/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
Myocardial infarction is a major contributor to CVD-related mortality. T2DM is a risk factor for MI. Stress activates the HPA axis, SNS, and endogenous OPS. These POMC derivatives increase the blood glucose and cardiovascular response by inhibiting the PI3K/AkT insulin signaling pathway and increasing cardiac contraction. Opioids regulate the effect of the HPA axis and SNS and they are cardioprotective. The chronic activation of the stress response may lead to insulin resistance, cardiac dysfunction, and MI. Stress and T2DM, therefore, increase the risk of MI. T2DM is preceded by prediabetes. Studies have shown that prediabetes is associated with an increased risk of MI because of inflammation, hyperlipidemia, endothelial dysfunction, and hypertension. The HPA axis is reported to be dysregulated in prediabetes. However, the SNS and the OPS have not been explored during prediabetes. The effect of prediabetes on POMC derivatives has yet to be fully explored and understood. The impact of stress and prediabetes on the cardiovascular response needs to be investigated. This study sought to review the potential impact of prediabetes on the POMC derivatives and pathways that could lead to MI.
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Affiliation(s)
- Nompumelelo Anna-Cletta Gumede
- Department of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban X54001, South Africa;
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Zhou W, Lee A, Zhou A, Lombardo D. Integrative care: acupuncture based neuromodulation therapy for diabetes and heart failure. Front Neurosci 2024; 18:1332957. [PMID: 38298910 PMCID: PMC10827876 DOI: 10.3389/fnins.2024.1332957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
The relationship between heart failure and diabetes is intricate and bidirectional. Individuals with diabetes face an elevated risk of developing heart failure due to factors like insulin resistance, chronic inflammation, and metabolic irregularities. Elevated blood sugar levels can harm blood vessels and nerves, culminating in the buildup of fatty deposits in arteries, atherosclerosis, and hypertension, which significantly contribute to heart failure. Furthermore, diabetes can adversely impact the structure and function of the heart muscle, impairing its pumping capacity. Conversely, heart failure can also contribute to the onset of diabetes by disrupting the body's metabolic processes and amplifying insulin resistance. The complex interaction between these conditions mandates a comprehensive approach to managing individuals with both diabetes and heart failure, underscoring the importance of addressing both aspects for enhanced patient outcomes. Although existing pharmacological treatments are limited and frequently associated with undesirable side effects, acupuncture has established itself as a traditional practice with a legacy. It remains a supplementary option for treating cardiovascular diseases. Heart failure and diabetes are both heavily associated with chronic upregulation of the sympathetic nervous system, which has been identified as a pivotal factor in the progression of disease. Mechanistic interplays such as the attenuation of central nitric oxide signaling may interfere with the production or availability of nitric oxide in key areas of the central nervous system, including the brainstem and hypothalamus. This review will delve into the current understanding of acupuncture on the autonomic nervous system and offer insights into its potential role in the future treatment landscape for diabetes and heart failure.
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Affiliation(s)
- Wei Zhou
- Division of Cardiology, University of California, Irvine, Orange, CA, United States
| | - Andy Lee
- Division of Cardiology, University of California, Irvine, Orange, CA, United States
| | - Aren Zhou
- Irvine Valley College, Irvine, CA, United States
| | - Dawn Lombardo
- Division of Cardiology, University of California, Irvine, Orange, CA, United States
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Suarez Arbelaez MC, Nackeeran S, Shah K, Blachman-Braun R, Bronson I, Towe M, Bhat A, Marcovich R, Ramasamy R, Shah HN. Association between body mass index, metabolic syndrome and common urologic conditions: a cross-sectional study using a large multi-institutional database from the United States. Ann Med 2023; 55:2197293. [PMID: 37036830 PMCID: PMC10088970 DOI: 10.1080/07853890.2023.2197293] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 03/25/2023] [Indexed: 04/11/2023] Open
Abstract
INTRODUCTION The study aims to determine whether body mass index (BMI), metabolic syndrome (MS) or its individual components (primary hypertension, type 2 diabetes mellitus and dyslipidemias) are risk factors for common urological diseases. MATERIALS AND METHODS Cross-sectional study with data collected on February 28, 2022 from the TriNetX Research Network. Patients were divided in cohorts according to their BMI, presence of MS (BMI > 30 kg/m2, type 2 diabetes mellitus, primary hypertension and disorders of lipoprotein metabolism) and its individual components and its association with common urological conditions was determined. For each analysis, odds ratio (OR) with 95% confidence intervals were calculated. Statistical significance was assessed at p < .05. RESULTS BMI > 30 kg/m2 was associated with increased risk of lithiasis, kidney cancer, overactive bladder, male hypogonadism, benign prostatic hyperplasia, and erectile dysfunction (p < .05). On the contrary, BMI was inversely associated with ureteral, bladder and prostate cancer (p < .05). In all urological diseases, MS was the strongest risk factor, with prostate cancer (OR = 2.53) showing the weakest and male hypogonadism the strongest (OR = 13.00) associations. CONCLUSIONS MS and its individual components were significant risk factors for common urological conditions. Hence holistic approaches with lifestyle modification might prevent common urological disease.Key messagesOverall, metabolic syndrome is the strongest risk factor for all the analysed urological diseases.Abnormally high body mass index can be a risk or protective factor depending on the threshold and urological disease that are being evaluated.Metabolic syndrome and increased BMI should be considered important factors associated to the prevalence of common urological diseases.
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Affiliation(s)
| | - Sirpi Nackeeran
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Khushi Shah
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ruben Blachman-Braun
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Isaac Bronson
- UMass Chann Medical School, University of Massachusetts, Amherst, MA, USA
| | - Maxwell Towe
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Abhishek Bhat
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert Marcovich
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hemendra N. Shah
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Song Y, Gong L, Lou X, Zhou H, Hao Y, Chen Q, Zhao Y, Jiang X, Li L, Wang X. Sleep-Body Composition Relationship: Roles of Sleep Behaviors in General and Abdominal Obesity in Chinese Adolescents Aged 17-22 Years. Nutrients 2023; 15:4130. [PMID: 37836414 PMCID: PMC10574676 DOI: 10.3390/nu15194130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/17/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
This study aimed to investigate the association between sleep behaviors and body composition, which was measured by bioelectrical impedance analysis (BIA) among Chinese adolescents. Overall, 444 students (65.3% females, 19.12 ± 1.177 years) completed questionnaires describing sleep characteristics. Sleep characteristics were derived from subjective means. Body composition was obtained from BIA by InBody 720 (Biospace Co. Ltd., Seoul, Republic of Korea). Regression models tested relationships between sleep and body composition after adjustment for covariates. Students with weekday nap duration (>30 min/d) exerted higher waist-height ratio (WHtR) (B = 0.013, FDR-corrected p = 0.080). Average sleep duration (≤7 h/d) was linked to more WHtR (B = 0.016, FDR-corrected p = 0.080). People with high social jetlag showed gained visceral fat area (B = 7.475), WHtR (B = 0.015), waist to hip ratio (B = 0.012), fat mass index (B = 0.663) and body fat percentage (B = 1.703) (all FDR-corrected p < 0.1). Individuals with screen time before sleep (>0.5 h) exhibited higher visceral fat area (B = 7.934, FDR-corrected p = 0.064), WHtR (B = 0.017, FDR-corrected p = 0.080), waist to hip ratio (B = 0.016, FDR-corrected p = 0.090), fat mass index (B = 0.902, FDR-corrected p = 0.069) and body fat percentage (B = 2.892, FDR-corrected p = 0.018). We found poor sleep characteristics were closely related to general and abdominal obesity.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Xian Wang
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou 450001, China; (Y.S.); (L.G.); (X.L.); (H.Z.); (Y.H.); (Q.C.); (Y.Z.); (X.J.); (L.L.)
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Cai Z, Yang Y, Zhang J, Liu Y. The relationship between daytime napping and obesity: a systematic review and meta-analysis. Sci Rep 2023; 13:12124. [PMID: 37495671 PMCID: PMC10372090 DOI: 10.1038/s41598-023-37883-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 06/29/2023] [Indexed: 07/28/2023] Open
Abstract
Daytime napping, a habit widely adopted globally, has an unclear association with obesity. In this study, we executed a meta-analysis to explore the relationship between daytime napping and obesity. We conducted a comprehensive search of the PubMed, Embase, Cochrane Library, Scopus, PsycINFO, and Web of Science databases for pertinent articles published up to April 2023. Random-effects models were utilized to calculate odds ratios (ORs) with 95% confidence intervals (CIs), and we assessed the heterogeneity of the included studies using the I2 statistic. To explore potential sources of heterogeneity, subgroup analyses were performed. The methodological quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS), and funnel plots were employed to detect any publication bias. Sensitivity analyses were conducted by sequentially omitting each study. We conducted a meta-analysis of twelve studies that included one each from the UK and Spain, five from the USA, and five from China, totalling 170,134 participants, to probe the association between napping and obesity. The pooled analysis suggested a higher risk of obesity in individuals who nap (OR: 1.22 [1.10-1.35], p < 0.001, I2 = 87%) compared to non-nappers. The meta-analysis results revealed variations in the summary ORs for studies conducted in China, Spain, the USA, and the UK. The ORs for China, Spain, the USA, and the UK were 1.05 (95% CI 0.90-1.23), 9.36 (95% CI 4.74-18.45), 1.27 (95% CI 1.10-1.47), and 1.39 (95% CI 1.32-1.47), respectively. A subgroup analysis based on age within the American population disclosed that napping in both adults and children heightened obesity incidence. A subgroup analysis based on nap duration found a significant rise in obesity occurrence when nap duration exceeded one hour, but no clear relationship emerged when nap duration was less than 1 h. In a subgroup analysis based on the definition of obesity, napping did not demonstrate a significant relationship with obesity when diagnostic criteria set obesity at a BMI of 25 or above. However, when the criteria were set at a BMI of 28 or 30 or more, napping significantly increased obesity risk. Our meta-analysis indicates a positive association between daytime napping and the risk of obesity. However, given the limited number of included studies, potential confounding factors might not have been fully addressed. Future well-designed prospective studies are required to further investigate this relationship. Large-scale studies are necessary to confirm our findings and elucidate the underlying mechanisms that drive these associations and causation.
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Affiliation(s)
- Zixin Cai
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yan Yang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jingjing Zhang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yu Liu
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
- Department of Nephrology, Hunan Key Laboratory of Kidney Disease and Blood Purification, The Second Xiangya Hospital at Central South University, Changsha, 410011, China.
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Identificación del fenotipo ahorrador para la personalización del manejo del sobrepeso y la obesidad. REVISTA MÉDICA CLÍNICA LAS CONDES 2022. [DOI: 10.1016/j.rmclc.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gao H, Jin Z, Tang K, Ji Y, Suarez J, Suarez JA, Cunha e Rocha K, Zhang D, Dillmann WH, Mahata SK, Ying W. Microbial DNA Enrichment Promotes Adrenomedullary Inflammation, Catecholamine Secretion, and Hypertension in Obese Mice. J Am Heart Assoc 2022; 11:e024561. [PMID: 35112881 PMCID: PMC9245808 DOI: 10.1161/jaha.121.024561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Obesity is an established risk factor for hypertension. Although obesity‐induced gut barrier breach leads to the leakage of various microbiota‐derived products into host circulation and distal organs, the roles of microbiota in mediating the development of obesity‐associated adrenomedullary disorders and hypertension have not been elucidated. We seek to explore the impacts of microbial DNA enrichment on inducing obesity‐related adrenomedullary abnormalities and hypertension. Methods and Results Obesity was accompanied by remarkable bacterial DNA accumulation and elevated inflammation in the adrenal glands. Gut microbial DNA containing extracellular vesicles (mEVs) were readily leaked into the bloodstream and infiltrated into the adrenal glands in obese mice, causing microbial DNA enrichment. In lean wild‐type mice, adrenal macrophages expressed CRIg (complement receptor of the immunoglobulin superfamily) that efficiently blocks the infiltration of gut mEVs. In contrast, the adrenal CRIg+ cell population was greatly decreased in obese mice. In lean CRIg−/− or C3−/− (complement component 3) mice intravenously injected with gut mEVs, adrenal microbial DNA accumulation elevated adrenal inflammation and norepinephrine secretion, concomitant with hypertension. In addition, microbial DNA promoted inflammatory responses and norepinephrine production in rat pheochromocytoma PC12 cells treated with gut mEVs. Depletion of microbial DNA cargo markedly blunted the effects of gut mEVs. We also validated that activation of cGAS (cyclic GMP‐AMP synthase)/STING (cyclic GMP–AMP receptor stimulator of interferon genes) signaling is required for the ability of microbial DNA to trigger adrenomedullary dysfunctions in both in vivo and in vitro experiments. Restoring CRIg+ cells in obese mice decreased microbial DNA abundance, inflammation, and hypertension. Conclusions The leakage of gut mEVs leads to adrenal enrichment of microbial DNA that are pathogenic to induce obesity‐associated adrenomedullary abnormalities and hypertension. Recovering the CRIg+ macrophage population attenuates obesity‐induced adrenomedullary disorders.
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Affiliation(s)
- Hong Gao
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
| | - Zhongmou Jin
- Division of Biological SciencesUniversity of California, San DiegoLa JollaCA
| | | | - Yudong Ji
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
- Department of AnesthesiologyInstitute of Anesthesiology and Critical CareUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Jorge Suarez
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
| | - Jorge A. Suarez
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
| | - Karina Cunha e Rocha
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
| | - Dinghong Zhang
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
| | - Wolfgang H. Dillmann
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
| | - Sushil K. Mahata
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
- VA San Diego Healthcare SystemSan DiegoCA
| | - Wei Ying
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of California, San DiegoLa JollaCA
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Wang F, Zou J, Xu H, Huang W, Zhang X, Wei Z, Li X, Liu Y, Zou J, Liu F, Zhu H, Yi H, Guan J, Yin S. Effects of Chronic Intermittent Hypoxia and Chronic Sleep Fragmentation on Gut Microbiome, Serum Metabolome, Liver and Adipose Tissue Morphology. Front Endocrinol (Lausanne) 2022; 13:820939. [PMID: 35178032 PMCID: PMC8846366 DOI: 10.3389/fendo.2022.820939] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/06/2022] [Indexed: 12/29/2022] Open
Abstract
Chronic intermittent hypoxia (CIH) and chronic sleep fragmentation (CSF) are two cardinal pathological features of obstructive sleep apnea (OSA). Dietary obesity is a crucial risk intermediator for OSA and metabolic disorders. Gut microbiota affect hepatic and adipose tissue morphology under conditions of CIH or CSF through downstream metabolites. However, the exact relationship is unclear. Herein, chow and high-fat diet (HFD)-fed mice were subjected to CIH or CSF for 10 weeks each and compared to normoxia (NM) or normal sleep (NS) controls. 16S rRNA amplicon sequencing, untargeted liquid chromatography-tandem mass spectrometry, and histological assessment of liver and adipose tissues were used to investigate the correlations between the microbiome, metabolome, and lipid metabolism under CIH or CSF condition. Our results demonstrated that CIH and CSF regulate the abundance of intestinal microbes (such as Akkermansia mucinphila, Clostridium spp., Lactococcus spp., and Bifidobacterium spp.) and functional metabolites, such as tryptophan, free fatty acids, branched amino acids, and bile acids, which influence adipose tissue and hepatic lipid metabolism, and the level of lipid deposition in tissues and peripheral blood. In conclusion, CIH and CSF adversely affect fecal microbiota composition and function, and host metabolism; these findings provide new insight into the independent and synergistic effects of CIH, CSF, and HFD on lipid disorders.
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Affiliation(s)
- Fan Wang
- Department of Otolaryngology-Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing and Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Juanjuan Zou
- Department of Otorhinolaryngology and National Health Commission (NHC) Key Laboratory of Otorhinolaryngology, Shandong University Affiliated Qilu Hospital, Jinan, China
| | - Huajun Xu
- Department of Otolaryngology-Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing and Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Huajun Xu, ; Jian Guan, ; Shankai Yin,
| | - Weijun Huang
- Department of Otolaryngology-Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing and Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Xiaoman Zhang
- Department of Otolaryngology-Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing and Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Zhicheng Wei
- Department of Otolaryngology-Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing and Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Xinyi Li
- Department of Otolaryngology-Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing and Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Yupu Liu
- Department of Otolaryngology-Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing and Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Jianyin Zou
- Department of Otolaryngology-Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing and Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Feng Liu
- Department of Otolaryngology-Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing and Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Huaming Zhu
- Department of Otolaryngology-Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing and Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Hongliang Yi
- Department of Otolaryngology-Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing and Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Jian Guan
- Department of Otolaryngology-Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing and Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Huajun Xu, ; Jian Guan, ; Shankai Yin,
| | - Shankai Yin
- Department of Otolaryngology-Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing and Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Huajun Xu, ; Jian Guan, ; Shankai Yin,
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Salvadori A, Fanari P, Marzullo P, Codecasa F, Tovaglieri I, Cornacchia M, Terruzzi I, Ferrulli A, Palmulli P, Brunani A, Lanzi S, Luzi L. Playing around the anaerobic threshold during COVID-19 pandemic: advantages and disadvantages of adding bouts of anaerobic work to aerobic activity in physical treatment of individuals with obesity. Acta Diabetol 2021; 58:1329-1341. [PMID: 34047810 PMCID: PMC8159723 DOI: 10.1007/s00592-021-01747-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/15/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Obesity is a condition that generally limits work capacity and predisposes to a number of comorbidities and related diseases, the last being COVID-19 and its complications and sequelae. Physical exercise, together with diet, is a milestone in its management and rehabilitation, although there is still a debate on intensity and duration of training. Anaerobic threshold (AT) is a broad term often used either as ventilatory threshold or as lactate threshold, respectively, detected by respiratory ventilation and/or respiratory gases (VCO2 and VO2), and by blood lactic acid. AIMS AND METHODOLOGY This review outlines the role of AT and of the different variations of growth hormone and catecholamine, in subjects with obesity vs normal weight individuals below and beyond AT, during a progressive increase in exercise training. We present a re-evaluation of the effects of physical activity on body mass and metabolism of individuals with obesity in light of potential benefits and pitfalls during COVID-19 pandemic. Comparison of a training program at moderate-intensity exercise (< AT) with training performed at moderate intensity (< AT) plus a final bout of high-intensity (> AT) exercise at the end of the aerobic session will be discussed. RESULTS Based on our data and considerations, a tailored strategy for individuals with obesity concerning the most appropriate intensity of training in the context of rehabilitation is proposed, with special regard to potential benefits of work program above AT. CONCLUSION Adding bouts of exercise above AT may improve lactic acid and H+ disposal and improve growth hormone. Long-term aerobic exercise may improve leptin reduction. In this way, the propensity of subjects with obesity to encounter a serious prognosis of COVID-19 may be counteracted and the systemic and cardiorespiratory sequelae that may ensue after COVID-19, can be overcome. Individuals with serious comorbidities associated with obesity should avoid excessive exercise intensity.
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Affiliation(s)
- Alberto Salvadori
- Department of Pulmonary Rehabilitation, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Paolo Fanari
- Department of Pulmonary Rehabilitation, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Paolo Marzullo
- Division of General Medicine, Ospedale S. Giuseppe, Istituto Auxologico Italiano, via Cadorna 90, 28824, Piancavallo Di Oggebbio (VB), Italy
- Department of Translational Medicine, University of Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy
| | - Franco Codecasa
- Department of Pulmonary Rehabilitation, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Ilaria Tovaglieri
- Department of Pulmonary Rehabilitation, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Mauro Cornacchia
- Department of Pulmonary Rehabilitation, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Ileana Terruzzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Anna Ferrulli
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Patrizia Palmulli
- Department of Pulmonary Rehabilitation, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Amelia Brunani
- Department of Rehabilitation Medicine, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Stefano Lanzi
- Division of Angiology, Heart and Vessel Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Livio Luzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, Italy.
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
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Wang N, Zou J, Fang S, Zhou J. Association between daytime napping and obesity in Chinese middle-aged and older adults. J Glob Health 2021; 10:020804. [PMID: 33312510 PMCID: PMC7719355 DOI: 10.7189/jogh.10.020804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background No studies have assessed the association between daytime napping and obesity in China. The study aimed to examine the association between daytime napping and obesity among Chinese middle-aged and older adults, and to evaluate the difference between the aforementioned association in men and women. Methods Overall, 14 685 participants aged 45 years and older were included by using data from China Health and Retirement Longitudinal Study (CHARLS) in 2015. A multivariable logistic regression model was used to investigate the relationship between daytime napping and obesity after adjusting for potential confounders. Stratified analyses were performed to examine the association differences by sex. Besides, the Cochran-Armitage test for trend was used to detect if there was a significant dose-response relationship between daytime napping and obesity. Results The mean age of participants was 60.32, and the mean daytime napping duration was 38.97 minutes. In the sample, compared with no daytime napping group, the risks of being obese were higher in both moderate daytime napping group (1-60 minute/d) (odds ratio OR = 1.27, 95% confidence interval (CI) = 1.13-1.44) and extend long daytime napping group (>60 minute/d) (OR = 1.34, 95% CI = 1.15-1.56). In sex stratification, these significant correlations only existed in women but not in men. Compared with no daytime napping, women who napped 1-60 minute/d and over 60 minute/d were more likely to be obese (OR = 1.37, 95% CI = 1.18-1.59 and OR = 1.49, 95% CI = 1.23-1.81, respectively). Besides, the Cochran-Armitage trend test revealed that the prevalence rate of obesity increased as the daytime napping duration increased (P < 0.001). Conclusions The study established the relationship between daytime napping and obesity in a general Chinese population. The association, however, was only detected among women. Furthermore, there was a dose-response relationship between daytime napping and obesity among women. Future studies may verify this association by using a longitudinal design and focus on the mechanisms behind such association.
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Affiliation(s)
- Nan Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Junyi Zou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shu Fang
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Junmin Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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Russo B, Menduni M, Borboni P, Picconi F, Frontoni S. Autonomic Nervous System in Obesity and Insulin-Resistance-The Complex Interplay between Leptin and Central Nervous System. Int J Mol Sci 2021; 22:ijms22105187. [PMID: 34068919 PMCID: PMC8156658 DOI: 10.3390/ijms22105187] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 04/23/2021] [Accepted: 05/12/2021] [Indexed: 02/06/2023] Open
Abstract
The role of the autonomic nervous system in obesity and insulin-resistant conditions has been largely explored. However, the exact mechanisms involved in this relation have not been completely elucidated yet, since most of these mechanisms display a bi-directional effect. Insulin-resistance, for instance, can be caused by sympathetic activation, but, in turn, the associated hyperinsulinemia can activate the sympathetic branch of the autonomic nervous system. The picture is made even more complex by the implicated neural, hormonal and nutritional mechanisms. Among them, leptin plays a pivotal role, being involved not only in appetite regulation and glucose homeostasis but also in energy expenditure. The purpose of this review is to offer a comprehensive view of the complex interplay between leptin and the central nervous system, providing further insights on the impact of autonomic nervous system balance on adipose tissue and insulin-resistance. Furthermore, the link between the circadian clock and leptin and its effect on metabolism and energy balance will be evaluated.
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Affiliation(s)
- Benedetta Russo
- Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita, Fatebenefratelli Hospital, 00186 Rome, Italy; (B.R.); (M.M.); (P.B.); (F.P.)
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Marika Menduni
- Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita, Fatebenefratelli Hospital, 00186 Rome, Italy; (B.R.); (M.M.); (P.B.); (F.P.)
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Patrizia Borboni
- Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita, Fatebenefratelli Hospital, 00186 Rome, Italy; (B.R.); (M.M.); (P.B.); (F.P.)
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Fabiana Picconi
- Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita, Fatebenefratelli Hospital, 00186 Rome, Italy; (B.R.); (M.M.); (P.B.); (F.P.)
| | - Simona Frontoni
- Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita, Fatebenefratelli Hospital, 00186 Rome, Italy; (B.R.); (M.M.); (P.B.); (F.P.)
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence:
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Jabbour G, Iancu HD. Supramaximal-Exercise Training Improves Heart Rate Variability in Association With Reduced Catecholamine in Obese Adults. Front Physiol 2021; 12:654695. [PMID: 33859574 PMCID: PMC8042138 DOI: 10.3389/fphys.2021.654695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/12/2021] [Indexed: 12/18/2022] Open
Abstract
This study investigates the effect of 6 weeks of supramaximal exercise training (SET) on heart rate variability (HRV) and associated factors in sedentary obese (OB) and normal-weight (NW) adults. In this study, 19 OB [22.9 (8.4) years; body mass index (BMI) 33.4 (1.4) kg/m2] and 18 NW [23.2 (4.4) years; BMI 23.3 (1.2) kg/m2] adults completed a 6-week SET intervention. Anthropometric and aerobic indicators as well the homeostasis model assessment index for insulin resistance index (HOMA-IR) were assessed at baseline and after SET. The low- and high-frequency [(LF (0.03–0.15 Hz) in ms2 and HF (0.15–0.4 Hz) in ms2)] analysis of HRV as well as adrenaline (A in nmol/l) and noradrenaline (NA in nmol/l) responses were assessed at resting condition and during ventilatory threshold 1 (VT1) of a graded maximal test at baseline and after SET. At baseline, resting HF, LF and the LF/HF ratio were different among groups (P < 0.01, respectively) and were significantly associated with waist-to-hip ratio (β = −0.26; p = 0.01, β = −0.12; p = 0.01 and, β = 0.21; p = 0.01). During exertion at VT1, only LF/HF ratio was associated with NA responses (β = 0.23; p = 0.01). After SET, the frequency domain marker improved significantly for both groups in comparison to baseline. These improvements are manifested by LF and HF increases and LF/HF ratio decreases in the rest condition (p < 0.01, respectively) and during exertion at VT1 (p < 0.01, respectively). The improvement in LH and HF were associated with VO2max increases (β = 0.22 p = 0.01 and β = 0.33; p = 0.01). The decreases observed for the LF/HF ratio are mainly associated to NA decreases observed at rest (β = 0.31; p = 0.001) and at VT1 (β = 0.38; p = 0.001). Obese adults have altered HRV, and 6 weeks of SET improves HRV variables at rest and during VT1 exertion. While LF and HF improvement were associated with VO2max increases, the LF/HF ratio was mainly associated with noradrenaline decreases observed at rest and at VT1.
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Affiliation(s)
- Georges Jabbour
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
| | - Horia D Iancu
- School of Kinesiology and Leisure, University of Moncton, Moncton, NB, Canada
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Abstract
PURPOSE OF REVIEW There is substantial inter-individual variability in body weight change, which is not fully accounted by differences in daily energy intake and physical activity levels. The metabolic responses to short-term perturbations in energy intake can explain part of this variability by quantifying the degree of metabolic "thriftiness" that confers more susceptibility to weight gain and more resistance to weight loss. It is unclear which metabolic factors and pathways determine this human "thrifty" phenotype. This review will investigate and summarize emerging research in the field of energy metabolism and highlight important metabolic mechanisms implicated in body weight regulation in humans. RECENT FINDINGS Dysfunctional adipose tissue lipolysis, reduced brown adipose tissue activity, blunted fibroblast growth factor 21 secretion in response to low-protein hypercaloric diets, and impaired sympathetic nervous system activity might constitute important metabolic factors characterizing "thriftiness" and favoring weight gain in humans. The individual propensity to weight gain in the current obesogenic environment could be ascertained by measuring specific metabolic factors which might open up new pathways to prevent and treat human obesity.
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Affiliation(s)
- Tim Hollstein
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - Paolo Piaggi
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA.
- Department of Information Engineering, University of Pisa, Pisa, Italy.
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Hollstein T, Basolo A, Ando T, Votruba SB, Krakoff J, Piaggi P. Urinary Norepinephrine Is a Metabolic Determinant of 24-Hour Energy Expenditure and Sleeping Metabolic Rate in Adult Humans. J Clin Endocrinol Metab 2020; 105:5718326. [PMID: 32002540 PMCID: PMC7055738 DOI: 10.1210/clinem/dgaa047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 01/28/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Interindividual variability in 24-hour energy expenditure (24EE) during energy-balance conditions is mainly determined by differences in body composition and demographic factors. Previous studies suggested that 24EE might also be influenced by sympathetic nervous system activity via catecholamine (norepinephrine, epinephrine) secretion. Therefore, we analyzed the association between catecholamines and energy expenditure in 202 individuals from a heterogeneous population of mixed ethnicities. METHODS Participants (n = 202, 33% female, 14% black, 32% white, 41% Native American, 11% Hispanic, age: 36.9 ± 10.3 y [mean ± SD], percentage body fat: 30.3 ± 9.4) resided in a whole-room calorimeter over 24 hours during carefully controlled energy-balance conditions to measure 24EE and its components: sleeping metabolic rate (SMR), awake-fed thermogenesis (AFT), and spontaneous physical activity (SPA). Urine samples were collected, and 24-h urinary epinephrine and norepinephrine excretion rates were assessed by high-performance liquid chromatography. RESULTS Both catecholamines were associated with 24EE and SMR (norepinephrine: +27 and +19 kcal/d per 10 μg/24h; epinephrine: +18 and +10 kcal/d per 1 μg/24h) in separate analyses after adjustment for age, sex, ethnicity, fat mass, fat-free mass, calorimeter room, temperature, and physical activity. In a multivariate model including both norepinephrine and epinephrine, only norepinephrine was independently associated with both 24EE and SMR (both P < .008), whereas epinephrine became insignificant. Neither epinephrine nor norepinephrine were associated with adjusted AFT (both P = .37) but epinephrine was associated with adjusted SPA (+0.5% per 1 μg/24h). CONCLUSIONS Our data provide compelling evidence that sympathetic nervous system activity, mediated via norepinephrine, is a determinant of human energy expenditure during nonstressed, eucaloric conditions.
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Affiliation(s)
- Tim Hollstein
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, US
| | - Alessio Basolo
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, US
| | - Takafumi Ando
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, US
| | - Susanne B Votruba
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, US
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, US
| | - Paolo Piaggi
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, US
- Department of Information Engineering, University of Pisa, Pisa, Italy
- Correspondence and Reprint Requests: Paolo Piaggi, PhD, Obesity and Diabetes Clinical Research Section, NIDDK, NIH, 4212 North 16th Street, Phoenix, AZ 85016. E-mail: ;
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Tanik N, Saçmaci H, Aktürk T. The relationship between exposure to hot/cold weather and the clinical features of headaches in patients with migraine and tension-type headaches. Neurol Res 2020; 42:239-243. [PMID: 32048556 DOI: 10.1080/01616412.2020.1723300] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background and purpose: This study investigates the relationship between exposure to hot/cold weather and the characteristic clinical features of headaches in patients with migraine and tension-type headaches.Methods: This cross-sectional study was conducted with the participation of 190 patients with migraine, and 140 patients with tension-type headaches. The patients were evaluated using a form that collected data on their sociodemographic profile, the clinical features of their headaches, any accompanying symptoms and their relationships with changes in the weather (hot/cold). The headaches of all the participants in the study were thought to be triggered by exposure to hot/cold weather.Results: In the patients with migraine, the exposure to hot/cold weather as a trigger was not found to have a significant relationship with age, body mass index or the characteristic clinical features of headaches (p > 0.05). In patients with tension-type headaches, exposure to hot/cold weather as a trigger was found to have a significant relationship with body mass index (p = 0.019), but not with age or the characteristic clinical features of headaches (p > 0.05).Conclusions: In obese patients with tension-type headache, it was found that hot weather triggered headache more than cold weather. In patients with migraine and tension-type headaches, no relationship was found between exposure to hot/cold weather as a trigger and the clinical features of headaches. The accurate identification of the factors precipitating headaches by both clinicians and patients can help lower the frequency of headaches.
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Affiliation(s)
- Nermin Tanik
- Assoc. Prof. MD, Yozgat Bozok University Medical School, Department of Neurology, Turkey
| | - Hikmet Saçmaci
- Assist. Prof. MD, Yozgat Bozok University Medical School, Department of Neurology, Turkey
| | - Tülin Aktürk
- Assist. Prof. MD, Yozgat Bozok University Medical School, Department of Neurology, Turkey
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Chamarthi B, Vinik A, Ezrokhi M, Cincotta AH. Circadian-timed quick-release bromocriptine lowers elevated resting heart rate in patients with type 2 diabetes mellitus. Endocrinol Diabetes Metab 2020; 3:e00101. [PMID: 31922028 PMCID: PMC6947713 DOI: 10.1002/edm2.101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 09/09/2019] [Accepted: 10/20/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Sympathetic nervous system (SNS) overactivity is a risk factor for insulin resistance and cardiovascular disease (CVD). We evaluated the impact of bromocriptine-QR, a dopamine-agonist antidiabetes medication, on elevated resting heart rate (RHR) (a marker of SNS overactivity in metabolic syndrome), blood pressure (BP) and the relationship between bromocriptine-QR's effects on RHR and HbA1c in type 2 diabetes subjects. DESIGN AND SUBJECTS RHR and BP changes were evaluated in this post hoc analysis of data from a randomized controlled trial in 1014 type 2 diabetes subjects randomized to bromocriptine-QR vs placebo added to standard therapy (diet ± ≤2 oral antidiabetes medications) for 24 weeks without concomitant antihypertensive or antidiabetes medication changes, stratified by baseline RHR (bRHR). RESULTS In subjects with bRHR ≥70 beats/min, bromocriptine-QR vs placebo reduced RHR by -3.4 beats/min and reduced BP (baseline 130/79; systolic, diastolic, mean arterial BP reductions [mm Hg]: -3.6 [P = .02], -1.9 [P = .05], -2.5 [P = .02]). RHR reductions increased with higher baseline HbA1c (bHbA1c) (-2.7 [P = .03], -5 [P = .002], -6.1 [P = .002] with bHbA1c ≤7, >7, ≥7.5%, respectively] in the bRHR ≥70 group and more so with bRHR ≥80 (-4.5 [P = .07], -7.8 [P = .015], -9.9 [P = .005]). Subjects with bRHR <70 had no significant change in RHR or BP. With bHbA1c ≥7.5%, %HbA1c reductions with bromocriptine-QR vs placebo were -0.50 (P = .04), -0.73 (P = .005) and -1.22 (P = .008) with bRHR <70, ≥70 and ≥80, respectively. With bRHR ≥70, the magnitude of bromocriptine-QR-induced RHR reduction was an independent predictor of bromocriptine-QR's HbA1c lowering effect. CONCLUSION Bromocriptine-QR lowers elevated RHR with concurrent decrease in BP and hyperglycaemia. These findings suggest a potential sympatholytic mechanism contributing to bromocriptine-QR's antidiabetes effect and potentially its previously demonstrated effect to reduce CVD events.
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Affiliation(s)
| | - Aaron Vinik
- Eastern Virginia Medical School Strelitz Diabetes CenterNorfolkVirginia
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Shama N, Kumari R, Bais S, Shrivastava A. Some important peptides and their role in obesity-current insights. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.obmed.2019.100144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Benign prostate hyperplasia and nutrition. Clin Nutr ESPEN 2019; 33:5-11. [DOI: 10.1016/j.clnesp.2019.07.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/07/2019] [Accepted: 07/27/2019] [Indexed: 11/20/2022]
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Saad M, Ray LB, Bujaki B, Parvaresh A, Palamarchuk I, De Koninck J, Douglass A, Lee EK, Soucy LJ, Fogel S, Morin CM, Bastien C, Merali Z, Robillard R. Using heart rate profiles during sleep as a biomarker of depression. BMC Psychiatry 2019; 19:168. [PMID: 31174510 PMCID: PMC6554996 DOI: 10.1186/s12888-019-2152-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/20/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Abnormalities in heart rate during sleep linked to impaired neuro-cardiac modulation may provide new information about physiological sleep signatures of depression. This study assessed the validity of an algorithm using patterns of heart rate changes during sleep to discriminate between individuals with depression and healthy controls. METHODS A heart rate profiling algorithm was modeled using machine-learning based on 1203 polysomnograms from individuals with depression referred to a sleep clinic for the assessment of sleep abnormalities, including insomnia, excessive daytime fatigue, and sleep-related breathing disturbances (n = 664) and mentally healthy controls (n = 529). The final algorithm was tested on a distinct sample (n = 174) to categorize each individual as depressed or not depressed. The resulting categorizations were compared to medical record diagnoses. RESULTS The algorithm had an overall classification accuracy of 79.9% [sensitivity: 82.8, 95% CI (0.73-0.89), specificity: 77.0, 95% CI (0.67-0.85)]. The algorithm remained highly sensitive across subgroups stratified by age, sex, depression severity, comorbid psychiatric illness, cardiovascular disease, and smoking status. CONCLUSIONS Sleep-derived heart rate patterns could act as an objective biomarker of depression, at least when it co-occurs with sleep disturbances, and may serve as a complimentary objective diagnostic tool. These findings highlight the extent to which some autonomic functions are impaired in individuals with depression, which warrants further investigation about potential underlying mechanisms.
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Affiliation(s)
- Mysa Saad
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38Department of Cellular and Molecular Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5 Canada
| | - Laura B. Ray
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Brad Bujaki
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 1503 7525grid.414622.7Sleep Clinic, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Amir Parvaresh
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Iryna Palamarchuk
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Joseph De Koninck
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5 Canada
| | - Alan Douglass
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 1503 7525grid.414622.7Sleep Clinic, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38Department of Psychiatry, University of Ottawa, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Elliott K. Lee
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 1503 7525grid.414622.7Sleep Clinic, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38Department of Psychiatry, University of Ottawa, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Louis J. Soucy
- 0000 0001 1503 7525grid.414622.7Sleep Clinic, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38Department of Psychiatry, University of Ottawa, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Stuart Fogel
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5 Canada
| | - Charles M. Morin
- 0000 0001 0621 4067grid.420732.0Centre d’étude des troubles du sommeil, Centre de recherche de l’institut universitaire en santé mentale de Québec, 2525 boulevard de la Canardière, Québec, QC G1J 2G3 Canada
| | - Célyne Bastien
- 0000 0004 1936 8390grid.23856.3aSchool of Psychology, Université Laval, 2325 rue des Bibliothèques, Québec, QC G1V 0A6 Canada ,CERVO Brain Research Centre, 2601 Chemin de la Canardière, Québec, QC G1J 2G3 Canada
| | - Zul Merali
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38Department of Cellular and Molecular Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5 Canada
| | - Rébecca Robillard
- Sleep Research Unit, The Royal's Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada. .,School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada.
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Lundqvist MH, Almby K, Abrahamsson N, Eriksson JW. Is the Brain a Key Player in Glucose Regulation and Development of Type 2 Diabetes? Front Physiol 2019; 10:457. [PMID: 31133864 PMCID: PMC6524713 DOI: 10.3389/fphys.2019.00457] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/01/2019] [Indexed: 01/08/2023] Open
Abstract
Ever since Claude Bernards discovery in the mid 19th-century that a lesion in the floor of the third ventricle in dogs led to altered systemic glucose levels, a role of the CNS in whole-body glucose regulation has been acknowledged. However, this finding was later overshadowed by the isolation of pancreatic hormones in the 20th century. Since then, the understanding of glucose homeostasis and pathology has primarily evolved around peripheral mechanism. Due to scientific advances over these last few decades, however, increasing attention has been given to the possibility of the brain as a key player in glucose regulation and the pathogenesis of metabolic disorders such as type 2 diabetes. Studies of animals have enabled detailed neuroanatomical mapping of CNS structures involved in glucose regulation and key neuronal circuits and intracellular pathways have been identified. Furthermore, the development of neuroimaging techniques has provided methods to measure changes of activity in specific CNS regions upon diverse metabolic challenges in humans. In this narrative review, we discuss the available evidence on the topic. We conclude that there is much evidence in favor of active CNS involvement in glucose homeostasis but the relative importance of central vs. peripheral mechanisms remains to be elucidated. An increased understanding of this field may lead to new CNS-focusing pharmacologic strategies in the treatment of type 2 diabetes.
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Affiliation(s)
| | - Kristina Almby
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Jan W Eriksson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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von Schnurbein J, Manzoor J, Brandt S, Denzer F, Kohlsdorf K, Fischer-Posovszky P, Weißenberger M, Frank-Podlech S, Mahmood S, Wabitsch M. Leptin Is Not Essential for Obesity-Associated Hypertension. Obes Facts 2019; 12:460-475. [PMID: 31357197 PMCID: PMC6758712 DOI: 10.1159/000501319] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/03/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Hyperleptinemia is supposed to play a causal role in the development of obesity-associated hypertension, possibly via increased sympathetic tone. Hence patients with congenital leptin deficiency should be hypotensive and their low blood pressure should increase under leptin substitution. SUBJECTS AND METHODS To test this assumption, we examined ambulatory blood pressure, resting heart rate, Schellong test results, cold pressor test results, heart rate variability, catecholamine metabolites, and aldosterone levels in 6 patients with congenital leptin deficiency before as well as 2-7 days and 7-14 months after the start of leptin substitution. Ambulatory blood pressure was also examined in 3 patients with biallelic disease-causing variants in the leptin receptor gene. RESULTS Contrary to our expectations, even before leptin substitution, 1 patient with biallelic leptin receptor gene variants and 4 patients with leptin deficiency had been suffering from hypertension. Short-term substitution with leptin increased blood pressure further in 3 out of 4 patients (from 127.0 ± 11.7 to 133.8 ± 10.6 mm Hg), concomitant with an increase in resting heart rate as well as in heart rate during the Schellong test in all patients (from 87.6 ± 7.7 to 99.9 ± 11.0 bpm, p = 0.031, and from 102.9 ± 13.5 to 115.6 ± 11.3 bpm, p = 0.031, respectively). Furthermore, the systolic blood pressure response during the cold pressor test increased in 4 out of 6 patients. Unexpectedly, catecholamine metabolites and aldosterone levels did not increase. After long-term leptin substitution and weight loss, the resting heart rate decreased in 4 out of 6 patients compared to baseline, and in all patients below the heart rate seen immediately after the start of therapy (from 99.9 ± 11.0 to 81.7 ± 5.4 bpm; p = 0.031). CONCLUSIONS These results show that obesity-associated hypertension does not depend on the presence of leptin. However, short-term leptin substitution can increase the blood pressure and heart rate in obese humans with leptin deficiency, indicating that leptin plays at least an additive role in obesity-associated hypertension. The mechanisms behind this are not clear but might include an increase in regional sympathetic tone.
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Affiliation(s)
- Julia von Schnurbein
- Division of Pediatric Endocrinology and Diabetes, Ulm University Hospital, Ulm, Germany
- *Dr. Julia von Schnurbein or Prof. Dr. Martin Wabitsch, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University of Ulm, Eythstrasse 24, DE–89075 Ulm (Germany), E-Mail or
| | - Jaida Manzoor
- The Children's Hospital and Institute of Child Health, Lahore, Pakistan
| | - Stephanie Brandt
- Division of Pediatric Endocrinology and Diabetes, Ulm University Hospital, Ulm, Germany
| | - Friederike Denzer
- Division of Pediatric Endocrinology and Diabetes, Ulm University Hospital, Ulm, Germany
| | - Katja Kohlsdorf
- Division of Pediatric Endocrinology and Diabetes, Ulm University Hospital, Ulm, Germany
| | | | - Mario Weißenberger
- Division of Pediatric Endocrinology and Diabetes, Ulm University Hospital, Ulm, Germany
| | - Sabine Frank-Podlech
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, German Center for Diabetes Research (DZD), Tübingen, Germany
- Department of Internal Medicine IV, University Hospital, Tübingen, Germany
| | - Saqib Mahmood
- Department of Human Genetics and Molecular Biology, University of Health Sciences Lahore, Lahore, Pakistan
| | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Ulm University Hospital, Ulm, Germany
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Futtrup J, Nordentoft M, Elfving B, Krogh J. The association between norepinephrine and metabolism in patients with major depression. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.npbr.2018.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Yin X, Qian J, Wang Y, Yang C, Jia B, Cheng Y, Yu G, Wang Y. Short-term outcome and early effect on blood pressure of laparoscopic sleeve gastrectomy in morbidly obese patients. Clin Exp Hypertens 2018; 41:622-626. [PMID: 30373398 DOI: 10.1080/10641963.2018.1529775] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Xiaoqiang Yin
- The Second Affiliated Hospital, Anhui Medical University, China
| | - Jin Qian
- The Second Affiliated Hospital, Anhui Medical University, China
| | - Yang Wang
- The Second Affiliated Hospital, Anhui Medical University, China
| | - Chuang Yang
- The Second Affiliated Hospital, Anhui Medical University, China
| | - Benli Jia
- The Second Affiliated Hospital, Anhui Medical University, China
| | - Yunsheng Cheng
- The Second Affiliated Hospital, Anhui Medical University, China
| | - Gang Yu
- The Second Affiliated Hospital, Anhui Medical University, China
| | - Yong Wang
- The Second Affiliated Hospital, Anhui Medical University, China
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Looking for new diagnostic tools and biomarkers of hypertension in obese pediatric patients. Blood Press Monit 2018; 22:122-130. [PMID: 28272108 DOI: 10.1097/mbp.0000000000000242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Development of obesity in childhood may be linked to an increased risk of hypertension. OBJECTIVES This study aimed (a) to analyze the expression of genes associated with blood pressure (BP) in obese children, (b) to evaluate ambulatory blood pressure monitoring (ABPM) as a diagnostic tool in hypertension in children, and (c) to assess the prevalence of metabolic syndrome in children with obesity. PATIENTS AND METHODS Office BP measurements and ABPM were performed in 49 children with obesity and 25 age-matched healthy children. Expressions of 12 monogenic hypertension genes and 45 genes variants associated with BP were assessed using the microarray technique. RESULTS No significant differences in gene expression levels were found. Children with obesity had significantly higher (P<0.001) mean office systolic and diastolic BPs compared with the controls. The diagnosis of high normal BP and hypertension with ABPM was established in 27 and 33% of children, respectively. Nocturnal BP decrease less than 10% was found in 27% of children, whereas nocturnal BP decrease more than 20% was found in 13% of children. Nocturnal BP increase was found in 13% of patients. The diagnosis of metabolic syndrome was established in 29% of obese patients. CONCLUSION The following can be concluded: (a) the prevalence of metabolic syndrome was found in nearly one-third of children with obesity. (b) ABPM is a useful and reliable tool in the diagnostics of pediatric hypertension. Abnormal BP can be observed in ∼50% of obese children.
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Obermeyer Z, Samra JK, Mullainathan S. Individual differences in normal body temperature: longitudinal big data analysis of patient records. BMJ 2017; 359:j5468. [PMID: 29237616 PMCID: PMC5727437 DOI: 10.1136/bmj.j5468] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To estimate individual level body temperature and to correlate it with other measures of physiology and health. DESIGN Observational cohort study. SETTING Outpatient clinics of a large academic hospital, 2009-14. PARTICIPANTS 35 488 patients who neither received a diagnosis for infections nor were prescribed antibiotics, in whom temperature was expected to be within normal limits. MAIN OUTCOME MEASURES Baseline temperatures at individual level, estimated using random effects regression and controlling for ambient conditions at the time of measurement, body site, and time factors. Baseline temperatures were correlated with demographics, medical comorbidities, vital signs, and subsequent one year mortality. RESULTS In a diverse cohort of 35 488 patients (mean age 52.9 years, 64% women, 41% non-white race) with 243 506 temperature measurements, mean temperature was 36.6°C (95% range 35.7-37.3°C, 99% range 35.3-37.7°C). Several demographic factors were linked to individual level temperature, with older people the coolest (-0.021°C for every decade, P<0.001) and African-American women the hottest (versus white men: 0.052°C, P<0.001). Several comorbidities were linked to lower temperature (eg, hypothyroidism: -0.013°C, P=0.01) or higher temperature (eg, cancer: 0.020, P<0.001), as were physiological measurements (eg, body mass index: 0.002 per m/kg2, P<0.001). Overall, measured factors collectively explained only 8.2% of individual temperature variation. Despite this, unexplained temperature variation was a significant predictor of subsequent mortality: controlling for all measured factors, an increase of 0.149°C (1 SD of individual temperature in the data) was linked to 8.4% higher one year mortality (P=0.014). CONCLUSIONS Individuals' baseline temperatures showed meaningful variation that was not due solely to measurement error or environmental factors. Baseline temperatures correlated with demographics, comorbid conditions, and physiology, but these factors explained only a small part of individual temperature variation. Unexplained variation in baseline temperature, however, strongly predicted mortality.
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Affiliation(s)
- Ziad Obermeyer
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Emergency Medicine and Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Jasmeet K Samra
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
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Abstract
Obesity continues to increase in prevalence worldwide. Hypertension has long been associated with obesity, and weight loss continues to be a first-line therapy in the treatment of hypertension. Lifestyle modification and pharmacologic therapy, however, often meet with treatment failure. Bariatric surgery continues to be the most successful approach to sustained weight loss. This review focuses on the underlying physiologic mechanisms of obesity-hypertension, and the impact of bariatric surgery on the treatment of hypertension. Current available literature on the physiologic mechanisms of obesity-hypertension, and the major trials, meta-analyses and systematic reviews of the impact of bariatric surgery procedures on hypertension are reviewed. Evidence suggests significant improvement in obesity-hypertension in patients who undergo surgical weight-reduction procedures. Malabsorptive techniques such as the Roux-en-Y gastric bypass or surgical resection techniques such as laparoscopic sleeve gastrectomy appear to offer superior results in regards to hypertension control over restrictive techniques such as Gastric Banding. Though long-term control of hypertension following surgery remains a concern, available follow-up post-operative data of up to 10 years suggests a sustained, if lessened, effect on hypertension control over time.
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Affiliation(s)
- Jonathan G Owen
- LSUHSC Department of Medicine, Section of Nephrology and Hypertension, USA
| | - Farshid Yazdi
- LSUHSC Department of Medicine, Section of Nephrology and Hypertension, USA
| | - Efrain Reisin
- LSUHSC Department of Medicine, Section of Nephrology and Hypertension, USA
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The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins. Hypertens Res 2017; 40:947-963. [DOI: 10.1038/hr.2017.75] [Citation(s) in RCA: 169] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/07/2017] [Accepted: 04/14/2017] [Indexed: 02/07/2023]
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Body weight-dependent relationships between alcohol consumption and pulse pressure in middle-aged Japanese women. ACTA ACUST UNITED AC 2017; 11:801-810.e2. [PMID: 29102320 DOI: 10.1016/j.jash.2017.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/22/2017] [Accepted: 09/24/2017] [Indexed: 11/23/2022]
Abstract
High pulse pressure is a risk factor for cardiovascular disease, and excessive alcohol drinking increases the risk of hypertension. The purpose of this study was to elucidate the relationship between alcohol intake and pulse pressure in women and to determine whether body weight influences their relationship. The subjects were 18,791 Japanese middle-aged women, and they were divided into tertile groups for body weight or three different body mass index (BMI, kg/m2) groups (low BMI <22; middle BMI ≥22 and <25; high BMI ≥25). The subjects in each group were further divided into four groups of nondrinkers, occasional drinkers, regular light drinkers, and regular heavy drinkers by habitual alcohol consumption. Pulse pressure levels were compared between nondrinkers and drinkers in each group for body weight or BMI. Pulse pressure was significantly higher in regular heavy drinkers than in nondrinkers in the first tertile group for body weight and in the low BMI group but not in the second and third tertile groups for body weight and in the middle and high BMI groups. In all tertile groups and all BMI groups, pulse pressure was not significantly different in occasional drinkers and regular light drinkers than in nondrinkers. In women with lower body weight, heavy drinking was positively associated with pulse pressure, while this association was not found in women with middle or higher body weight. Thus, body weight potently confounds the relationship between alcohol consumption and pulse pressure.
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Temporal stability and drivers of change in cardiac autonomic nervous system activity. Auton Neurosci 2017; 208:117-125. [PMID: 28774803 DOI: 10.1016/j.autneu.2017.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/21/2017] [Accepted: 07/24/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study determined temporal stability of ambulatory measured cardiac autonomic activity for different time periods and investigated potential drivers of changes in this activity. METHODS Data was drawn from baseline (n=2379), 2-year (n=2245), and 6-year (n=1876) follow-up from the Netherlands Study of Depression and Anxiety. Cardiac autonomic activity was measured with heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP). Autonomic temporal stability was determined across 2, 4, and 6year intervals. We subsequently examined the association between sociodemographics, lifestyle, mental health, cardiometabolic health, and the use of antidepressant and cardiac medication with change in cardiac autonomic activity. RESULTS Over 2years, stability was good for HR (ICC=0.703), excellent for RSA (ICC=0.792) and moderate for PEP (ICC=0.576). Stability decreased for a 4- (HR ICC=0.688, RSA ICC=0.652 and PEP ICC=0.387) and 6-year interval (HR ICC=0.633, RSA ICC=0.654 and PEP ICC=0.355). The most important determinants for increase in HR were (increase in) smoking, increase in body mass index (BMI) and (starting) the use of antidepressants. Beta-blocking/antiarrhythmic drug use led to a decrease in HR. Decrease in RSA was associated with age, smoking and (starting) antidepressant use. Decrease in PEP was associated with age and (increase in) BMI. CONCLUSIONS Cardiac autonomic measures were rather stable over 2years, but stability decreased with increasing time span. Determinants contributing to cardiac autonomic deterioration were older age, (increase in) smoking and BMI, and (starting) the use of antidepressants. (Starting) the use of cardiac medication improved autonomic function.
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Di Meo S, Iossa S, Venditti P. Skeletal muscle insulin resistance: role of mitochondria and other ROS sources. J Endocrinol 2017; 233:R15-R42. [PMID: 28232636 DOI: 10.1530/joe-16-0598] [Citation(s) in RCA: 205] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 01/31/2017] [Indexed: 12/12/2022]
Abstract
At present, obesity is one of the most important public health problems in the world because it causes several diseases and reduces life expectancy. Although it is well known that insulin resistance plays a pivotal role in the development of type 2 diabetes mellitus (the more frequent disease in obese people) the link between obesity and insulin resistance is yet a matter of debate. One of the most deleterious effects of obesity is the deposition of lipids in non-adipose tissues when the capacity of adipose tissue is overwhelmed. During the last decade, reduced mitochondrial function has been considered as an important contributor to 'toxic' lipid metabolite accumulation and consequent insulin resistance. More recent reports suggest that mitochondrial dysfunction is not an early event in the development of insulin resistance, but rather a complication of the hyperlipidemia-induced reactive oxygen species (ROS) production in skeletal muscle, which might promote mitochondrial alterations, lipid accumulation and inhibition of insulin action. Here, we review the literature dealing with the mitochondria-centered mechanisms proposed to explain the onset of obesity-linked IR in skeletal muscle. We conclude that the different pathways leading to insulin resistance may act synergistically because ROS production by mitochondria and other sources can result in mitochondrial dysfunction, which in turn can further increase ROS production leading to the establishment of a harmful positive feedback loop.
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Affiliation(s)
- Sergio Di Meo
- Department of BiologyUniversity of Naples 'Federico II', Naples, Italy
| | - Susanna Iossa
- Department of BiologyUniversity of Naples 'Federico II', Naples, Italy
| | - Paola Venditti
- Department of BiologyUniversity of Naples 'Federico II', Naples, Italy
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Christou GA, Kiortsis DN. The effects of body weight status on orthostatic intolerance and predisposition to noncardiac syncope. Obes Rev 2017; 18:370-379. [PMID: 28112481 DOI: 10.1111/obr.12501] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/07/2016] [Accepted: 11/24/2016] [Indexed: 12/16/2022]
Abstract
Orthostatic intolerance (OI) is frequently the mechanism underlying the occurrence of noncardiac syncope (NCS) and is associated with substantial risk for injury. Body weight status appears to be a modifier of orthostatic responses and possibly influences the propensity to NCS. The majority of cross-sectional studies have found that the lower the body mass index (BMI) the greater the predisposition to OI is, accompanied with both down-regulation of sympathetic nervous system activity and up-regulation of parasympathetic nervous system activity. These changes appear to occur across the whole spectrum of BMI values from underweight to obesity, while they may be associated more strongly with central body fat than total body fat. Weight loss following bariatric surgery has been consistently found to increase OI, attributed first to the effects of weight loss per se, second to the specific type of surgical procedure and third to the potential postoperative autonomic neuropathy due to vitamin deficiency. The increased OI following bariatric surgery renders this intervention not easily tolerable for the affected individuals, mandating increased fluid and salt intake, pharmacological measures or surgical adjustments to attenuate OI. All future studies investigating orthostatic responses and NCS should implement a matching of the population arms for BMI and ideally for body fat.
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Affiliation(s)
- G A Christou
- Laboratory of Physiology, Medical School, University of Ioannina, Ioannina, Greece
| | - D N Kiortsis
- Laboratory of Physiology, Medical School, University of Ioannina, Ioannina, Greece
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Cabandugama PK, Gardner MJ, Sowers JR. The Renin Angiotensin Aldosterone System in Obesity and Hypertension: Roles in the Cardiorenal Metabolic Syndrome. Med Clin North Am 2017; 101:129-137. [PMID: 27884224 PMCID: PMC5125542 DOI: 10.1016/j.mcna.2016.08.009] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In the United States, more than 50 million people have blood pressure at or above 120/80 mm Hg. All components of cardiorenal metabolic syndrome (CRS) are linked to metabolic abnormalities and obesity. A major driver for CRS is obesity. Current estimates show that many of those with hypertension and CRS show some degree of systemic and cardiovascular insulin resistance. Several pathophysiologic factors participate in the link between hypertension and CRS. This article updates recent literature with a focus on the function of insulin resistance, obesity, and renin angiotensin aldosterone system-mediated oxidative stress on endothelial dysfunction and the pathogenesis of hypertension.
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Affiliation(s)
- Peminda K Cabandugama
- Division of Endocrinology, Department of Medicine, Diabetes and Cardiovascular Center, University of Missouri, D109 Diabetes Center UHC, One Hospital Drive, Columbia, MO 65212, USA
| | - Michael J Gardner
- Division of Endocrinology, Department of Medicine, Diabetes and Cardiovascular Center, University of Missouri, D109 Diabetes Center UHC, One Hospital Drive, Columbia, MO 65212, USA
| | - James R Sowers
- Division of Endocrinology, Department of Medicine, Diabetes and Cardiovascular Center, University of Missouri, D109 Diabetes Center UHC, One Hospital Drive, Columbia, MO 65212, USA; Department of Physiology and Pharmacology, University of Missouri, One Hospital Drive, Columbia, MO 65212, USA; Harry S. Truman VA Hospital, 800 Hospital Drive, Columbia, MO 65201, USA.
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Conceição EPS, Moura EG, Oliveira E, Guarda DS, Figueiredo MS, Quitete FT, Calvino C, Miranda RA, Mathias PCF, Manhães AC, Lisboa PC. Dietary calcium supplementation in adult rats reverts brown adipose tissue dysfunction programmed by postnatal early overfeeding. J Nutr Biochem 2017; 39:117-125. [DOI: 10.1016/j.jnutbio.2016.09.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 07/05/2016] [Accepted: 09/02/2016] [Indexed: 11/28/2022]
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An association between diet, metabolic syndrome and lower urinary tract symptoms. AFRICAN JOURNAL OF UROLOGY 2016. [DOI: 10.1016/j.afju.2015.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Shi Y, Shu ZJ, Xue X, Yeh CK, Katz MS, Kamat A. β2-Adrenergic receptor ablation modulates hepatic lipid accumulation and glucose tolerance in aging mice. Exp Gerontol 2016; 78:32-8. [PMID: 26952573 DOI: 10.1016/j.exger.2016.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/02/2016] [Accepted: 03/03/2016] [Indexed: 01/10/2023]
Abstract
Catecholamines acting through β-adrenergic receptors (β(1)-, β(2)-, β(3)-AR subtypes) modulate important biological responses in various tissues. Our previous studies suggest a role for increased hepatic β-AR-mediated signaling during aging as a mediator of hepatic steatosis, liver glucose output, and insulin resistance in rodents. In the current study, we have utilized β(2)-AR knockout (KO) and wildtype (WT) control mice to define further the role of β(2)-AR signaling during aging on lipid and glucose metabolism. Our results demonstrate for the first time that age-related increases in hepatic triglyceride accumulation and body weight are attenuated upon β(2)-AR ablation. Although no differences in plasma triglyceride, non-esterified fatty acids or insulin levels were detected between old WT and KO animals, an age-associated increase in hepatic expression of lipid homeostasis regulator Cidea was significantly reduced in old KO mice. Interestingly, we also observed a shift from reduced glucose tolerance in young adult KO animals to significantly improved glucose tolerance in old KO when compared to age-matched WT mice. These results provide evidence for an important role played by β(2)-ARs in the regulation of lipid and glucose metabolism during aging. The effect of β(2)-AR ablation on caloric intake during aging is currently not known and requires investigation. Future studies are also warranted to delineate the β(2)-AR-mediated mechanisms involved in the control of lipid and glucose homeostasis, especially in the context of a growing aging population.
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Affiliation(s)
- Yun Shi
- Geriatric Research, Education and Clinical Center, Audie L. Murphy Division, South Texas Veterans Health Care System, San Antonio, TX 78229, USA; Department of Medicine, University of Texas Health Science Center at San Antonio, TX 78229, USA.
| | - Zhen-Ju Shu
- Geriatric Research, Education and Clinical Center, Audie L. Murphy Division, South Texas Veterans Health Care System, San Antonio, TX 78229, USA; Department of Medicine, University of Texas Health Science Center at San Antonio, TX 78229, USA.
| | - Xiaoling Xue
- Geriatric Research, Education and Clinical Center, Audie L. Murphy Division, South Texas Veterans Health Care System, San Antonio, TX 78229, USA; Department of Medicine, University of Texas Health Science Center at San Antonio, TX 78229, USA.
| | - Chih-Ko Yeh
- Geriatric Research, Education and Clinical Center, Audie L. Murphy Division, South Texas Veterans Health Care System, San Antonio, TX 78229, USA; Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, TX 78229, USA; Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, TX 78229, USA.
| | - Michael S Katz
- Geriatric Research, Education and Clinical Center, Audie L. Murphy Division, South Texas Veterans Health Care System, San Antonio, TX 78229, USA; Department of Medicine, University of Texas Health Science Center at San Antonio, TX 78229, USA; Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, TX 78229, USA.
| | - Amrita Kamat
- Geriatric Research, Education and Clinical Center, Audie L. Murphy Division, South Texas Veterans Health Care System, San Antonio, TX 78229, USA; Department of Medicine, University of Texas Health Science Center at San Antonio, TX 78229, USA; Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, TX 78229, USA.
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Seravalle G, Grassi G. Sympathetic Nervous System, Hypertension, Obesity and Metabolic Syndrome. High Blood Press Cardiovasc Prev 2016; 23:175-9. [DOI: 10.1007/s40292-016-0137-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 02/26/2016] [Indexed: 11/29/2022] Open
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Abstract
As the development of hypertension and target organ damage becomes more prevalent, it becomes exceedingly important to determine the underlying mechanisms through which this detrimental development occurs. Specifically, our studies and others have explored mechanisms through which stress elicits a salt-sensitive response in approximately 20-30 % of the population, resulting in the early development of hypertension and target organ damage. Data associated with this stress-induced cardiovascular response pattern have recently demonstrated additional effects across the body systems including factors contributing to the development of osteoporosis, obesity, autoimmune disease, and chronic inflammation. As each of these diseases become more prevalent in conjunction with hypertension, further research may discover stress and salt sensitivity to be at the "heart" of the matter for the development of many of today's most deadly conditions.
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Triggiani AI, Valenzano A, Ciliberti MAP, Moscatelli F, Villani S, Monda M, Messina G, Federici A, Babiloni C, Cibelli G. Heart rate variability is reduced in underweight and overweight healthy adult women. Clin Physiol Funct Imaging 2015. [PMID: 26211739 DOI: 10.1111/cpf.12281] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Heart rate variability (HRV) is altered in obese subjects, but whether this is true also in underweight (UW) subjects is still under debate. We investigated the HRV profile in a sample of healthy adult women and its association with adiposity. Five-minute resting state electrocardiographic activity was recorded in 69 subjects grouped according to their body mass index, [23 normal weight (NW), 23 overweight/obese (OW) and 23 UW). Body fat mass (FM) was measured by bio-impedance. Frequency- and time-domain analyses were performed. Compared to NW, UW and OW subjects showed a significant decrease in HRV indices, as revealed by spectral analysis. No differences were observed between UW and OW subjects. A second-order polynomial regression unveiled an inverted U-shaped relationship between FM extent and HRV indices. A decrease of HRV indices was associated with changes in FM extent, proving that in UW and OW subjects, the adaptive flexibility of autonomic cardiac function was reduced. These findings provide important clues to guide future studies addressed to determine how changes in adiposity and autonomic cardiac function may contribute to health risk.
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Affiliation(s)
| | - Anna Valenzano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | - Fiorenzo Moscatelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.,Department of Motor, Human and Health Science, University of Rome "Foro Italico", Rome, Italy
| | | | - Marcellino Monda
- Department of Experimental Medicine, Section of Human Physiology and Unit of dietetic and sports medicine, Second University of Naples, Naples, Italy
| | - Giovanni Messina
- Department of Experimental Medicine, Section of Human Physiology and Unit of dietetic and sports medicine, Second University of Naples, Naples, Italy
| | - Antonio Federici
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Claudio Babiloni
- Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy.,IRCCS San Raffaele Pisana, Rome, Italy
| | - Giuseppe Cibelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Owen JG, Reisin E. Anti-hypertensive Drug Treatment of Patients with and the Metabolic Syndrome and Obesity: a Review of Evidence, Meta-Analysis, Post hoc and Guidelines Publications. Curr Hypertens Rep 2015; 17:558. [DOI: 10.1007/s11906-015-0558-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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43
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Hillebrand S, Swenne CA, Gast KB, Maan AC, le Cessie S, Jukema JW, Rosendaal FR, den Heijer M, de Mutsert R. The role of insulin resistance in the association between body fat and autonomic function. Nutr Metab Cardiovasc Dis 2015; 25:93-99. [PMID: 25171899 DOI: 10.1016/j.numecd.2014.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 07/21/2014] [Accepted: 07/22/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIM Excess body fat is associated with altered autonomic function. We investigated whether this association is mediated by insulin resistance. METHODS AND RESULTS Cross-sectional analysis of a subgroup of the Netherlands Epidemiology of Obesity study with measurements of autonomic function (heart rate variability calculated as mean interbeat interval, standard deviation of all normal intervals (SDNN), low frequency (LF) power and high frequency (HF) power). We measured BMI(kg/m²), total body fat(%) and waist circumference(cm), and calculated the HOMA-index of insulin resistance (HOMA-IR). We examined the association between body fat and heart rate variability with multivariate linear regression analysis. To investigate whether the association was mediated by insulin resistance, we additionally adjusted for HOMA-IR. After exclusion of participants with glucose lowering medication (n = 19), 466 participants were included. Per SD of BMI, the difference in SDNN was -2.7% (95%CI: -5.5, 0.1) in the multivariate model. Additional adjustment for HOMA-IR attenuated this association to -1.2% (95%CI: -4.2, 1.7), suggesting that 55% of the association between BMI and SDNN was mediated by HOMA-IR. All measures of body fat were associated with mean interbeat interval, SDNN and LF power. Depending on the parameter of body fat or heart rate variability, 29-81% of the association was mediated by HOMA-IR. CONCLUSION In this cross-sectional study, body fat was associated with heart rate variability. This association may at least partially be mediated by insulin resistance. Future studies should investigate whether a reduction in obesity and insulin resistance may prevent the adverse cardiovascular consequences of altered autonomic function.
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Affiliation(s)
- S Hillebrand
- Department of Clinical Epidemiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands.
| | - C A Swenne
- Department of Cardiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - K B Gast
- Department of Clinical Epidemiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands; Department of Internal Medicine, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - A C Maan
- Department of Cardiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - S le Cessie
- Department of Clinical Epidemiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands; Department of Medical Statistics, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - J W Jukema
- Department of Cardiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, PO Box 19258, 3501 DG Utrecht, The Netherlands
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands; Department of Thrombosis and Hemostasis, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - M den Heijer
- Department of Clinical Epidemiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands; Department of Internal Medicine, VU Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands
| | - R de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands
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De Frène V, Vansteelandt S, T'Sjoen G, Gerris J, Somers S, Vercruysse L, De Sutter P. A retrospective study of the pregnancy, delivery and neonatal outcome in overweight versus normal weight women with polycystic ovary syndrome. Hum Reprod 2014; 29:2333-8. [PMID: 24963163 DOI: 10.1093/humrep/deu154] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
STUDY QUESTION Do overweight women with polycystic ovary syndrome (PCOS) have a higher risk of perinatal complications than normal weight women with PCOS? SUMMARY ANSWER Overweight women with PCOS with an ongoing singleton pregnancy have an increased risk of preterm birth as well as an increased risk of giving birth to a baby with a higher birthweight than normal weight women with PCOS. WHAT IS KNOWN ALREADY There is evidence that overweight (BMI > 25 kg/m²) has a negative influence on the prevalence of gestational diabetes mellitus and fetal macrosomia in women with PCOS. STUDY DESIGN, SIZE, DURATION We set up a retrospective comparative cohort study of 93 overweight (BMI ≥ 25 kg/m²) and 107 normal weight (BMI < 25 kg/m²) women with PCOS who were scheduled for fertility treatment between January 2000 and December 2009 and achieved a pregnancy as a result of a treatment cycle, or spontaneously before or between treatment cycles. PARTICIPANTS/MATERIALS, SETTING, METHODS All data (patient characteristics, medical information, pregnancy, delivery and neonatal outcome) were retrieved from patient medical files. All pregnancy, delivery and neonatal outcome parameters were adjusted for age and pre-pregnancy smoking behaviour. The neonatal outcome parameters were additionally adjusted for gestational age. MAIN RESULTS AND THE ROLE OF CHANCE The median BMI in the overweight and normal weight women was, respectively, 30.8 kg/m² [interquartile quartile range (IQR) 5.8] and 20.9 kg/m² (IQR 2.3) (P < 0.001). Baseline characteristics did not differ between groups, except for free testosterone and fasting insulin levels, which were higher, and sex hormone-binding globulin, which was lower, in overweight versus normal weight women (all P < 0.001). The time-to-pregnancy was significantly higher in the overweight group (P = 0.01). Multivariate analyses of the ongoing singleton pregnancies showed significantly more preterm births in overweight (10/61) versus normal weight (2/71) women [adjusted odds ratio 0.1, 95% confidence interval (CI) 0-0.6, P = 0.01]. The mean birthweight of newborns was significantly higher in overweight (3386 ± 663 g) than in normal weight (3251 ± 528 g) women (adjusted mean difference 259.4, 95% CI 83.4-435.4, P = 0.004). LIMITATIONS, REASON FOR CAUTION Our results only represent the pregnancy, delivery and neonatal outcome of ongoing singleton pregnancies. The rather small sample size and observational nature of the study are further limitations. WIDER IMPLICATIONS OF THE FINDINGS Our results suggest the importance of pre-pregnancy weight loss in overweight women with PCOS in order to reduce the risk of adverse perinatal outcomes. STUDY FUNDING/COMPETING INTERESTS Veerle De Frène is holder of a Special PhD Fellowship by the Flemish Foundation for Scientific Research (FWO-Vlaanderen). Petra De Sutter is holder of a fundamental clinical research mandate by the Flemish Foundation for Scientific Research (FWO-Vlaanderen). There are no competing interests.
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Affiliation(s)
- V De Frène
- Department of Reproductive Medicine, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
| | - S Vansteelandt
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Krijgslaan 281 (S9), B-9000 Ghent, Belgium
| | - G T'Sjoen
- Department of Endocrinology and Metabolic Diseases, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
| | - J Gerris
- Department of Reproductive Medicine, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
| | - S Somers
- Department of Reproductive Medicine, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
| | - L Vercruysse
- Department of Reproductive Medicine, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
| | - P De Sutter
- Department of Reproductive Medicine, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
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Feres MC, Cintra FD, Rizzi CF, Mello-Fujita L, Lino de Souza AA, Tufik S, Poyares D. Evaluation and validation of a method for determining platelet catecholamine in patients with obstructive sleep apnea and arterial hypertension. PLoS One 2014; 9:e98407. [PMID: 24911183 PMCID: PMC4049580 DOI: 10.1371/journal.pone.0098407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 05/02/2014] [Indexed: 11/23/2022] Open
Abstract
Background Measurements of plasma and urinary catecholamine are susceptible to confounding factors that influence the results, complicating the interpretation of sympathetic nervous system (SNS) activity in the Obstructive sleep apnea (OSA) and arterial hypertension (HYP) conditions. Objective In this study, we validated a test for platelet catecholamine and compared the catecholamine levels (adrenaline and noradrenaline) in urine, plasma and platelets in patients with OSA and HYP compared with controls. Methods In the validation, 30 healthy, nonsmoking volunteers who were not currently undergoing treatment or medication were selected as the control group. One hundred fifty-four individuals (114 OSA, 40 non-OSA) were consecutively selected from the outpatient clinic of the Sleep Institute and underwent clinical, polysomnographic and laboratory evaluation, including the urinary, plasma and platelet levels of adrenaline (AD) and noradrenaline (NA). Patients were then allocated to groups according to the presence of OSA and/or hypertension. Results A logistic regression model, controlled for age and BMI, showed that urinary AD and urinary NA were risk factors in the OSA+HYP group and the HYP group; however, the model showed higher levels of platelet NA for OSA without HYP. After 1 year of CPAP (continuous upper airway pressure) treatment, patients (n = 9) presented lower levels of urinary NA (p = 0.04) and platelet NA (p = 0.05). Conclusion Urinary NA and AD levels were significantly associated with the condition of hypertension with and without OSA, whereas platelet NA with OSA without comorbidity. These findings suggest that platelet catecholamine levels might reflect nocturnal sympathetic activation in OSA patients without hypertension.
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Affiliation(s)
- Marcia C. Feres
- Psychobiology Department of Universidade Federal de São Paulo, Sao Paulo, SP, Brazil
- * E-mail:
| | - Fatima D. Cintra
- Cardiology Department of Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Camila F. Rizzi
- Psychobiology Department of Universidade Federal de São Paulo, Sao Paulo, SP, Brazil
| | - Luciane Mello-Fujita
- Psychobiology Department of Universidade Federal de São Paulo, Sao Paulo, SP, Brazil
| | | | - Sergio Tufik
- Psychobiology Department of Universidade Federal de São Paulo, Sao Paulo, SP, Brazil
- Associação Fundo de Incentivo a Pesquisa – AFIP- São Paulo, São Paulo, SP, Brazil
| | - Dalva Poyares
- Psychobiology Department of Universidade Federal de São Paulo, Sao Paulo, SP, Brazil
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Kawai M, Kinoshita S, Shimba S, Ozono K, Michigami T. Sympathetic activation induces skeletal Fgf23 expression in a circadian rhythm-dependent manner. J Biol Chem 2014; 289:1457-66. [PMID: 24302726 PMCID: PMC3894328 DOI: 10.1074/jbc.m113.500850] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 11/18/2013] [Indexed: 12/20/2022] Open
Abstract
The circadian clock network is well known to link food intake and metabolic outputs. Phosphorus is a pivotal nutritional factor involved in energy and skeletal metabolisms and possesses a circadian profile in the circulation; however, the precise mechanisms whereby phosphate metabolism is regulated by the circadian clock network remain largely unknown. Because sympathetic tone, which displays a circadian profile, is activated by food intake, we tested the hypothesis that phosphate metabolism was regulated by the circadian clock network through the modification of food intake-associated sympathetic activation. Skeletal Fgf23 expression showed higher expression during the dark phase (DP) associated with elevated circulating FGF23 levels and enhanced phosphate excretion in the urine. The peaks in skeletal Fgf23 expression and urine epinephrine levels, a marker for sympathetic tone, shifted from DP to the light phase (LP) when mice were fed during LP. Interestingly, β-adrenergic agonist, isoproterenol (ISO), induced skeletal Fgf23 expression when administered at ZT12, but this was not observed in Bmal1-deficient mice. In vitro reporter assays revealed that ISO trans-activated Fgf23 promoter through a cAMP responsive element in osteoblastic UMR-106 cells. The mechanism of circadian regulation of Fgf23 induction by ISO in vivo was partly explained by the suppressive effect of Cryptochrome1 (Cry1) on ISO signaling. These results indicate that the regulation of skeletal Fgf23 expression by sympathetic activity is dependent on the circadian clock system and may shed light on new regulatory networks of FGF23 that could be important for understanding the physiology of phosphate metabolism.
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Affiliation(s)
- Masanobu Kawai
- From the Department of Bone and Mineral Research, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan
| | - Saori Kinoshita
- From the Department of Bone and Mineral Research, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan
| | - Shigeki Shimba
- the Department of Health Science, School of Pharmacy, Nihon University, 7-7-1 Narashinodai, Funabashi, Chiba 274-8555, Japan, and
| | - Keiichi Ozono
- the Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Toshimi Michigami
- From the Department of Bone and Mineral Research, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan
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Ganne S, Arora S, Karam J, McFarlane SI. Therapeutic interventions for hypertension in metabolic syndrome: a comprehensive approach. Expert Rev Cardiovasc Ther 2014; 5:201-11. [PMID: 17338665 DOI: 10.1586/14779072.5.2.201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Hypertension is a major component of the metabolic syndrome and a major cardiovascular risk factor. Both disorders are rapidly increasing in frequency, with hypertension affecting nearly 60 million Americans and over 1 billion people worldwide, and metabolic syndrome affecting 44% of the US population above the age of 60 years. Sedentary lifestyle, together with obesity and aging of the population, are the major contributing factors for this growing epidemic. Hypertension in metabolic syndrome possesses unique pathophysiological aspects that have considerable implications on therapy of this disease. In this article, we review the pathophysiology and provide a rationale for the current therapeutic options in light of the most recent clinical trials in the field.
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Affiliation(s)
- Sudha Ganne
- State University of New York, Division of Endocrinology, Diabetes and Hypertension, Downstate Medical Center, Brooklyn, NY, USA.
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Licht CMM, de Geus EJC, Penninx BWJH. Dysregulation of the autonomic nervous system predicts the development of the metabolic syndrome. J Clin Endocrinol Metab 2013; 98:2484-93. [PMID: 23553857 DOI: 10.1210/jc.2012-3104] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONTEXT Stress is suggested to lead to metabolic dysregulations as clustered in the metabolic syndrome. Although dysregulation of the autonomic nervous system is found to associate with the metabolic syndrome and its dysregulations, no longitudinal study has been performed to date to examine the predictive value of this stress system in the development of the metabolic syndrome. OBJECTIVE We examined whether autonomic nervous system functioning predicts 2-year development of metabolic abnormalities that constitute the metabolic syndrome. DESIGN Data of the baseline and 2-year follow-up assessment of a prospective cohort: the Netherlands Study of Depression and Anxiety was used. SETTING Participants were recruited in the general community, primary care, and specialized mental health care organizations. PARTICIPANTS A group of 1933 participants aged 18-65 years. MAIN OUTCOME MEASURES The autonomic nervous system measures included heart rate (HR), respiratory sinus arrhythmia (RSA; high RSA reflecting high parasympathetic activity), pre-ejection period (PEP; high PEP reflecting low sympathetic activity), cardiac autonomic balance (CAB), and cardiac autonomic regulation (CAR). Metabolic syndrome was based on the updated Adult Treatment Panel III criteria and included high waist circumference, serum triglycerides, blood pressure, serum glucose, and low high-density lipoprotein (HDL) cholesterol. RESULTS Baseline short PEP, low CAB, high HR, and CAR were predictors of an increase in the number of components of the metabolic syndrome during follow-up. High HR and low CAB were predictors of a 2-year decrease in HDL cholesterol, and 2-year increase in diastolic and systolic blood pressure. Short PEP and high CAR also predicted a 2-year increase in systolic blood pressure, and short PEP additionally predicted 2-year increase in diastolic blood pressure. Finally, a low baseline RSA was predictive for subsequent decreases in HDL cholesterol. CONCLUSION Increased sympathetic activity predicts an increase in metabolic abnormalities over time. These findings suggest that a dysregulation of the autonomic nervous system is an important predictor of cardiovascular diseases and diabetes through dysregulating lipid metabolism and blood pressure over time.
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Affiliation(s)
- Carmilla M M Licht
- Department of Psychiatry, Vrije Universiteit (VU) University Medical Center Amsterdam, The Netherlands.
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Landsberg L, Aronne LJ, Beilin LJ, Burke V, Igel LI, Lloyd-Jones D, Sowers J. Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment--a position paper of the The Obesity Society and The American Society of Hypertension. Obesity (Silver Spring) 2013; 21:8-24. [PMID: 23401272 DOI: 10.1002/oby.20181] [Citation(s) in RCA: 193] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 10/18/2012] [Indexed: 01/11/2023]
Abstract
In light of the worldwide epidemic of obesity, and in recognition of hypertension as a major factor in the cardiovascular morbidity and mortality associated with obesity, The Obesity Society and The American Society of Hypertension agreed to jointly sponsor a position paper on obesity-related hypertension to be published jointly in the journals of each society. The purpose is to inform the members of both societies, as well as practicing clinicians, with a timely review of the association between obesity and high blood pressure, the risk that this association entails, and the options for rational, evidenced-based treatment. The position paper is divided into six sections plus a summary as follows: pathophysiology, epidemiology and cardiovascular risk, the metabolic syndrome, lifestyle management in prevention and treatment, pharmacologic treatment of hypertension in the obese, and the medical and surgical treatment of obesity in obese hypertensive patients.
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Affiliation(s)
- Lewis Landsberg
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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