1
|
Cincotta AH. Brain Dopamine-Clock Interactions Regulate Cardiometabolic Physiology: Mechanisms of the Observed Cardioprotective Effects of Circadian-Timed Bromocriptine-QR Therapy in Type 2 Diabetes Subjects. Int J Mol Sci 2023; 24:13255. [PMID: 37686060 PMCID: PMC10487918 DOI: 10.3390/ijms241713255] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 09/10/2023] Open
Abstract
Despite enormous global efforts within clinical research and medical practice to reduce cardiovascular disease(s) (CVD), it still remains the leading cause of death worldwide. While genetic factors clearly contribute to CVD etiology, the preponderance of epidemiological data indicate that a major common denominator among diverse ethnic populations from around the world contributing to CVD is the composite of Western lifestyle cofactors, particularly Western diets (high saturated fat/simple sugar [particularly high fructose and sucrose and to a lesser extent glucose] diets), psychosocial stress, depression, and altered sleep/wake architecture. Such Western lifestyle cofactors are potent drivers for the increased risk of metabolic syndrome and its attendant downstream CVD. The central nervous system (CNS) evolved to respond to and anticipate changes in the external (and internal) environment to adapt survival mechanisms to perceived stresses (challenges to normal biological function), including the aforementioned Western lifestyle cofactors. Within the CNS of vertebrates in the wild, the biological clock circuitry surveils the environment and has evolved mechanisms for the induction of the obese, insulin-resistant state as a survival mechanism against an anticipated ensuing season of low/no food availability. The peripheral tissues utilize fat as an energy source under muscle insulin resistance, while increased hepatic insulin resistance more readily supplies glucose to the brain. This neural clock function also orchestrates the reversal of the obese, insulin-resistant condition when the low food availability season ends. The circadian neural network that produces these seasonal shifts in metabolism is also responsive to Western lifestyle stressors that drive the CNS clock into survival mode. A major component of this natural or Western lifestyle stressor-induced CNS clock neurophysiological shift potentiating the obese, insulin-resistant state is a diminution of the circadian peak of dopaminergic input activity to the pacemaker clock center, suprachiasmatic nucleus. Pharmacologically preventing this loss of circadian peak dopaminergic activity both prevents and reverses existing metabolic syndrome in a wide variety of animal models of the disorder, including high fat-fed animals. Clinically, across a variety of different study designs, circadian-timed bromocriptine-QR (quick release) (a unique formulation of micronized bromocriptine-a dopamine D2 receptor agonist) therapy of type 2 diabetes subjects improved hyperglycemia, hyperlipidemia, hypertension, immune sterile inflammation, and/or adverse cardiovascular event rate. The present review details the seminal circadian science investigations delineating important roles for CNS circadian peak dopaminergic activity in the regulation of peripheral fuel metabolism and cardiovascular biology and also summarizes the clinical study findings of bromocriptine-QR therapy on cardiometabolic outcomes in type 2 diabetes subjects.
Collapse
|
2
|
Watso JC, Fancher IS, Gomez DH, Hutchison ZJ, Gutiérrez OM, Robinson AT. The damaging duo: Obesity and excess dietary salt contribute to hypertension and cardiovascular disease. Obes Rev 2023; 24:e13589. [PMID: 37336641 PMCID: PMC10406397 DOI: 10.1111/obr.13589] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/08/2023] [Accepted: 05/24/2023] [Indexed: 06/21/2023]
Abstract
Hypertension is a primary risk factor for cardiovascular disease. Cardiovascular disease is the leading cause of death among adults worldwide. In this review, we focus on two of the most critical public health challenges that contribute to hypertension-obesity and excess dietary sodium from salt (i.e., sodium chloride). While the independent effects of these factors have been studied extensively, the interplay of obesity and excess salt overconsumption is not well understood. Here, we discuss both the independent and combined effects of excess obesity and dietary salt given their contributions to vascular dysfunction, autonomic cardiovascular dysregulation, kidney dysfunction, and insulin resistance. We discuss the role of ultra-processed foods-accounting for nearly 60% of energy intake in America-as a major contributor to both obesity and salt overconsumption. We highlight the influence of obesity on elevated blood pressure in the presence of a high-salt diet (i.e., salt sensitivity). Throughout the review, we highlight critical gaps in knowledge that should be filled to inform us of the prevention, management, treatment, and mitigation strategies for addressing these public health challenges.
Collapse
Affiliation(s)
- Joseph C. Watso
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, Florida, USA
| | - Ibra S. Fancher
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
| | - Dulce H. Gomez
- School of Kinesiology, Auburn University, Auburn, Alabama, USA
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | - Orlando M. Gutiérrez
- Division of Nephrology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | |
Collapse
|
3
|
Christen T, de Mutsert R, Smit RA, Willems van Dijk K, Lamb HJ, Rosendaal FR, Jukema JW, Trompet S. The association between leptin and subclinical cardiovascular disease explained by body fat: Observational and Mendelian randomization analyses. Nutr Metab Cardiovasc Dis 2023; 33:1077-1086. [PMID: 36958975 DOI: 10.1016/j.numecd.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/31/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND AND AIMS Leptin has been associated with adverse effects on cardiovascular disease, but the effect of confounding by body fat in these associations remains unclear. To investigate associations between leptin and heart function and subclinical cardiovascular disease adjusted for total body fat, and to investigate the causal relation between leptin and cardiovascular disease using Mendelian randomisation. METHODS AND RESULTS Leptin concentrations, total body fat and diverse measures of subclinical cardiovascular disease were determined in participants of the Netherlands Epidemiology of Obesity study. Linear regression between leptin concentration and measures of heart function, ECG measures, and carotid intima media thickness as a measure of subclinical atherosclerosis was adjusted for potential confounding factors, and additionally including total body fat. We analysed the combined effects of genetic variants from a GWAS on leptin concentrations in publicly-available summary statistics of coronary heart disease GWAS (CARDIoGRAMplusC4D, n = 184,305). As many as 6107 men and women, mean (SD) age 56 (6) years, BMI 26 (4) kg/m2, and median leptin concentration 12.1 μg (IQR: 6.7-22.6) were included. In observational analyses, leptin was weakly associated with heart function and subclinical cardiovascular disease, but these associations attenuated when adjusting for total body fat. A doubling of genetically-determined leptin concentration was associated with an odds ratio of cardiovascular disease of 0.69 (0.37, 1.27). CONCLUSION Observational associations between leptin and subclinical measures of cardiovascular disease were largely explained by differences in total body fat. Results of analyses of genetically-determined leptin and coronary heart disease risk were inconclusive due to a large confidence interval.
Collapse
Affiliation(s)
- Tim Christen
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Roelof Aj Smit
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Ko Willems van Dijk
- Einthoven Laboratory for Experimental Vascular Medicine, LUMC, Leiden, the Netherlands; Department of Human Genetics, LUMC, Leiden, the Netherlands; Internal Medicine, Division of Endocrinology, LUMC, Leiden, the Netherlands
| | - Hildo J Lamb
- Department of Radiology, LUMC, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | | | - Stella Trompet
- Department of Gerontology and Geriatrics, LUMC, Leiden, the Netherlands.
| |
Collapse
|
4
|
Shih YL, Shih YH, Huang TC, Shih CC, Chen JY. Association between sedentary time and plasma leptin levels in middle-aged and older adult population in Taiwan: A community-based, cross-sectional study. Front Cardiovasc Med 2023; 9:1057497. [PMID: 36698957 PMCID: PMC9868819 DOI: 10.3389/fcvm.2022.1057497] [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: 09/29/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023] Open
Abstract
Background Association of sedentary behavior and plasma leptin levels is a popular topic in recent research. Aged populations often suffer from cardiometabolic diseases, and leptin is considered a novel marker for many cardiometabolic diseases. To further explore this topic, our research investigates the relationship between sedentary time and serum leptin levels in middle-aged and older populations. Methods A total of 396 middle-aged and older adult Taiwanese participants were included in this study. We recorded their self-reported sitting time as sedentary time. Participants were categorized into low leptin, medium leptin group, and high leptin groups according to the tertile of serum leptin level in the study. We also analyzed the anthropometric and cardiometabolic parameters between the three groups. Spearman's correlation coefficient was used to analyze the correlation between leptin level, sedentary time, and other cardiometabolic risk factors. The relationsip between leptin and sedentary time was also shown in a scatter plot. Multivariate linear regression was performed to determine the association between serum leptin levels and sedentary time after adjusting for age, sex, alcohol consumption, smoking, triglycerides, body mass index (BMI), fasting plasma glucose, systolic blood pressure, uric acid, creatinine, and alanine transaminase (ALT). Results In our study, data from a total of 396 participants were analyzed. The average age of participants was 64.75 (±8.75) years, and ~41.4% were male. A longer period of sedentary time was observed in the high leptin group. A positive correlation was found between serum leptin level and sedentary time in Spearman's correlation, in all BMI groups. Serum leptin levels were positively associated with sedentary time (B = 0.603, p = 0.016) in the multivariate linear regression after adjusting for age, sex, alcohol consumption, smoking, triglycerides, BMI, fasting plasma glucose, systolic blood pressure, uric acid, creatinine, and ALT. Conclusion Prolonged sedentary time can be an independent risk factor for high serum leptin levels, and high leptin levels can be a novel marker in future healthcare to screen the individual with prolonged sedentary time. Furthermore, based on our study, future research can further explore the relationship between leptin levels and health promotion, especially decreasing sedentary time in the middle-aged and elder population, which is vulnerable to cardiometabolic diseases.
Collapse
Affiliation(s)
- Yu-Lin Shih
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yun-Hsiang Shih
- School of Medicine, Medical University of Lublin, Lublin, Poland
| | - Tzu-Cheng Huang
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chin-Chuan Shih
- General Administrative Department, United Safety Medical Group, New Taipei City, Taiwan
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan,College of Medicine, Chang Gung University, Taoyuan, Taiwan,*Correspondence: Jau-Yuan Chen ✉
| |
Collapse
|
5
|
Kulej-Lyko K, Niewinski P, Tubek S, Krawczyk M, Kosmala W, Ponikowski P. Inhibition of peripheral chemoreceptors improves ventilatory efficiency during exercise in heart failure with preserved ejection fraction − a role of tonic activity and acute reflex response. Front Physiol 2022; 13:911636. [PMID: 36111161 PMCID: PMC9470150 DOI: 10.3389/fphys.2022.911636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/19/2022] [Indexed: 11/22/2022] Open
Abstract
Peripheral chemoreceptors (PChRs) play a significant role in maintaining adequate oxygenation in the bloodstream. PChRs functionality comprises two components: tonic activity (PChT) which regulates ventilation during normoxia and acute reflex response (peripheral chemosensitivity, PChS), which increases ventilation following a specific stimulus. There is a clear link between augmented PChS and exercise intolerance in patients with heart failure with reduced ejection fraction. It has been also shown that inhibition of PChRs leads to the improvement in exercise capacity. However, it has not been established yet: 1) whether similar mechanisms take part in heart failure with preserved ejection fraction (HFpEF) and 2) which component of PChRs functionality (PChT vs. PChS) is responsible for the benefit seen after the acute experimental blockade. To answer those questions we enrolled 12 stable patients with HFpEF. All participants underwent an assessment of PChT (attenuation of minute ventilation in response to low-dose dopamine infusion), PChS (enhancement of minute ventilation in response to hypoxia) and a symptom-limited cardiopulmonary exercise test on cycle ergometer. All tests were placebo-controlled, double-blinded and performed in a randomized order. Under resting conditions and at normoxia dopamine attenuated minute ventilation and systemic vascular resistance (p = 0.03 for both). These changes were not seen with placebo. Dopamine also decreased ventilatory and mean arterial pressure responses to hypoxia (p < 0.05 for both). Inhibition of PChRs led to a decrease in V˙E/V˙CO2 comparing to placebo (36 ± 3.6 vs. 34.3 ± 3.7, p = 0.04), with no effect on peak oxygen consumption. We found a significant relationship between PChT and the relative decrement of V˙E/V˙CO2 on dopamine comparing to placebo (R = 0.76, p = 0.005). There was a trend for correlation between PChS (on placebo) and V˙E/V˙CO2 during placebo infusion (R = 0.56, p = 0.059), but the relative improvement in V˙E/V˙CO2 was not related to the change in PChS (dopamine vs. placebo). We did not find a significant relationship between PChT and PChS. In conclusion, inhibition of PChRs in HFpEF population improves ventilatory efficiency during exercise. Increased PChS is associated with worse (higher) V˙E/V˙CO2, whereas PChT predicts an improvement in V˙E/V˙CO2 after PChRs inhibition. This results may be meaningful for patient selection in further clinical trials involving PChRs modulation.
Collapse
Affiliation(s)
- Katarzyna Kulej-Lyko
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- Department of Cardiology, University Clinical Hospital, Wroclaw, Poland
- *Correspondence: Katarzyna Kulej-Lyko,
| | - Piotr Niewinski
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- Department of Cardiology, University Clinical Hospital, Wroclaw, Poland
| | - Stanislaw Tubek
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- Department of Cardiology, University Clinical Hospital, Wroclaw, Poland
| | | | - Wojciech Kosmala
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- Department of Cardiology, University Clinical Hospital, Wroclaw, Poland
| | - Piotr Ponikowski
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- Department of Cardiology, University Clinical Hospital, Wroclaw, Poland
| |
Collapse
|
6
|
Köchli S, Botha-Le Roux S, Uys AS, Kruger R. Cardiorespiratory Fitness, Blood Pressure and Ethnicity Are Related to Salivary Cortisol Responses after an Exercise Test in Children: The ExAMIN Youth SA Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157898. [PMID: 34360198 PMCID: PMC8345404 DOI: 10.3390/ijerph18157898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Childhood elevated circulatory stress mediators such as cortisol seem to play an important role in the development of hypertension and metabolic disorders later in life. Little is known about the association of body composition, cardiorespiratory fitness (CRF), blood pressure (BP) and ethnicity with cortisol reactivity in young children. METHODS In this cross-sectional study, 324 black and 227 white school children (aged 7.4 ± 1.0 years) were screened for salivary cortisol reactivity, body mass index, BP and CRF (shuttle run) by standardised assessments for children. RESULTS Children in the lower cortisol reactivity percentile (<25th) had a higher heart rate (87.0 ± 12.9 bpm) and a lower CRF (3.1 ± 1.3 stages) compared to children in the upper (>25th) percentile (86.2 ± 11.5 bpm and 3.5 ± 1.7 stages, respectively). At baseline, children of black ethnicity had a higher cortisol level (p < 0.001). Immediately before the exercise test, no associations of obesity, BP, CRF and ethnicity with cortisol levels were found. In analysis of covariance (ANCOVA) we found that low CRF, high BP and black ethnicity were independently associated with lower cortisol reactivity by performing the shuttle run test (p < 0.01). CONCLUSION Low CRF and high BP were associated with lower cortisol reactivity after a cardiorespiratory exercise test. Black children showed a lower cortisol reactivity which may contribute to the earlier onset of hypertension reported in black compared to white populations. Primary prevention programs need to focus on improving physical fitness to reduce the growing prevalence of cardiometabolic disorders during childhood.
Collapse
Affiliation(s)
- Sabrina Köchli
- Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom 2520, South Africa; (S.K.); (S.B.-L.R.); (A.S.U.)
| | - Shani Botha-Le Roux
- Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom 2520, South Africa; (S.K.); (S.B.-L.R.); (A.S.U.)
- Medical Research Council, Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom 2520, South Africa
| | - Aletta Sophia Uys
- Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom 2520, South Africa; (S.K.); (S.B.-L.R.); (A.S.U.)
- Medical Research Council, Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom 2520, South Africa
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom 2520, South Africa; (S.K.); (S.B.-L.R.); (A.S.U.)
- Medical Research Council, Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom 2520, South Africa
- Correspondence: ; Tel.: +27-18-299-2904
| |
Collapse
|
7
|
Garcia ML, Milanez MIO, Nishi EE, Sato AYS, Carvalho PM, Nogueira FN, Campos RR, Oyama LM, Bergamaschi CT. Retroperitoneal adipose tissue denervation improves cardiometabolic and autonomic dysfunction in a high fat diet model. Life Sci 2021; 283:119841. [PMID: 34298036 DOI: 10.1016/j.lfs.2021.119841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/29/2022]
Abstract
Sympathetic vasomotor overactivity is a major feature leading to the cardiovascular dysfunction related to obesity. Considering that the retroperitoneal white adipose tissue (rWAT) is an important fat visceral depot and receives intense sympathetic and afferent innervations, the present study aimed to evaluate the effects evoked by bilateral rWAT denervation in obese rats. Male Wistar rats were fed with HFD for 8 consecutive weeks and rWAT denervation was performed at the 6th week. Arterial pressure, splanchnic and renal sympathetic vasomotor nerve activities were assessed and inflammation and the components of the renin -angiotensin system were evaluated in different white adipose tissue depots. HFD animals presented higher serum levels of leptin and glucose, an increase in arterial pressure and splanchnic sympathetic nerve activity; rWAT denervation, normalized these parameters. Pro-inflammatory cytokines levels were significantly increased, as well as RAAS gene expression in WAT of HFD animals; rWAT denervation significantly attenuated these changes. In conclusion, HFD promotes vasomotor sympathetic overactivation and inflammation with repercussions on the cardiovascular system. In conclusion, the neural communication between WAT and the brain is fundamental to trigger sympathetic vasomotor activation and this pathway is a possible new therapeutic target to treat obesity-associated cardiovascular dysfunction.
Collapse
Affiliation(s)
- Michelle L Garcia
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Maycon I O Milanez
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Erika E Nishi
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Alex Y S Sato
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Polliane M Carvalho
- Department of Biomaterials and Oral Biology, Faculdade de Odontologia, Universidade de São Paulo, Brazil
| | - Fernando N Nogueira
- Department of Biomaterials and Oral Biology, Faculdade de Odontologia, Universidade de São Paulo, Brazil
| | - Ruy R Campos
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Lila M Oyama
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Cássia T Bergamaschi
- Department of Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil.
| |
Collapse
|
8
|
Carnagarin R, Tan K, Adams L, Matthews VB, Kiuchi MG, Marisol Lugo Gavidia L, Lambert GW, Lambert EA, Herat LY, Schlaich MP. Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)-A Condition Associated with Heightened Sympathetic Activation. Int J Mol Sci 2021; 22:ijms22084241. [PMID: 33921881 PMCID: PMC8073135 DOI: 10.3390/ijms22084241] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 02/06/2023] Open
Abstract
Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common liver disease affecting a quarter of the global population and is often associated with adverse health outcomes. The increasing prevalence of MAFLD occurs in parallel to that of metabolic syndrome (MetS), which in fact plays a major role in driving the perturbations of cardiometabolic homeostasis. However, the mechanisms underpinning the pathogenesis of MAFLD are incompletely understood. Compelling evidence from animal and human studies suggest that heightened activation of the sympathetic nervous system is a key contributor to the development of MAFLD. Indeed, common treatment strategies for metabolic diseases such as diet and exercise to induce weight loss have been shown to exert their beneficial effects at least in part through the associated sympathetic inhibition. Furthermore, pharmacological and device-based approaches to reduce sympathetic activation have been demonstrated to improve the metabolic alterations frequently present in patients with obesity, MetSand diabetes. Currently available evidence, while still limited, suggests that sympathetic activation is of specific relevance in the pathogenesis of MAFLD and consequentially may offer an attractive therapeutic target to attenuate the adverse outcomes associated with MAFLD.
Collapse
Affiliation(s)
- Revathy Carnagarin
- Dobney Hypertension Centre, School of Medicine—Royal Perth Hospital Unit, RPH Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, WA 6000, Australia; (R.C.); (K.T.); (V.B.M.); (M.G.K.); (L.M.L.G.); (L.Y.H.)
| | - Kearney Tan
- Dobney Hypertension Centre, School of Medicine—Royal Perth Hospital Unit, RPH Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, WA 6000, Australia; (R.C.); (K.T.); (V.B.M.); (M.G.K.); (L.M.L.G.); (L.Y.H.)
| | - Leon Adams
- Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, WA 6009, Australia;
| | - Vance B. Matthews
- Dobney Hypertension Centre, School of Medicine—Royal Perth Hospital Unit, RPH Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, WA 6000, Australia; (R.C.); (K.T.); (V.B.M.); (M.G.K.); (L.M.L.G.); (L.Y.H.)
| | - Marcio G. Kiuchi
- Dobney Hypertension Centre, School of Medicine—Royal Perth Hospital Unit, RPH Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, WA 6000, Australia; (R.C.); (K.T.); (V.B.M.); (M.G.K.); (L.M.L.G.); (L.Y.H.)
| | - Leslie Marisol Lugo Gavidia
- Dobney Hypertension Centre, School of Medicine—Royal Perth Hospital Unit, RPH Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, WA 6000, Australia; (R.C.); (K.T.); (V.B.M.); (M.G.K.); (L.M.L.G.); (L.Y.H.)
| | - Gavin W. Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia; (G.W.L.); (E.A.L.)
- Human Neurotransmitter Lab, Melbourne, VIC 3004, Australia
| | - Elisabeth A. Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia; (G.W.L.); (E.A.L.)
- Human Neurotransmitter Lab, Melbourne, VIC 3004, Australia
| | - Lakshini Y. Herat
- Dobney Hypertension Centre, School of Medicine—Royal Perth Hospital Unit, RPH Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, WA 6000, Australia; (R.C.); (K.T.); (V.B.M.); (M.G.K.); (L.M.L.G.); (L.Y.H.)
| | - Markus P. Schlaich
- Dobney Hypertension Centre, School of Medicine—Royal Perth Hospital Unit, RPH Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, WA 6000, Australia; (R.C.); (K.T.); (V.B.M.); (M.G.K.); (L.M.L.G.); (L.Y.H.)
- Neurovascular Hypertension and Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth, WA 6000, Australia
- Correspondence: ; Tel.: +61-8-9224-0382; Fax: +61-8-9224-0374
| |
Collapse
|
9
|
Lu SC, Akanji AO. Leptin, Obesity, and Hypertension: A Review of Pathogenetic Mechanisms. Metab Syndr Relat Disord 2020; 18:399-405. [PMID: 32876506 DOI: 10.1089/met.2020.0065] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The adipokine leptin is expressed at higher concentrations in obese subjects, who also incidentally have a higher prevalence of hypertension. The pathogenesis of this obesity-related hypertension is controversial and is believed to be related to many factors including increased sympathetic activity, abnormalities of the renin-angiotensin system, sodium retention, and an endotheliopathy acting independently or in concert with increased circulating leptin. This review discusses the potential mechanisms through which changes in leptin signal transduction pathways in tissues with the leptin receptor, especially the hypothalamus, mediate the pathogenetic relationships between obesity and hypertension. The hypothesis is explored that leptin effects on blood pressure (BP) are meditated by the downstream effects of hypothalamic leptin signaling and ultimately result in activation of specific melanocortin receptors located on sympathetic neurons in the spinal cord. The physiological consequences of this sympathetic activation of the heart and kidney are activation of the renin-angiotensin system, sodium retention and circulatory expansion and finally, elevated BP. This sequence of events has been elegantly demonstrated with leptin infusion and gene knockout studies in animal models but has not been convincingly reproducibly confirmed in humans. Further studies in human subjects on the specific roles of hypothalamic leptin in essential hypertension are indicated as elucidation of the signaling pathways should provide better understanding of the role of weight loss in BP control and afford an additional mechanism for pharmacologic control of BP in adults and children at risk of cardiovascular disease.
Collapse
Affiliation(s)
- Song Chi Lu
- Department of Medical Sciences, Frank H. Netter School of Medicine, NH-MED, Quinnipiac University, Hamden, Connecticut, USA
| | - Abayomi O Akanji
- Department of Medical Sciences, Frank H. Netter School of Medicine, NH-MED, Quinnipiac University, Hamden, Connecticut, USA
| |
Collapse
|
10
|
Yoo JK, Fu Q. Impact of sex and age on metabolism, sympathetic activity, and hypertension. FASEB J 2020; 34:11337-11346. [PMID: 32779294 DOI: 10.1096/fj.202001006rr] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 12/13/2022]
Abstract
In this brief review, we summarize the current knowledge on the complex interplay between metabolism, sympathetic activity and hypertension with a focus on sex differences and changes with age in humans. Evidence suggests that in premenopausal women, sex hormones, particularly estrogen exerts a profound cardioprotective effect which may be associated with favorable metabolic profiles, as well as lower sympathetic activity and blood pressure at rest and any given physiological and environmental stimuli compared with men of a similar age. Along this line, premenopausal women seem to be generally protected from obesity-induced metabolic and cardiovascular complications. However, postmenopausal estrogen deprivation during midlife and older age has a detrimental impact on metabolism, may lead to adipose tissue redistribution from the subcutaneous to abdominal area, and augments sympathetic activity. All these changes could contribute significantly to the higher prevalence of hypertension and greater cardiometabolic risk in older women than older men. It is proposed that obesity-related hypertension has a neurogenic component which is characterized by sympathetic overactivity, but the impact of sex and age remains largely unknown. Understanding sex and age-specific differences in obesity and sympathetic neural control of blood pressure is important in the prevention and/or risk reduction of cardiometabolic disorders for both men and women.
Collapse
Affiliation(s)
- Jeung-Ki Yoo
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
11
|
Exploring the Mediators that Promote Carotid Body Dysfunction in Type 2 Diabetes and Obesity Related Syndromes. Int J Mol Sci 2020; 21:ijms21155545. [PMID: 32756352 PMCID: PMC7432672 DOI: 10.3390/ijms21155545] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/26/2020] [Accepted: 07/30/2020] [Indexed: 12/12/2022] Open
Abstract
Carotid bodies (CBs) are peripheral chemoreceptors that sense changes in blood O2, CO2, and pH levels. Apart from ventilatory control, these organs are deeply involved in the homeostatic regulation of carbohydrates and lipid metabolism and inflammation. It has been described that CB dysfunction is involved in the genesis of metabolic diseases and that CB overactivation is present in animal models of metabolic disease and in prediabetes patients. Additionally, resection of the CB-sensitive nerve, the carotid sinus nerve (CSN), or CB ablation in animals prevents and reverses diet-induced insulin resistance and glucose intolerance as well as sympathoadrenal overactivity, meaning that the beneficial effects of decreasing CB activity on glucose homeostasis are modulated by target-related efferent sympathetic nerves, through a reflex initiated in the CBs. In agreement with our pre-clinical data, hyperbaric oxygen therapy, which reduces CB activity, improves glucose homeostasis in type 2 diabetes patients. Insulin, leptin, and pro-inflammatory cytokines activate the CB. In this manuscript, we review in a concise manner the putative pathways linking CB chemoreceptor deregulation with the pathogenesis of metabolic diseases and discuss and present new data that highlight the roles of hyperinsulinemia, hyperleptinemia, and chronic inflammation as major factors contributing to CB dysfunction in metabolic disorders.
Collapse
|
12
|
Emara TA, Khazbak AO, Mohammed O, Elgaml M, Zidan A, Hosny SM. Changes in Serum Leptin Level After Multilevel Surgery in Patients with Obstructive Sleep Apnea. Laryngoscope 2020; 131:E665-E670. [PMID: 32640082 DOI: 10.1002/lary.28908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/08/2020] [Accepted: 06/15/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Leptin hormone plays an important role in metabolic control and is elevated in obstructive sleep apnea (OSA). The aim of this study was to assess the hypothesis that surgical treatment will reduce leptin levels in OSA patients. STUDY DESIGN Prospective study. SUBJECTS AND METHODS Twenty-three patients with multilevel OSA underwent modified genioglossus muscle advancement with anterolateral advancement pharyngoplasty between April 2018 and September 2019. Serum leptin level was measured preoperatively and 3 months postoperatively for all patients and 18 control subjects. All patients were evaluated before and 3 months after surgery by history taking, clinical examination, polysomnography, cephalometry, and Epworth Sleepiness Scale. RESULTS Preoperatively, patients with OSA had a higher Leptin level (18.46 ± 4.73 ng/mL) than did control subjects (7.07 ± 1.26 ng/mL) (P < .001). Surgery resulted in a significant reduction in the level of leptin from 18.46 ± 4.73 ng/mL to 8.03 ± 2.22 ng/mL (P < .001). Reductions in leptin level was correlated with changes in apnea hypopnea index (AHI) (r = 0.61, P = .002) and minimum oxygen saturation (SaO2) (r = -0.54, P = .008). CONCLUSION Effective multilevel surgery in the form of modified genioglossus muscle advancement with anterolateral advancement pharyngoplasty could significantly reduce leptin level in OSA patients and this reduction is correlated with the degree of OSA improvement in term of AHI and SaO2. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E665-E670, 2021.
Collapse
Affiliation(s)
- Tarek A Emara
- Otorhinolaryngology-Head & Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Alaa O Khazbak
- Otorhinolaryngology-Head & Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Omnya Mohammed
- Otorhinolaryngology-Head & Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed Elgaml
- Otorhinolaryngology-Head & Neck Surgery Department, Al Ahrar Teaching Hospital, Zagazig, Egypt
| | - Amal Zidan
- Clinical Pathology Department, Zagazig University, Zagazig, Egypt
| | - Sameh M Hosny
- Otorhinolaryngology-Head & Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| |
Collapse
|
13
|
Alassiri M, Alanazi A, Aldera H, Alqahtani SA, Alraddadi AS, Alberreet MS, Alhussaini AI, Alotaibi Y, Alkhateeb MA, Shatoor AS. Exposure to cell phones reduces heart rate variability in both normal-weight and obese normotensive medical students. Explore (NY) 2020; 16:264-270. [PMID: 32249199 DOI: 10.1016/j.explore.2020.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 01/26/2020] [Accepted: 02/20/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND We investigated and compared the effect of the radiofrequency electromagnetic field (RF-EM) emitted by a cell phone on the electrocardiogram and heart rate variability (HRV) of normotensive normal-weight and obese medical students. METHOD Twenty medical student volunteers, normal weight (age = 23 ± 2, BMI = 23.05 ± 1.72) or obese (age = 24 ± 2, BMI = 32.39 ± 4.78), were exposed to a cell phone (1) close to the heart in silent mode, no ringing or vibrating; (2) close to the heart in ring and vibration mode; (3) next to the ear (brain) while listening; and (4) next to the ear while listening and speaking. RESULTS The average basal HR of obese students significantly increased, while the PR interval; time domains, including standard deviation (SD) of all normal R-R intervals (SDNN), mean of the SD of all normal R-R intervals (SDNNi), SD of the average of normal R-R intervals (SDANN), and percentage of R-R intervals at least 50 ms different from the previous interval (pNN50); and high-power frequency (HF) decreased. The LF/HF ratio also significantly increased. The SDNN, SDNNi, SDANN, pNN50, and HF levels significantly decreased and the LF/HF significantly increased in normal-weight and obese individuals only when the phone was near the apex of the heart in ring and vibration mode. All changes were more profound in obese students. CONCLUSION Keeping the phone in a chest pocket reduced the HRV of normal-weight and obese medical students and exaggerated the effect of obesity on sympathetic activation.
Collapse
Affiliation(s)
- Mohammed Alassiri
- Department of Basic Sciences, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia.; King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia.
| | - Asma Alanazi
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia; King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Hussain Aldera
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia; King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Sultan A Alqahtani
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia; King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Abdulrahman S Alraddadi
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia; King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Meshal S Alberreet
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | - Abdullah I Alhussaini
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | - Yousef Alotaibi
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | - Mahmoud A Alkhateeb
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | - Abdullah S Shatoor
- College Medicine, Department of Internal Medicine, Cardiology Section, King Khalid University, Abha, Saudi Arabia
| |
Collapse
|
14
|
Lambert GW, Schlaich MP, Eikelis N, Lambert EA. Sympathetic activity in obesity: a brief review of methods and supportive data. Ann N Y Acad Sci 2019; 1454:56-67. [PMID: 31268175 DOI: 10.1111/nyas.14140] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/11/2019] [Accepted: 05/23/2019] [Indexed: 12/12/2022]
Abstract
The increase in the prevalence of obesity and the concomitant rise in obesity-related illness have led to substantial pressure on health care systems throughout the world. While the combination of reduced exercise, increased sedentary time, poor diet, and genetic predisposition is undoubtedly pivotal in generating obesity and increasing disease risk, a large body of work indicates that the sympathetic nervous system (SNS) contributes to obesity-related disease development and progression. In obesity, sympathetic nervous activity is regionalized, with activity in some outflows being particularly sensitive to the obese state, whereas other outflows, or responses to stimuli, may be blunted, thereby making the assessment of sympathetic nervous activation in the clinical setting difficult. Isotope dilution methods and direct nerve recording techniques have been developed and utilized in clinical research, demonstrating that in obesity there is preferential activation of the muscle vasoconstrictor and renal sympathetic outflows. With weight loss, sympathetic activity is reduced. Importantly, sympathetic nervous activity is associated with end-organ dysfunction and changes in sympathetic activation that accompany weight loss are often reflected in an improvement of end-organ function. Whether targeting the SNS directly improves obesity-related illness remains unknown, but merits further attention.
Collapse
Affiliation(s)
- Gavin W Lambert
- The Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia.,The School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Markus P Schlaich
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Nina Eikelis
- The Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia.,The School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Elisabeth A Lambert
- The Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia.,The School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| |
Collapse
|
15
|
Obi IE, McPherson KC, Pollock JS. Childhood adversity and mechanistic links to hypertension risk in adulthood. Br J Pharmacol 2019; 176:1932-1950. [PMID: 30656638 PMCID: PMC6534788 DOI: 10.1111/bph.14576] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/17/2018] [Accepted: 10/29/2018] [Indexed: 02/07/2023] Open
Abstract
Adverse childhood experiences (ACEs), defined as traumatic events in childhood that range from various forms of abuse to household challenges and dysfunction, have devastating consequences on adult health. Epidemiological studies in humans and animal models of early life stress (ELS) have revealed a strong association and insight into the mechanistic link between ACEs and increased risk of cardiovascular disease (CVD). This review focuses on the mechanistic links of ACEs in humans and ELS in mice and rats to vasoactive factors and immune mediators associated with CVD and hypertension risk, as well as sex differences in these phenomena. Major topics of discussion in this review are as follows: (a) epidemiological associations between ACEs and CVD risk focusing on hypertension, (b) evidence for association of ACE exposures to immune-mediated and/or vasoactive pathways, (c) rodent models of ELS-induced hypertension risk, (d) proinflammatory mediators and vasoactive factors as mechanisms of ELS-induced hypertension risk. We also provide some overall conclusions and directions of further research. LINKED ARTICLES: This article is part of a themed section on Immune Targets in Hypertension. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.12/issuetoc.
Collapse
Affiliation(s)
- Ijeoma E. Obi
- CardioRenal Physiology and Medicine Section, Division of Nephrology, Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUnited States
| | - Kasi C. McPherson
- CardioRenal Physiology and Medicine Section, Division of Nephrology, Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUnited States
| | - Jennifer S. Pollock
- CardioRenal Physiology and Medicine Section, Division of Nephrology, Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUnited States
| |
Collapse
|
16
|
Ganguly A, Sharma K, Majumder K. Food-derived bioactive peptides and their role in ameliorating hypertension and associated cardiovascular diseases. ADVANCES IN FOOD AND NUTRITION RESEARCH 2019; 89:165-207. [PMID: 31351525 DOI: 10.1016/bs.afnr.2019.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Non-communicable diseases including cardiovascular diseases (CVDs) and associated metabolic disorders are responsible for nearly 40 million deaths globally per year. Hypertension or high blood pressure (BP) is one of the primary reasons for the development of CVDs. A healthy nutritional strategy complementing with physical activity can substantially reduce high BP and prevent the occurrence of CVD-associated morbidity and mortality. Bioactive peptides currently are the next wave of the promising bench to clinic options for potential targeting chronic and acute health issues including hypertension. Peptides demonstrating anti-inflammatory, anti-oxidant, and angiotensin-converting enzyme-I inhibitory activity are widely studied for the amelioration of hypertension and associated CVDs. Isolating these potent bioactive peptides from different food sources is a promising endeavor toward nutraceutical based dietary management and prevention of hypertension. Understanding the pathophysiology of hypertension and the action mechanisms of the bioactive peptides would complement in designing and characterizing more potent peptides and suitable comprehensive dietary plans for the prevention of hypertension and associated CVDs.
Collapse
Affiliation(s)
- Advaita Ganguly
- Comprehensive Tissue Centre, UAH Transplant Services, Alberta Health Services, Edmonton, AB, Canada
| | - Kumakshi Sharma
- Health, Safety and Environment Branch, National Research Council Canada, Edmonton, AB, Canada
| | - Kaustav Majumder
- Department of Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE, United States.
| |
Collapse
|
17
|
Fu Q. Sex differences in sympathetic activity in obesity and its related hypertension. Ann N Y Acad Sci 2019; 1454:31-41. [PMID: 31087350 DOI: 10.1111/nyas.14095] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/15/2019] [Accepted: 03/21/2019] [Indexed: 01/15/2023]
Abstract
The prevalence of obesity is rapidly increasing in the United States, particularly among women. Approximately 60-70% of hypertension in adults may be directly attributed to obesity. In addition, maternal obesity is a major risk factor for hypertensive disorders during pregnancy. The underlying mechanisms for the association between obesity and cardiovascular risk are multifactorial, but activation of the sympathetic nervous system is one significant contributing factor. This brief review summarizes the current knowledge on sex differences in sympathetic activity in obesity and its related hypertension, with a focus on studies in humans. Evidence suggests that abdominal visceral fat, rather than subcutaneous fat, is related to augmented sympathetic activity regardless of sex. Race/ethnicity may affect the relationship between obesity and sympathetic activity. Obesity-related hypertension has an important neurogenic component, which is characterized by sympathetic overactivity. However, sex may influence the association between hypertension and sympathetic overactivity in obese people. Finally, both body weight and sympathetic overactivity seem to be involved in the development of gestational hypertensive disorders in women. Chronic hyperinsulinemia due to insulin resistance, high plasma levels of leptin, and/or obstructive sleep apnea may be responsible for sympathetic overactivity in obesity-related hypertension.
Collapse
Affiliation(s)
- Qi Fu
- Women's Heart Health Laboratory, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, University of Texas Southwestern Medical Center, Dallas, Texas
| |
Collapse
|
18
|
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: 4.4] [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.
Collapse
Affiliation(s)
| | - Kristina Almby
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Jan W Eriksson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| |
Collapse
|
19
|
A polymorphism in the noradrenaline transporter gene is associated with increased blood pressure in patients with resistant hypertension. J Hypertens 2018; 36:1571-1577. [DOI: 10.1097/hjh.0000000000001736] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
20
|
Effects of 2-day calorie restriction on cardiovascular autonomic response, mood, and cognitive and motor functions in obese young adult women. Exp Brain Res 2018; 236:2299-2308. [DOI: 10.1007/s00221-018-5305-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 06/01/2018] [Indexed: 12/19/2022]
|
21
|
Farah BQ, Andrade-Lima A, Germano-Soares AH, Christofaro DGD, de Barros MVG, do Prado WL, Ritti-Dias RM. Physical Activity and Heart Rate Variability in Adolescents with Abdominal Obesity. Pediatr Cardiol 2018; 39:466-472. [PMID: 29164276 DOI: 10.1007/s00246-017-1775-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/13/2017] [Indexed: 12/16/2022]
Abstract
Physical activity is a protective factor for autonomic dysfunction. However, whether this occurs in adolescents with abdominal obesity is still unclear. Thus, the aim of this study was to analyze the association between physical activity and heart rate variability (HRV) in adolescents with and without abdominal obesity. This cross-sectional study included 1152 boys (age: 17 ± 1 years). HRV measures of time (root mean square of the squared differences between adjacent normal RR intervals-RMSSD and the percentage of adjacent intervals over 50 ms-PNN50) and frequency domains (balance sympathetic-vagal-LF/HF) were evaluated, as well as total physical activity, commuting physical activity, leisure-time physical activity, and abdominal obesity. All physical activity domains were associated with better RMSSD, PNN50, and LF/HF in normal weight adolescents (p < 0.05), whereas in adolescents with abdominal obesity only leisure-time physical activity was associated with better PNN50 (b = 0.174, p = 0.035) independent of age, period of the day, body mass index, and blood pressure. In conclusion, higher leisure-time physical activity, but not total and commuting physical activity levels, was associated with improved HRV in adolescents with abdominal obesity.
Collapse
Affiliation(s)
| | - Aluísio Andrade-Lima
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, Av. Professor Melo Moraes, 65, São Paulo, SP, 05508-030, Brazil.
| | | | - Diego Giulliano Destro Christofaro
- Laboratory of Investigation in Exercise - LIVE, Department of Physical Education, University of Paulista State (UNESP), São Paulo, SP, Brazil
| | - Mauro Virgílio Gomes de Barros
- Associate Graduate Program in Physical Education, University of Pernambuco, Recife, PE, Brazil.,Adolescent Health, University of Pernambuco, Camaragibe, PE, Brazil
| | - Wagner Luiz do Prado
- Department of Human Movement Sciences, Federal University of São Paulo, Santos, Brazil
| | | |
Collapse
|
22
|
Ribeiro MJ, Sacramento JF, Gallego-Martin T, Olea E, Melo BF, Guarino MP, Yubero S, Obeso A, Conde SV. High fat diet blunts the effects of leptin on ventilation and on carotid body activity. J Physiol 2018; 596:3187-3199. [PMID: 29271068 DOI: 10.1113/jp275362] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 12/13/2017] [Indexed: 12/21/2022] Open
Abstract
KEY POINTS Leptin plays a role in the control of breathing, acting mainly on central nervous system; however, leptin receptors have been recently shown to be expressed in the carotid body (CB), and this finding suggests a physiological role for leptin in the regulation of CB function. Leptin increases minute ventilation in both basal and hypoxic conditions in rats. It increases the frequency of carotid sinus nerve discharge in basal conditions, as well as the release of adenosine from the CB. However, in a metabolic syndrome animal model, the effects of leptin in ventilatory control, carotid sinus nerve activity and adenosine release by the CB are blunted. Although leptin may be involved in triggering CB overactivation in initial stages of obesity and dysmetabolism, resistance to leptin signalling and blunting of responses develops in metabolic syndrome animal models. ABSTRACT Leptin plays a role in the control of breathing, acting mainly on central nervous system structures. Leptin receptors are expressed in the carotid body (CB) and this finding has been associated with a putative physiological role of leptin in the regulation of CB function. Since, the CBs are implicated in energy metabolism, here we tested the effects of different concentrations of leptin administration on ventilatory parameters and on carotid sinus nerve (CSN) activity in control and high-fat (HF) diet fed rats, in order to clarify the role of leptin in ventilation control in metabolic disease states. We also investigated the expression of leptin receptors and the neurotransmitters involved in leptin signalling in the CBs. We found that in non-disease conditions, leptin increases minute ventilation in both basal and hypoxic conditions. However, in the HF model, the effect of leptin in ventilatory control is blunted. We also observed that HF rats display an increased frequency of CSN discharge in basal conditions that is not altered by leptin, in contrast to what is observed in control animals. Leptin did not modify intracellular Ca2+ in CB chemoreceptor cells, but it produced an increase in the release of adenosine from the whole CB. We conclude that CBs represent an important target for leptin signalling, not only to coordinate peripheral ventilatory chemoreflexive drive, but probably also to modulate metabolic variables. We also concluded that leptin signalling is mediated by adenosine release and that HF diets blunt leptin responses in the CB, compromising ventilatory adaptation.
Collapse
Affiliation(s)
- Maria J Ribeiro
- CEDOC, Centro Estudos Doenças Crónicas, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Joana F Sacramento
- CEDOC, Centro Estudos Doenças Crónicas, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Teresa Gallego-Martin
- Departamento de Bioquímica y Biología Molecular y Fisiología, Universidad de Valladolid, Facultad de Medicina, Instituto de Biología y Genética Molecular, CSIC, Ciber de Enfermedades Respiratorias, CIBERES, Valladolid, Spain
| | - Elena Olea
- Departamento de Bioquímica y Biología Molecular y Fisiología, Universidad de Valladolid, Facultad de Medicina, Instituto de Biología y Genética Molecular, CSIC, Ciber de Enfermedades Respiratorias, CIBERES, Valladolid, Spain
| | - Bernardete F Melo
- CEDOC, Centro Estudos Doenças Crónicas, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Maria P Guarino
- CEDOC, Centro Estudos Doenças Crónicas, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.,School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Sara Yubero
- Departamento de Bioquímica y Biología Molecular y Fisiología, Universidad de Valladolid, Facultad de Medicina, Instituto de Biología y Genética Molecular, CSIC, Ciber de Enfermedades Respiratorias, CIBERES, Valladolid, Spain
| | - Ana Obeso
- Departamento de Bioquímica y Biología Molecular y Fisiología, Universidad de Valladolid, Facultad de Medicina, Instituto de Biología y Genética Molecular, CSIC, Ciber de Enfermedades Respiratorias, CIBERES, Valladolid, Spain
| | - Silvia V Conde
- CEDOC, Centro Estudos Doenças Crónicas, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| |
Collapse
|
23
|
Sordi CCD, Lemos MDP, Marocolo M, Chriguer RS, Mendes EL, Mota GRD, Barbosa Neto O. Exercise training reverse autonomic dysfunction and hypertension in rats fed with high-fat diet. MOTRIZ: REVISTA DE EDUCACAO FISICA 2017. [DOI: 10.1590/s1980-6574201700040004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
24
|
Esler M, Lambert G, Schlaich M, Dixon J, Sari CI, Lambert E. Obesity Paradox in Hypertension: Is This Because Sympathetic Activation in Obesity-Hypertension Takes a Benign Form? Hypertension 2017; 71:22-33. [PMID: 29158358 DOI: 10.1161/hypertensionaha.117.09790] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Murray Esler
- From the Baker Heart and Diabetes Institute, Melbourne, Australia (M.E., J.D., C.I.S.); Swinburne University of Technology, Melbourne, Australia (G.L., E.L.); and School of Medicine, Royal Perth Hospital Unit, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth (M.S.).
| | - Gavin Lambert
- From the Baker Heart and Diabetes Institute, Melbourne, Australia (M.E., J.D., C.I.S.); Swinburne University of Technology, Melbourne, Australia (G.L., E.L.); and School of Medicine, Royal Perth Hospital Unit, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth (M.S.)
| | - Markus Schlaich
- From the Baker Heart and Diabetes Institute, Melbourne, Australia (M.E., J.D., C.I.S.); Swinburne University of Technology, Melbourne, Australia (G.L., E.L.); and School of Medicine, Royal Perth Hospital Unit, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth (M.S.)
| | - John Dixon
- From the Baker Heart and Diabetes Institute, Melbourne, Australia (M.E., J.D., C.I.S.); Swinburne University of Technology, Melbourne, Australia (G.L., E.L.); and School of Medicine, Royal Perth Hospital Unit, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth (M.S.)
| | - Carolina Ika Sari
- From the Baker Heart and Diabetes Institute, Melbourne, Australia (M.E., J.D., C.I.S.); Swinburne University of Technology, Melbourne, Australia (G.L., E.L.); and School of Medicine, Royal Perth Hospital Unit, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth (M.S.)
| | - Elisabeth Lambert
- From the Baker Heart and Diabetes Institute, Melbourne, Australia (M.E., J.D., C.I.S.); Swinburne University of Technology, Melbourne, Australia (G.L., E.L.); and School of Medicine, Royal Perth Hospital Unit, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth (M.S.)
| |
Collapse
|
25
|
Marinos A, Gamboa A, Celedonio JE, Preheim BA, Okamoto LE, Ramirez CE, Arnold AC, Diedrich A, Biaggioni I, Shibao CA. Hypertension in Obese Black Women is Not Caused by Increased Sympathetic Vascular Tone. J Am Heart Assoc 2017; 6:JAHA.117.006971. [PMID: 29151035 PMCID: PMC5721777 DOI: 10.1161/jaha.117.006971] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background Black women have one of the highest prevalence rates of hypertension and obesity in the United States. We previously reported that sympathetic activation induced by obesity is a significant contributor to hypertension in white patients. It is unknown whether sympathetic activity similarly contributes to hypertension in obese black women. Methods and Results We studied 42 obese women (16 white, body mass index 36±4 kg/m2, 44% with hypertension; 26 black, body mass index 35±4 kg/m2, 46% with hypertension). Antihypertensive medications were discontinued for 2 weeks before the day of the study. All patients underwent complete autonomic blockade with trimethaphan at a dosage of 4 mg/min. Resting sympathetic activity determined from muscle sympathetic nerve recordings was similar between obese black women with hypertension and those with normotension. In whites, sympathetic activity was elevated in obese patients with hypertension compared with normotension; the decrease in mean arterial blood pressure produced by trimethaphan was greater in obese white patients with hypertension compared with those with normotension (−26.8±9.7 mm Hg versus −14.8±7.9 mm Hg, P=0.02). In contrast, there was no difference in the depressor responses induced by trimethaphan between obese black women with hypertension and those with normotension (−15.5±10.5 mm Hg versus −12.3±10.2 mm Hg, P=0.45). Mean arterial blood pressure remained elevated in obese blacks with hypertension compared with those with normotension during trimethaphan infusion (83.7±15.0 mm Hg versus 71.7±9.8 mm Hg, P=0.02). Heart rate increased similarly with trimethaphan between white (P=0.11) and black (P=0.76) women with hypertension and normotension. Conclusions These findings suggest that sympathetic activity does not contribute to hypertension in obese black women and provide further evidence for racial differences in hypertension mechanisms.
Collapse
|
26
|
The Spleen: A Hub Connecting Nervous and Immune Systems in Cardiovascular and Metabolic Diseases. Int J Mol Sci 2017; 18:ijms18061216. [PMID: 28590409 PMCID: PMC5486039 DOI: 10.3390/ijms18061216] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 05/30/2017] [Accepted: 06/02/2017] [Indexed: 12/14/2022] Open
Abstract
Metabolic disorders have been identified as major health problems affecting a large portion of the world population. In addition, obesity and insulin resistance are principal risk factors for the development of cardiovascular diseases. Altered immune responses are common features of both hypertension and obesity and, moreover, the involvement of the nervous system in the modulation of immune system is gaining even more attention in both pathophysiological contexts. For these reasons, during the last decades, researches focused their efforts on the comprehension of the molecular mechanisms connecting immune system to cardiovascular and metabolic diseases. On the other hand, it has been reported that in these pathological conditions, central neural pathways modulate the activity of the peripheral nervous system, which is strongly involved in onset and progression of the disease. It is interesting to notice that neural reflex can also participate in the modulation of immune functions. In this scenario, the spleen becomes the crucial hub allowing the interaction of different systems differently involved in metabolic and cardiovascular diseases. Here, we summarize the major findings that dissect the role of the immune system in disorders related to metabolic and cardiovascular dysfunctions, and how this could also be influenced by neural reflexes.
Collapse
|
27
|
Eikelis N, Hering D, Marusic P, Duval J, Hammond LJ, Walton AS, Lambert EA, Esler MD, Lambert GW, Schlaich MP. The Effect of Renal Denervation on Plasma Adipokine Profile in Patients with Treatment Resistant Hypertension. Front Physiol 2017; 8:369. [PMID: 28611687 PMCID: PMC5447749 DOI: 10.3389/fphys.2017.00369] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/18/2017] [Indexed: 12/16/2022] Open
Abstract
Background: We previously demonstrated the effectiveness of renal denervation (RDN) to lower blood pressure (BP) at least partially via the reduction of sympathetic stimulation to the kidney. A number of adipocyte-derived factors are implicated in BP control in obesity. Aim: The aim of this study was to examine whether RDN may have salutary effects on the adipokine profile in patients with resistant hypertension (RH). Methods: Fifty seven patients with RH undergoing RDN program have been included in this study (65% males, age 60.8 ± 1.5 years, BMI 32.6 ± 0.7 kg/m2, mean ± SEM). Throughout the study, the patients were on an average of 4.5 ± 2.7 antihypertensive drugs. Automated seated office BP measurements and plasma concentrations of leptin, insulin, non-esterified fatty acids (NEFA), adiponectin and resistin were assessed at baseline and the 3 months after RDN. Results: There was a significant reduction in mean office systolic (168.75 ± 2.57 vs. 155.23 ± 3.17 mmHg, p < 0.001) and diastolic (90.68 ± 2.31 vs. 83.74 ± 2.36 mmHg, p < 0.001) BP 3 months after RDN. Body weight, plasma leptin and resistin levels and heart rate remained unchanged. Fasting insulin concentration significantly increased 3 months after the procedure (20.05 ± 1.46 vs. 29.70 ± 2.51 uU/ml, p = 0.002). There was a significant drop in circulating NEFA at follow up (1.01 ± 0.07 vs. 0.47 ± 0.04 mEq/l, p < 0.001). Adiponectin concentration was significantly higher after RDN (5,654 ± 800 vs. 6,644 ± 967 ng/ml, p = 0.024). Conclusions: This is the first study to demonstrate that RDN is associated with potentially beneficial effects on aspects of the adipokine profile. Increased adiponectin and reduced NEFA production may contribute to BP reduction via an effect on metabolic pathways. Clinical Trial Registration Number: NCT00483808, NCT00888433.
Collapse
Affiliation(s)
- Nina Eikelis
- Human Neurotransmitters and Neurovascular Hypertension and Kidney Disease Laboratories, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia.,Iverson Health Innovation Research Institute, Swinburne University of TechnologyMelbourne, VIC, Australia
| | - Dagmara Hering
- Human Neurotransmitters and Neurovascular Hypertension and Kidney Disease Laboratories, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia.,School of Medicine and Pharmacology - Royal Perth Hospital Unit, University of Western AustraliaPerth, WA, Australia
| | - Petra Marusic
- Human Neurotransmitters and Neurovascular Hypertension and Kidney Disease Laboratories, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia.,School of Medicine and Pharmacology - Royal Perth Hospital Unit, University of Western AustraliaPerth, WA, Australia
| | - Jacqueline Duval
- Human Neurotransmitters and Neurovascular Hypertension and Kidney Disease Laboratories, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia
| | - Louise J Hammond
- Human Neurotransmitters and Neurovascular Hypertension and Kidney Disease Laboratories, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia
| | | | - Elisabeth A Lambert
- Human Neurotransmitters and Neurovascular Hypertension and Kidney Disease Laboratories, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia.,Iverson Health Innovation Research Institute, Swinburne University of TechnologyMelbourne, VIC, Australia
| | - Murray D Esler
- Human Neurotransmitters and Neurovascular Hypertension and Kidney Disease Laboratories, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia.,Heart Centre Alfred HospitalMelbourne, VIC, Australia
| | - Gavin W Lambert
- Human Neurotransmitters and Neurovascular Hypertension and Kidney Disease Laboratories, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia.,Iverson Health Innovation Research Institute, Swinburne University of TechnologyMelbourne, VIC, Australia
| | - Markus P Schlaich
- Human Neurotransmitters and Neurovascular Hypertension and Kidney Disease Laboratories, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia.,School of Medicine and Pharmacology - Royal Perth Hospital Unit, University of Western AustraliaPerth, WA, Australia.,Heart Centre Alfred HospitalMelbourne, VIC, Australia
| |
Collapse
|
28
|
Ramos-Lobo AM, Donato J. The role of leptin in health and disease. Temperature (Austin) 2017; 4:258-291. [PMID: 28944270 DOI: 10.1080/23328940.2017.1327003] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/27/2017] [Accepted: 05/02/2017] [Indexed: 02/07/2023] Open
Abstract
Leptin is a master regulator of energy balance and body adiposity. Additionally, leptin exerts important control on glucose homeostasis, thermogenesis, autonomic nervous system and neuroendocrine axes. In metabolic diseases, such as obesity and diabetes mellitus, leptin signaling may be compromised, indicating the important role of this hormone in the etiology and pathophysiological manifestations of these conditions. In the present manuscript, we reviewed important concepts of leptin signaling, as well as about the effects of leptin on several biologic functions. We also discussed the possible therapeutic use of leptin administration and how our current obesogenic environment contributes to the development of leptin resistance. Our objective was to provide a comprehensive and state-of-the-art review about the importance of leptin to maintain the homeostasis and during pathological conditions.
Collapse
Affiliation(s)
- Angela M Ramos-Lobo
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Jose Donato
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
29
|
Tseng PW, Wu DA, Hou JS, Hsu BG. Leptin is an independent marker of metabolic syndrome in elderly adults with type 2 diabetes. Tzu Chi Med J 2017; 29:109-114. [PMID: 28757776 PMCID: PMC5509196 DOI: 10.4103/tcmj.tcmj_31_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 03/22/2017] [Accepted: 04/24/2017] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE It is well established that patients with metabolic syndrome (MetS) demonstrate elevated levels of serum leptin. The aim of this study is to identify fasting serum leptin as an independent marker of MetS in geriatric diabetic patients. MATERIALS AND METHODS Sixty-four patients over 65 years old with type 2 diabetic mellitus (T2DM) were assessed for MetS based on the diagnostic criteria of the International Diabetes Federation. Fasting blood samples including serum leptin concentrations were obtained from the participants. Leptin levels were determined using a commercial enzyme immunoassay. RESULTS Forty-five (70.3%) of the 64 geriatric T2DM patients enrolled in this study were found to have MetS. This group of participants compared with those in the non-MetS group had higher serum levels of leptin (P = 0.004), triglycerides (P = 0.005), fasting glucose (P = 0.049), glycated hemoglobin (P = 0.016), white blood cells (P = 0.003), C-reactive protein (CRP, P = 0.028), insulin (P < 0.001), higher homeostatic model assessment insulin resistance values (HOMA1-IR and HOMA2-IR, both P < 0.001), a higher body weight (P = 0.024), body mass index (P < 0.001), body fat mass (P < 0.001), waist circumference (P < 0.001), systolic blood pressure (BP) (P < 0.001), diastolic BP (P < 0.001), percentage of women (P = 0.011), prevalence of hypertension (P = 0.042), and a lower level of serum high-density lipoprotein cholesterol (P = 0.001). Univariate linear analysis of the clinical variables associated with the fasting serum leptin level revealed that height (P = 0.020) had a negative correlation, while body fat mass (P < 0.001) and logarithmically transformed CRP (log-CRP, P < 0.001) had positive correlations with serum leptin levels. Multivariate forward step-wise linear regression analysis of the variables significantly associated with fasting serum leptin levels showed that body fat mass (P < 0.001) and log-CRP (P = 0.001) were independent predictors of these values. CONCLUSION Serum leptin is positively correlated with MetS. It serves as an independent marker of MetS in elderly patients with T2DM.
Collapse
Affiliation(s)
- Pei-Wei Tseng
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Du-An Wu
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Division of Metabolism and Endocrinology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Jia-Sian Hou
- Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Bang-Gee Hsu
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| |
Collapse
|
30
|
|
31
|
Machado-Vieira R, Gold PW, Luckenbaugh DA, Ballard ED, Richards EM, Henter ID, De Sousa RT, Niciu MJ, Yuan P, Zarate CA. The role of adipokines in the rapid antidepressant effects of ketamine. Mol Psychiatry 2017; 22:127-133. [PMID: 27046644 PMCID: PMC5112162 DOI: 10.1038/mp.2016.36] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 01/21/2016] [Accepted: 02/12/2016] [Indexed: 12/17/2022]
Abstract
We previously found that body mass index (BMI) strongly predicted response to ketamine. Adipokines have a key role in metabolism (including BMI). They directly regulate inflammation and neuroplasticity pathways and also influence insulin sensitivity, bone metabolism and sympathetic outflow; all of these have been implicated in mood disorders. Here, we sought to examine the role of three key adipokines-adiponectin, resistin and leptin-as potential predictors of response to ketamine or as possible transducers of its therapeutic effects. Eighty treatment-resistant subjects who met DSM-IV criteria for either major depressive disorder (MDD) or bipolar disorder I/II and who were currently experiencing a major depressive episode received a single ketamine infusion (0.5 mg kg-1 for 40 min). Plasma adipokine levels were measured at three time points (pre-infusion baseline, 230 min post infusion and day 1 post infusion). Overall improvement and response were assessed using percent change from baseline on the Montgomery-Asberg Depression Rating Scale and the Hamilton Depression Rating Scale. Lower baseline levels of adiponectin significantly predicted ketamine's antidepressant efficacy, suggesting an adverse metabolic state. Because adiponectin significantly improves insulin sensitivity and has potent anti-inflammatory effects, this finding suggests that specific systemic abnormalities might predict positive response to ketamine. A ketamine-induced decrease in resistin was also observed; because resistin is a potent pro-inflammatory compound, this decrease suggests that ketamine's anti-inflammatory effects may be transduced, in part, by its impact on resistin. Overall, the findings suggest that adipokines may either predict response to ketamine or have a role in its possible therapeutic effects.
Collapse
Affiliation(s)
- R Machado-Vieira
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - PW Gold
- Clinical Neuroendocrinology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - DA Luckenbaugh
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - ED Ballard
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - EM Richards
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - ID Henter
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - RT De Sousa
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - MJ Niciu
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - P Yuan
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - CA Zarate
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| |
Collapse
|
32
|
Straznicky NE, Grima MT, Sari CI, Lambert EA, Phillips SE, Eikelis N, Mariani JA, Kobayashi D, Hering D, Dixon JB, Lambert GW. Comparable Attenuation of Sympathetic Nervous System Activity in Obese Subjects with Normal Glucose Tolerance, Impaired Glucose Tolerance, and Treatment Naïve Type 2 Diabetes following Equivalent Weight Loss. Front Physiol 2016; 7:516. [PMID: 27857694 PMCID: PMC5093133 DOI: 10.3389/fphys.2016.00516] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 10/19/2016] [Indexed: 11/30/2022] Open
Abstract
Background and Purpose: Elevated sympathetic nervous system (SNS) activity is a characteristic of obesity and type 2 diabetes (T2D) that contributes to target organ damage and cardiovascular risk. In this study we examined whether baseline metabolic status influences the degree of sympathoinhibition attained following equivalent dietary weight loss. Methods: Un-medicated obese individuals categorized as normal glucose tolerant (NGT, n = 15), impaired glucose tolerant (IGT, n = 24), and newly-diagnosed T2D (n = 15) consumed a hypocaloric diet (29% fat, 23% protein, 45% carbohydrate) for 4-months. The three groups were matched for baseline age (56 ± 1 years), body mass index (BMI, 32.9 ± 0.7 kg/m2), and gender. Clinical measurements included whole-body norepinephrine kinetics, muscle sympathetic nerve activity (MSNA, by microneurography), spontaneous cardiac baroreflex sensitivity (BRS), and oral glucose tolerance test. Results: Weight loss averaged −7.5 ± 0.8, −8.1 ± 0.5, and −8.0 ± 0.9% of body weight in NGT, IGT, and T2D groups, respectively. T2D subjects had significantly greater reductions in fasting glucose, 2-h glucose and glucose area under the curve (AUC0−120) compared to NGT and IGT (group effect, P <0.001). Insulinogenic index decreased in IGT and NGT groups and increased in T2D (group × time, P = 0.04). The magnitude of reduction in MSNA (−7 ± 3, −8 ± 4, −15 ± 4 burst/100 hb, respectively) and whole-body norepinephrine spillover rate (−28 ± 8, −18 ± 6, and −25 ± 7%, respectively), time effect both P <0.001, did not differ between groups. After adjustment for age and change in body weight, Δ insulin AUC0−120 was independently associated with reduction in arterial norepinephrine concentration, whilst Δ LDL-cholesterol and improvement in BRS were independently associated with decrease in MSNA. Conclusions: Equivalent weight loss through hypocaloric diet is accompanied by similar sympathoinhibition in matched obese subjects with different baseline glucose tolerance. Attenuation of hyperinsulinemia and hyperlipidemia, rather than glycemic indices, is associated with reduction in SNS activity following weight loss intervention.
Collapse
Affiliation(s)
- Nora E Straznicky
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute Melbourne, VIC, Australia
| | - Mariee T Grima
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute Melbourne, VIC, Australia
| | - Carolina I Sari
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute Melbourne, VIC, Australia
| | - Elisabeth A Lambert
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes InstituteMelbourne, VIC, Australia; Department of Physiology, Monash UniversityMelbourne, VIC, Australia; Department of Physiology, University of MelbourneMelbourne, VIC, Australia
| | - Sarah E Phillips
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute Melbourne, VIC, Australia
| | - Nina Eikelis
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute Melbourne, VIC, Australia
| | - Justin A Mariani
- Heart Failure Research Group, Baker IDI Heart and Diabetes InstituteMelbourne, VIC, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash UniversityMelbourne, VIC, Australia
| | - Daisuke Kobayashi
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute Melbourne, VIC, Australia
| | - Dagmara Hering
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute Melbourne, VIC, Australia
| | - John B Dixon
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes InstituteMelbourne, VIC, Australia; Department of Primary Health Care, Monash UniversityMelbourne, VIC, Australia
| | - Gavin W Lambert
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes InstituteMelbourne, VIC, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash UniversityMelbourne, VIC, Australia
| |
Collapse
|
33
|
Middlemiss JE, McEniery CM. Feeling the pressure: (patho) physiological mechanisms of weight gain and weight loss in humans. Hypertens Res 2016; 40:226-236. [PMID: 27760999 DOI: 10.1038/hr.2016.142] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 08/30/2016] [Accepted: 09/12/2016] [Indexed: 12/12/2022]
Abstract
Obesity is an ongoing global epidemic and has adverse consequences for cardiovascular health. Obesity is often associated with hypertension, which is, itself, a common condition and an important cause of morbidity and mortality worldwide. Although animal models of obesity have provided extensive data on the links between obesity and hypertension, a greater understanding of the pathways linking obesity and hypertension in humans is likely to assist translation of animal data, and may, itself, identify important treatment strategies. Ultimately, this could have a substantial impact on human health, both at an individual and population level. The current review will focus specifically on studies of experimental weight gain and weight loss in humans and the following key areas, which are strongly related to blood pressure: cardiovascular function, autonomic nervous system function, metabolic function and the impact of cardiorespiratory fitness.
Collapse
Affiliation(s)
- Jessica E Middlemiss
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK
| | - Carmel M McEniery
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK
| |
Collapse
|
34
|
Chaar LJ, Coelho A, Silva NM, Festuccia WL, Antunes VR. High-fat diet-induced hypertension and autonomic imbalance are associated with an upregulation of CART in the dorsomedial hypothalamus of mice. Physiol Rep 2016; 4:4/11/e12811. [PMID: 27273815 PMCID: PMC4908489 DOI: 10.14814/phy2.12811] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/04/2016] [Indexed: 01/12/2023] Open
Abstract
We evaluated herein whether diet‐induced obesity alters sympathovagal balance, blood pressure, and neuropeptides levels at the hypothalamus and brainstem of mice. Male C57BL6J mice fed with a high‐fat (HFD) or a high‐fat high‐sucrose (HFHSu), or a regular chow diet (C) for 8 weeks were evaluated for metabolic parameters and blood pressure, the latter being performed in conscious freely moving mice. Spectral analysis from the records of systolic blood pressure (SBP) and cardiac pulse intervals (PI) was performed to analyse the autonomic balance in the cardiovascular system. HFD‐fed mice developed two distinct hemodynamic phenotypes: hypertensive mice (HFD‐H) with high systolic and diastolic BP levels and hypertension‐resistant mice (HFD‐R) whose BP levels were similar to C group. Spectral analysis of SBP and PI variabilities indicate that the low‐frequency (LF)/high‐frequency (HF) ratio, which is an index of sympathovagal balance, is higher in HFD‐H compared to HFD‐R. Along with hypertension and higher LF/HF ratio, HFD‐H mice presented increased hypothalamic mRNA levels of cocaine‐ and amphetamine‐regulated transcript (CART), and increased CART‐positive neurones in the dorsomedial hypothalamus (DMH) by high‐fat diet when compared to C group. Despite developing obesity to similar levels than HFD feeding, intake of a HFHSu was not associated with hypertension in mice neither CART levels increase. Collectively, our main findings indicate that high‐fat diet induced‐hypertension and autonomic imbalance are associated to an upregulation of CART levels in the DMH of mice.
Collapse
Affiliation(s)
- Laiali J Chaar
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Aline Coelho
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Natalia M Silva
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - William L Festuccia
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Vagner R Antunes
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|
35
|
Johncy SS, Karthik CS, Bondade SY, Jayalakshmi MK. Altered cardiovascular autonomic function in young normotensive offspring of hypertensive parents - Is obesity an additional risk factor? J Basic Clin Physiol Pharmacol 2016; 26:531-7. [PMID: 25803073 DOI: 10.1515/jbcpp-2014-0068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 01/05/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND A study was undertaken to analyze the nature and magnitude of autonomic dysregulation that starts early in the offspring of a hypertensive parent and also whether obesity in them add an additional risk for future hypertension. METHODS Forty normotensive subjects aged 18-25 years with at least one hypertensive parent constitute the study group. The study group was divided into obese and non-obese depending on their body mass index (non-obese with BMI 18.50-24.99 kg/m2; obese with BMI≥30 kg/m2). Twenty age-matched normotensive, without parental history subjects constitute the control group. Anthropometric parameters, heart rate, systolic and diastolic pressures were recorded. Heart rate variability indices like total power, LF, HF, LF/HF, SDNN, RMSSD, and PNN50% were studied. One-way ANOVA was used for simultaneous multiple group comparison followed by post hoc Tukey's test for groupwise comparison. The Pearson correlation coefficient was used to assess the relationship between BMI and other variables. RESULTS Subjects who were obese with parental history of hypertension showed significantly higher heart rate, diastolic blood pressure, LF, LF/HF ratio and reduced total power, HF, SDNN, RMSSD, and PNN50% compared to the other groups with normal BMI. HF and all the time domain indices showed negative correlation and LF a positive correlation with BMI. CONCLUSIONS In the obese offspring of hypertensive parents, HRV markers, which represent a vagal dominance were reduced substantially, and indices of sympathetic activity were increased. So obesity in a normotensive offspring of a hypertensive parent is an additional risk factor for the future development of hypertension as it further dysregulates the autonomic control of the heart.
Collapse
|
36
|
Abstract
Hypertension affects over 25 % of the population with the incidence continuing to rise, due in part to the growing obesity epidemic. Chronic elevations in sympathetic nerve activity (SNA) are a hallmark of the disease and contribute to elevations in blood pressure through influences on the vasculature, kidney, and heart (i.e., neurogenic hypertension). In this regard, a number of central nervous system mechanisms and neural pathways have emerged as crucial in chronically elevating SNA. However, it is important to consider that "sympathetic signatures" are present, with differential increases in SNA to regional organs that are dependent upon the disease progression. Here, we discuss recent findings on the central nervous system mechanisms and autonomic regulatory networks involved in neurogenic hypertension, in both non-obesity- and obesity-associated hypertension, with an emphasis on angiotensin-II, salt, oxidative and endoplasmic reticulum stress, inflammation, and the adipokine leptin.
Collapse
|
37
|
Paleczny B, Siennicka A, Zacharski M, Jankowska EA, Ponikowska B, Ponikowski P. Increased body fat is associated with potentiation of blood pressure response to hypoxia in healthy men: relations with insulin and leptin. Clin Auton Res 2016; 26:107-16. [PMID: 26781642 PMCID: PMC4819928 DOI: 10.1007/s10286-015-0338-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 12/16/2015] [Indexed: 12/18/2022]
Abstract
Background Increased peripheral chemosensitivity (PChS) has been proposed
as mechanism underlying obesity-related sympathoactivation, with insulin and/or leptin as possible mediators. However, human data on PChS in obesity are scarce. Therefore, we explored this issue in a sample of 41 healthy men aged 30–59 years, divided according to body fat percentage (fat %) into two groups: <25 and ≥25 %. Methods PChS was assessed using transient hypoxia method [respiratory (PChS-MV), heart rate (PChS-HR), and blood pressure (PChS-SBP) responses were calculated]. Baroreflex sensitivity (BRS-Seq) was assessed using sequence method. Fasting plasma insulin and leptin levels were measured. Homeostatic model assessment (HOMA) was used to assess insulin sensitivity/resistance. Results Individuals with ≥25 % body fat demonstrated increased PChS-SBP (p < 0.01), but unchanged PChS-MV and PChS-HR (both p > 0.4). PChS-SBP was related positively with anthropometric characteristics (e.g. waist circumference, fat %), plasma insulin and HOMA (all p < 0.05), and negatively with BRS-Seq (p = 0.001), but not with plasma leptin (p = 0.27). Conclusions In healthy men, overweight/obesity is accompanied by augmented blood pressure response from peripheral chemoreceptors, while respiratory and heart rate responses remain unaltered. Hyperinsulinaemia and insulin resistance (but not hyperleptinaemia) are associated with augmented pressure response from chemoreceptors. Electronic supplementary material The online version of this article (doi:10.1007/s10286-015-0338-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Bartłomiej Paleczny
- Department of Physiology, Wroclaw Medical University, ul. Chałubińskiego 10, 50-368, Wroclaw, Poland. .,Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland.
| | - Agnieszka Siennicka
- Department of Physiology, Wroclaw Medical University, ul. Chałubińskiego 10, 50-368, Wroclaw, Poland.,Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
| | - Maciej Zacharski
- Department of Biochemistry, Pharmacology and Toxicology, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Ewa Anita Jankowska
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland.,Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Beata Ponikowska
- Department of Physiology, Wroclaw Medical University, ul. Chałubińskiego 10, 50-368, Wroclaw, Poland
| | - Piotr Ponikowski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland.,Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| |
Collapse
|
38
|
Farah BQ, Christofaro DGD, Balagopal PB, Cavalcante BR, de Barros MVG, Ritti-Dias RM. Association between resting heart rate and cardiovascular risk factors in adolescents. Eur J Pediatr 2015; 174:1621-8. [PMID: 26101052 DOI: 10.1007/s00431-015-2580-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 06/02/2015] [Accepted: 06/08/2015] [Indexed: 01/30/2023]
Abstract
UNLABELLED This cross-sectional study was performed in 2011 and included 4619 Brazilian adolescents (14-19 years old) to analyze the association between elevated resting heart rate (RHR) and cardiovascular risk factors in boys and girls. RHR and blood pressure were measured using an oscillometric monitor. Overweight was assessed by body mass index and abdominal obesity by waist circumference. Physical activity levels and sedentary behaviors were obtained using a questionnaire. The effect of clustering of cardiovascular risk factors on RHR was analyzed. For boys, abdominal obesity (b = 0.106, p = 0.003), high sedentary behavior (b = 0.099, b < 0.001), physical inactivity (b = 0.049, p = 0.034), and high blood pressure (b = 0.160, p < 0.001) were associated with RHR, whereas for girls, only high blood pressure was associated with RHR (b = 0.259, p < 0.001), after adjustment for age, period of the day, and other cardiovascular risk factors. Boys with five risk factors presented significantly higher (p < 0.05) RHR values (82.5 ± 13.4 beats min(-1)) than those for boys without any cardiovascular risk factors (68.8 ± 10.4 beats min(-1)). The girls with five risk factors presented a mean RHR value of 89.8 ± 9.9 beats min(-1) that was higher (p < 0.05) than that for girls who had no risk factors (79.6 ± 10.9 beats min(-1)). CONCLUSIONS Our study demonstrated that while RHR was associated with cardiovascular risk factors in both sexes, the clustering of risk factors amplified the elevation of RHR in a gender-dependent fashion. WHAT IS KNOWN • Resting heart rate is a marker of cardiovascular disease and mortality in adults and associated with risk factor such as higher levels of blood pressure, triglycerides, glucose, and obesity in children and adolescents. WHAT IS NEW • The data from the current study suggest that the risk factor clustering is associated with elevated resting heart rate in adolescents and that the clustering of risk factors amplifies the elevation of resting heart rate in a gender-dependent fashion.
Collapse
Affiliation(s)
- Breno Quintella Farah
- Graduate Program in Physical Education, University of Pernambuco, Recife, PE, Brazil.
| | - Diego Giulliano Destro Christofaro
- Laboratory of Investigation in Exercise - LIVE, Department of Physical Education, University of Paulista State (UNESP), Presidente Prudente, SP, Brazil.
| | - P Babu Balagopal
- Nemours Children's Clinic and Mayo Clinic College of Medicine, Jacksonville, FL, USA.
| | | | | | - Raphael Mendes Ritti-Dias
- Graduate Program in Physical Education, University of Pernambuco, Recife, PE, Brazil. .,Albert Einstein Hospital, Albert Einstein Avenue, 627, 05652-900, Sao Paulo, SP, Brazil.
| |
Collapse
|
39
|
Bonnet F, Empana JP, Natali A, Monti L, Golay A, Lalic K, Dekker J, Mari A, Balkau B. Elevated heart rate predicts β cell function in non-diabetic individuals: the RISC cohort. Eur J Endocrinol 2015; 173:409-15. [PMID: 26034075 DOI: 10.1530/eje-15-0115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 06/01/2015] [Indexed: 11/08/2022]
Abstract
CONTEXT Elevated heart rate has been associated with insulin resistance and incident type 2 diabetes but its relationship with β-cell function is not known. Our aim was to investigate whether baseline heart rate is associated with β-cell function and hyperglycaemia. METHODS We used the prospective RISC cohort with 1005 non-diabetic individuals who had an oral glucose tolerance test (OGTT) at baseline and after 3 years. Impaired glucose regulation was defined as a fasting plasma glucose ≥ 6.1 mmol/l or a 2-h plasma glucose ≥ 7.8 mmol/l. Insulin sensitivity was assessed by the OGIS index and insulin secretion and β-cell glucose sensitivity at both baseline and 3 years. RESULTS Baseline heart rate was positively related to both fasting (P < 0.0001) and 2 h glucose levels (P = 0.02) at year 3 and predicted the presence of impaired glucose regulation at year 3 in a logistic regression model adjusting for insulin sensitivity at inclusion (OR/10 beats per min: 1.31; 95% CI (1.07-1.61); P = 0.01). Baseline heart rate was associated with lower insulin sensitivity (β = -0.11; P < .0001), a decrease in both β-cell glucose sensitivity (β = -0.11; P = 0.003) and basal insulin secretion rate (β = -0.11; P = 0.002) at 3 years in an adjusted multivariable regression model. Baseline heart rate predicted the 3-year decrease in β-cell glucose sensitivity (β = -0.10; P = 0.007) and basal insulin secretion (β = -0.12; P = 0.007). CONCLUSIONS Heart rate predicts β-cell function and impaired glucose regulation at 3 years in non-diabetic individuals, independently of the level of insulin sensitivity. These findings suggest a possible effect of the sympathetic nervous system on β-cell dysfunction, which deserves further investigation.
Collapse
Affiliation(s)
- Fabrice Bonnet
- Service Endocrinologie-DiabétologieCHU Rennes, Université Rennes 1, Rennes, FranceInserm Centre for research in Epidemiology and Population Health (CESP) U1018Villejuif, FranceParis Cardiovascular Research Centre (PARCC)INSERM UMRS 970, Paris, FranceDepartment of Internal MedicineUniversity of Pisa, Pisa, ItalyDepartment of Internal MedicineCardio-Diabetes and Core Lab, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, ItalyService d'enseignement thérapeutique pour maladies chroniquesHôpitaux Universitaires de Genève, Geneva, SwitzerlandFaculty of Medicine University of BelgradeClinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, SerbiaDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care Research, Amsterdam, The NetherlandsC N R Institute of NeurosciencePadova, Italy Service Endocrinologie-DiabétologieCHU Rennes, Université Rennes 1, Rennes, FranceInserm Centre for research in Epidemiology and Population Health (CESP) U1018Villejuif, FranceParis Cardiovascular Research Centre (PARCC)INSERM UMRS 970, Paris, FranceDepartment of Internal MedicineUniversity of Pisa, Pisa, ItalyDepartment of Internal MedicineCardio-Diabetes and Core Lab, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, ItalyService d'enseignement thérapeutique pour maladies chroniquesHôpitaux Universitaires de Genève, Geneva, SwitzerlandFaculty of Medicine University of BelgradeClinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, SerbiaDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care Research, Amsterdam, The NetherlandsC N R Institute of NeurosciencePadova, Italy
| | - Jean-Philippe Empana
- Service Endocrinologie-DiabétologieCHU Rennes, Université Rennes 1, Rennes, FranceInserm Centre for research in Epidemiology and Population Health (CESP) U1018Villejuif, FranceParis Cardiovascular Research Centre (PARCC)INSERM UMRS 970, Paris, FranceDepartment of Internal MedicineUniversity of Pisa, Pisa, ItalyDepartment of Internal MedicineCardio-Diabetes and Core Lab, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, ItalyService d'enseignement thérapeutique pour maladies chroniquesHôpitaux Universitaires de Genève, Geneva, SwitzerlandFaculty of Medicine University of BelgradeClinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, SerbiaDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care Research, Amsterdam, The NetherlandsC N R Institute of NeurosciencePadova, Italy
| | - Andrea Natali
- Service Endocrinologie-DiabétologieCHU Rennes, Université Rennes 1, Rennes, FranceInserm Centre for research in Epidemiology and Population Health (CESP) U1018Villejuif, FranceParis Cardiovascular Research Centre (PARCC)INSERM UMRS 970, Paris, FranceDepartment of Internal MedicineUniversity of Pisa, Pisa, ItalyDepartment of Internal MedicineCardio-Diabetes and Core Lab, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, ItalyService d'enseignement thérapeutique pour maladies chroniquesHôpitaux Universitaires de Genève, Geneva, SwitzerlandFaculty of Medicine University of BelgradeClinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, SerbiaDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care Research, Amsterdam, The NetherlandsC N R Institute of NeurosciencePadova, Italy
| | - Lucilla Monti
- Service Endocrinologie-DiabétologieCHU Rennes, Université Rennes 1, Rennes, FranceInserm Centre for research in Epidemiology and Population Health (CESP) U1018Villejuif, FranceParis Cardiovascular Research Centre (PARCC)INSERM UMRS 970, Paris, FranceDepartment of Internal MedicineUniversity of Pisa, Pisa, ItalyDepartment of Internal MedicineCardio-Diabetes and Core Lab, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, ItalyService d'enseignement thérapeutique pour maladies chroniquesHôpitaux Universitaires de Genève, Geneva, SwitzerlandFaculty of Medicine University of BelgradeClinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, SerbiaDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care Research, Amsterdam, The NetherlandsC N R Institute of NeurosciencePadova, Italy
| | - Alain Golay
- Service Endocrinologie-DiabétologieCHU Rennes, Université Rennes 1, Rennes, FranceInserm Centre for research in Epidemiology and Population Health (CESP) U1018Villejuif, FranceParis Cardiovascular Research Centre (PARCC)INSERM UMRS 970, Paris, FranceDepartment of Internal MedicineUniversity of Pisa, Pisa, ItalyDepartment of Internal MedicineCardio-Diabetes and Core Lab, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, ItalyService d'enseignement thérapeutique pour maladies chroniquesHôpitaux Universitaires de Genève, Geneva, SwitzerlandFaculty of Medicine University of BelgradeClinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, SerbiaDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care Research, Amsterdam, The NetherlandsC N R Institute of NeurosciencePadova, Italy
| | - Katarina Lalic
- Service Endocrinologie-DiabétologieCHU Rennes, Université Rennes 1, Rennes, FranceInserm Centre for research in Epidemiology and Population Health (CESP) U1018Villejuif, FranceParis Cardiovascular Research Centre (PARCC)INSERM UMRS 970, Paris, FranceDepartment of Internal MedicineUniversity of Pisa, Pisa, ItalyDepartment of Internal MedicineCardio-Diabetes and Core Lab, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, ItalyService d'enseignement thérapeutique pour maladies chroniquesHôpitaux Universitaires de Genève, Geneva, SwitzerlandFaculty of Medicine University of BelgradeClinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, SerbiaDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care Research, Amsterdam, The NetherlandsC N R Institute of NeurosciencePadova, Italy
| | - Jacqueline Dekker
- Service Endocrinologie-DiabétologieCHU Rennes, Université Rennes 1, Rennes, FranceInserm Centre for research in Epidemiology and Population Health (CESP) U1018Villejuif, FranceParis Cardiovascular Research Centre (PARCC)INSERM UMRS 970, Paris, FranceDepartment of Internal MedicineUniversity of Pisa, Pisa, ItalyDepartment of Internal MedicineCardio-Diabetes and Core Lab, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, ItalyService d'enseignement thérapeutique pour maladies chroniquesHôpitaux Universitaires de Genève, Geneva, SwitzerlandFaculty of Medicine University of BelgradeClinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, SerbiaDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care Research, Amsterdam, The NetherlandsC N R Institute of NeurosciencePadova, Italy
| | - Andrea Mari
- Service Endocrinologie-DiabétologieCHU Rennes, Université Rennes 1, Rennes, FranceInserm Centre for research in Epidemiology and Population Health (CESP) U1018Villejuif, FranceParis Cardiovascular Research Centre (PARCC)INSERM UMRS 970, Paris, FranceDepartment of Internal MedicineUniversity of Pisa, Pisa, ItalyDepartment of Internal MedicineCardio-Diabetes and Core Lab, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, ItalyService d'enseignement thérapeutique pour maladies chroniquesHôpitaux Universitaires de Genève, Geneva, SwitzerlandFaculty of Medicine University of BelgradeClinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, SerbiaDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care Research, Amsterdam, The NetherlandsC N R Institute of NeurosciencePadova, Italy
| | - Beverley Balkau
- Service Endocrinologie-DiabétologieCHU Rennes, Université Rennes 1, Rennes, FranceInserm Centre for research in Epidemiology and Population Health (CESP) U1018Villejuif, FranceParis Cardiovascular Research Centre (PARCC)INSERM UMRS 970, Paris, FranceDepartment of Internal MedicineUniversity of Pisa, Pisa, ItalyDepartment of Internal MedicineCardio-Diabetes and Core Lab, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, ItalyService d'enseignement thérapeutique pour maladies chroniquesHôpitaux Universitaires de Genève, Geneva, SwitzerlandFaculty of Medicine University of BelgradeClinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, SerbiaDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care Research, Amsterdam, The NetherlandsC N R Institute of NeurosciencePadova, Italy
| |
Collapse
|
40
|
Lambert EA, Straznicky NE, Dixon JB, Lambert GW. Should the sympathetic nervous system be a target to improve cardiometabolic risk in obesity? Am J Physiol Heart Circ Physiol 2015; 309:H244-58. [DOI: 10.1152/ajpheart.00096.2015] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/11/2015] [Indexed: 02/03/2023]
Abstract
The sympathetic nervous system (SNS) plays a key role in both cardiovascular and metabolic regulation; hence, disturbances in SNS regulation are likely to impact on both cardiovascular and metabolic health. With excess adiposity, in particular when visceral fat accumulation is present, sympathetic activation commonly occurs. Experimental investigations have shown that adipose tissue releases a large number of adipokines, cytokines, and bioactive mediators capable of stimulating the SNS. Activation of the SNS and its interaction with adipose tissue may lead to the development of hypertension and end-organ damage including vascular, cardiac, and renal impairment and in addition lead to metabolic abnormalities, especially insulin resistance. Lifestyle changes such as weight loss and exercise programs considerably improve the cardiovascular and metabolic profile of subjects with obesity and decrease their cardiovascular risk, but unfortunately weight loss is often difficult to achieve and sustain. Pharmacological and device-based approaches to directly or indirectly target the activation of the SNS may offer some benefit in reducing the cardiometabolic consequences of obesity. Preliminary evidence is encouraging, but more trials are needed to investigate whether sympathetic inhibition could be used in obesity to reverse or prevent cardiometabolic disease development. The purpose of this review article is to highlight the current knowledge of the role that SNS plays in obesity and its associated metabolic disorders and to review the potential benefits of sympathoinhibition on metabolic and cardiovascular functions.
Collapse
Affiliation(s)
- Elisabeth A. Lambert
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Department of Physiology, Monash University, Clayton, Australia
| | - Nora E. Straznicky
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - John B. Dixon
- Clinical Obesity Research Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; and
| | - Gavin W. Lambert
- Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| |
Collapse
|
41
|
Abe C, Nagai Y, Yamaguchi A, Aoki H, Shimizu S, Akiyama T, Kawada T, Sugimachi M, Morita H. Reduced carotid baroreceptor distensibility-induced baroreflex resetting contributes to impairment of sodium regulation in rats fed a high-fat diet. Am J Physiol Heart Circ Physiol 2015; 308:H942-50. [DOI: 10.1152/ajpheart.00697.2014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 02/09/2015] [Indexed: 12/21/2022]
Abstract
Decreased carotid arterial compliance has been reported in obese subjects and animals. Carotid baroreceptors are located at the bifurcation of the common carotid artery, and respond to distension of the arterial wall, suggesting that higher pressure is required to obtain the same distension in obese subjects and animals. A hyperosmotic NaCl solution induces circulatory volume expansion and arterial pressure (AP) increase, which reflexively augment renal excretion. Thus, we hypothesized that sodium regulation via the baroreflex might be impaired in response to chronic hyperosmotic NaCl infusion in rats fed a high-fat diet. To examine this hypothesis, we used rats fed a high-fat (Fat) or normal (NFD) diet, and measured mean AP, water and sodium balance, and renal function in response to chronic infusion of hyperosmotic NaCl solution via a venous catheter. Furthermore, we examined arterial baroreflex characteristics with static open-loop analysis and distensibility of the common carotid artery. Significant positive water and sodium balance was observed on the 1st day of 9% NaCl infusion; however, this disappeared by the 2nd day in Fat rats. Mean AP was significantly higher during 9% NaCl infusion in Fat rats compared with NFD rats. In the open-loop analysis of carotid sinus baroreflex, a rightward shift of the neural arc was observed in Fat rats compared with NFD rats. Furthermore, distensibility of the common carotid artery was significantly reduced in Fat rats. These results indicate that a reduced baroreceptor distensibility-induced rightward shift of the neural arc might contribute to impairment of sodium regulation in Fat rats.
Collapse
Affiliation(s)
- Chikara Abe
- Department of Physiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yuko Nagai
- Department of Physiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Aoi Yamaguchi
- Department of Physiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hitomi Aoki
- Department of Tissue and Organ Development, Regeneration, and Advanced Medical Science, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shuji Shimizu
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan; and
| | - Tsuyoshi Akiyama
- Department of Cardiac Physiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Toru Kawada
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan; and
| | - Masaru Sugimachi
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan; and
| | - Hironobu Morita
- Department of Physiology, Gifu University Graduate School of Medicine, Gifu, Japan
| |
Collapse
|
42
|
Abstract
Metabolic syndrome is associated with adverse health outcomes and is a growing problem worldwide. Although efforts to harmonise the definition of metabolic syndrome have helped to better understand the prevalence and the adverse outcomes associated with the disorder on a global scale, the mechanisms underpinning the metabolic changes that define it are incompletely understood. Accumulating evidence from laboratory and human studies suggests that activation of the sympathetic nervous system has an important role in metabolic syndrome. Indeed, treatment strategies commonly recommended for patients with metabolic syndrome, such as diet and exercise to induce weight loss, are associated with sympathetic inhibition. Pharmacological and device-based approaches to target activation of the sympathetic nervous system directly are available and have provided evidence to support the important part played by sympathetic regulation, particularly for blood pressure and glucose control. Preliminary evidence is encouraging, but whether therapeutically targeting sympathetic overactivity could help to prevent metabolic syndrome and attenuate its adverse outcomes remains to be determined.
Collapse
Affiliation(s)
- Markus Schlaich
- Neurovascular Hypertension and Kidney Disease and Human Neurotransmitters Laboratories, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia; Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, VIC, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
| | - Nora Straznicky
- Neurovascular Hypertension and Kidney Disease and Human Neurotransmitters Laboratories, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Elisabeth Lambert
- Neurovascular Hypertension and Kidney Disease and Human Neurotransmitters Laboratories, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Gavin Lambert
- Neurovascular Hypertension and Kidney Disease and Human Neurotransmitters Laboratories, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
43
|
Farr OM, Tsoukas MA, Mantzoros CS. Leptin and the brain: influences on brain development, cognitive functioning and psychiatric disorders. Metabolism 2015; 64:114-30. [PMID: 25092133 DOI: 10.1016/j.metabol.2014.07.004] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 06/16/2014] [Accepted: 07/05/2014] [Indexed: 12/20/2022]
Abstract
Receptors of leptin, the prototypical adipokine, are expressed throughout the cortex and several other areas of the brain. Although typically studied for its role in energy intake and expenditure, leptin plays a critical role in many other neurocognitive processes and interacts with various other hormones and neurotransmitters to perform these functions. Here, we review the literature on how leptin influences brain development, neural degradation, Alzheimer's disease, psychiatric disorders, and more complicated cognitive functioning and feeding behaviors. We also discuss modulators of leptin and the leptin receptor as they relate to normal cognitive functioning and may mediate some of the actions of leptin in the brain. Although we are beginning to better understand the critical role leptin plays in normal cognitive functioning, there is much to be discovered.
Collapse
Affiliation(s)
- Olivia M Farr
- Division of Endocrinology, Boston VA Healthcare System/Harvard Medical School, Boston, MA 02215.
| | - Michael A Tsoukas
- Division of Endocrinology, Boston VA Healthcare System/Harvard Medical School, Boston, MA 02215
| | - Christos S Mantzoros
- Division of Endocrinology, Boston VA Healthcare System/Harvard Medical School, Boston, MA 02215
| |
Collapse
|
44
|
Münzberg H, Morrison CD. Structure, production and signaling of leptin. Metabolism 2015; 64:13-23. [PMID: 25305050 PMCID: PMC4267896 DOI: 10.1016/j.metabol.2014.09.010] [Citation(s) in RCA: 260] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 09/17/2014] [Accepted: 09/20/2014] [Indexed: 01/07/2023]
Abstract
The cloning of leptin in 1994 was an important milestone in obesity research. In those days obesity was stigmatized as a condition caused by lack of character and self-control. Mutations in either leptin or its receptor were the first single gene mutations found to cause morbid obesity, and it is now appreciated that obesity is caused by a dysregulation of central neuronal circuits. From the first discovery of the leptin deficient obese mouse (ob/ob), to the cloning of leptin (ob aka lep) and leptin receptor (db aka lepr) genes, much has been learned about leptin and its action in the central nervous system. The initial high hopes that leptin would cure obesity were quickly dampened by the discovery that most obese humans have increased leptin levels and develop leptin resistance. Nevertheless, leptin target sites in the brain represent an excellent blueprint for distinct neuronal circuits that control energy homeostasis. A better understanding of the regulation and interconnection of these circuits will further guide and improve the development of safe and effective interventions to treat obesity. This review will highlight our current knowledge about the hormone leptin, its signaling pathways and its central actions to mediate distinct physiological functions.
Collapse
Affiliation(s)
- Heike Münzberg
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA.
| | | |
Collapse
|
45
|
Zhang Z, Wang F, Wang BJ, Chu G, Cao Q, Sun BG, Dai QY. Inhibition of leptin-induced vascular extracellular matrix remodelling by adiponectin. J Mol Endocrinol 2014; 53:145-54. [PMID: 24982243 PMCID: PMC4151455 DOI: 10.1530/jme-14-0027] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Vascular extracellular matrix (ECM) remodelling, which is the result of disruption in the balance of ECM synthesis and degradation, induces vessel fibrosis and thereby leads to hypertension. Leptin is known to promote tissue fibrosis, while adiponectin has recently been demonstrated to be anti-fibrogenic in tissue fibrosis. In this study, we aimed to evaluate the leptin-antagonist function of adiponectin and to further elucidate the mechanisms through which adiponectin dampens leptin signalling in vascular smooth muscle cells, thus preventing excess ECM production, in our already established 3D co-culture vessel models. Our 3D co-culture vessel model, which mimics true blood vessels, is composed of vascular endothelial cells, vascular smooth muscle cells and collagen type I. We validated the profibrogenic effects of leptin and analysed matrix metalloproteinase 2 (MMP2), MMP9, tissue inhibitor of metalloproteinase 1 (TIMP1) and collagen types II/IV secretion in 3D vessel models. The protective/inhibitory effects of adiponectin were re-analysed by inhibiting adiponectin receptor 1 (AdipoR) and AdipoR2 expression in endothelial cells using RNAi technology. In the 3D vessel models, adiponectin blocked the leptin-stimulated secretion of collagen types II/IV and TIMP1 while significantly increasing MMP2/9 activity. In endothelial cells, adiponectin induced phosphorylation of AMPK, thereby suppressing leptin-mediated STAT3 phosphorylation through induction of SOCS3 in smooth muscle cells. Our findings indicate that adiponectin disrupted the leptin-induced vascular ECM remodelling via AdipoR1 and enhanced AMPK signalling in endothelial cells, which, in turn, promoted SOCS3 up-regulation in smooth muscle cells to repress leptin-stimulated phosphorylation of STAT3.
Collapse
Affiliation(s)
- Zhi Zhang
- Department of CardiologySchool of Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, People's Republic of ChinaDepartment of CardiologyHuai'an First People's Hospital, Nanjing Medical University, Jiangsu Province 223300, People's Republic of China
| | - Fang Wang
- Department of CardiologySchool of Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, People's Republic of ChinaDepartment of CardiologyHuai'an First People's Hospital, Nanjing Medical University, Jiangsu Province 223300, People's Republic of China
| | - Bing-Jian Wang
- Department of CardiologySchool of Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, People's Republic of ChinaDepartment of CardiologyHuai'an First People's Hospital, Nanjing Medical University, Jiangsu Province 223300, People's Republic of China
| | - Guang Chu
- Department of CardiologySchool of Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, People's Republic of ChinaDepartment of CardiologyHuai'an First People's Hospital, Nanjing Medical University, Jiangsu Province 223300, People's Republic of China
| | - Qunan Cao
- Department of CardiologySchool of Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, People's Republic of ChinaDepartment of CardiologyHuai'an First People's Hospital, Nanjing Medical University, Jiangsu Province 223300, People's Republic of China
| | - Bao-Gui Sun
- Department of CardiologySchool of Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, People's Republic of ChinaDepartment of CardiologyHuai'an First People's Hospital, Nanjing Medical University, Jiangsu Province 223300, People's Republic of China
| | - Qiu-Yan Dai
- Department of CardiologySchool of Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, People's Republic of ChinaDepartment of CardiologyHuai'an First People's Hospital, Nanjing Medical University, Jiangsu Province 223300, People's Republic of China
| |
Collapse
|
46
|
Charles LE, Burchfiel CM, Sarkisian K, Li S, Miller DB, Gu JK, Fekedulegn D, Violanti JM, Andrew ME. Leptin, adiponectin, and heart rate variability among police officers. Am J Hum Biol 2014; 27:184-91. [PMID: 25270126 DOI: 10.1002/ajhb.22636] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 08/12/2014] [Accepted: 09/09/2014] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Police officers have a high prevalence of cardiovascular disease (CVD). Reduced heart rate variability (HRV) is known to increase CVD risk. Leptin and adiponectin may be related to CVD health. Therefore, our objective was to investigate the relationship between these variables and HRV. METHODS Leptin and adiponectin levels were measured in 388 officers from the Buffalo Cardio-Metabolic Occupational Police Stress study. HRV was assessed according to methods published by the Task Force of the European Society of Cardiology and the North American Society of Pacing Electrophysiology for measurement and analysis of HRV. Mean values of high-frequency (HF) and low-frequency (LF) HRV were compared across tertiles of leptin and adiponectin using analysis of variance and analysis of covariance; trends were assessed using linear regression models. RESULTS Leptin, but not adiponectin, was significantly and inversely associated with HRV. Body mass index (BMI) and percent body fat significantly modified the association between leptin and LF (but not HF) HRV. Among officers with BMI < 25 kg/m(2) , leptin was not significantly associated with HRV. However, among officers with BMI ≥ 25 kg/m(2) , leptin was inversely associated with HRV, after adjustment for age, gender, and race/ethnicity; HF HRV, P = 0.019 and LF HRV, P < 0.0001. Similarly, among officers with percent body fat ≥ 25.5%, leptin and LF HRV showed significant, inverse associations (adjusted P = 0.001). CONCLUSIONS Leptin levels were inversely associated with LF HRV, especially among officers with increased adiposity. Increased leptin levels may be associated with CVD-related health problems.
Collapse
Affiliation(s)
- Luenda E Charles
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Fong FM, Sahemey MK, Hamedi G, Eyitayo R, Yates D, Kuan V, Thangaratinam S, Walton RT. Maternal genotype and severe preeclampsia: a HuGE review. Am J Epidemiol 2014; 180:335-45. [PMID: 25028703 DOI: 10.1093/aje/kwu151] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Severe preeclampsia is a common cause of maternal and perinatal morbidity worldwide. The disease clusters in families; however, individual genetic studies have produced inconsistent results. We conducted a review to examine relationships between maternal genotype and severe preeclampsia. We searched the MEDLINE and Embase databases for prospective and retrospective cohort and case-control studies reporting associations between genes and severe preeclampsia. Four reviewers independently undertook study selection, quality assessment, and data extraction. We performed random-effects meta-analyses by genotype and predefined functional gene group (thrombophilic, vasoactive, metabolic, immune, and cell signalling). Fifty-seven studies evaluated 50 genotypes in 5,049 cases and 16,989 controls. Meta-analysis showed a higher risk of severe preeclampsia with coagulation factor V gene (proaccelerin, labile factor) (F5) polymorphism rs6025 (odds ratio = 1.90, 95% confidence interval: 1.42, 2.54; 23 studies, I(2) = 29%), coagulation factor II (thrombin) gene (F2) mutation G20210A (rs1799963) (odds ratio = 2.01, 95% confidence interval: 1.14, 3.55, 9 studies, I(2) = 0%), leptin receptor gene (LEPR) polymorphism rs1137100 (odds ratio = 1.75, 95% confidence interval: 1.15, 2.65; 2 studies, I(2) = 0%), and the thrombophilic gene group (odds ratio = 1.87, 95% confidence interval: 1.43, 2.45, I(2) = 27%). There were no associations with other gene groups. There was moderate heterogeneity between studies and potential for bias from poor-quality genotyping and inconsistent definition of phenotype. Further studies with robust methods should investigate genetic factors that might potentially be used to stratify pregnancies according to risk of complications.
Collapse
|
48
|
Barnes MJ, McDougal DH. Leptin into the rostral ventral lateral medulla (RVLM) augments renal sympathetic nerve activity and blood pressure. Front Neurosci 2014; 8:232. [PMID: 25152707 PMCID: PMC4125949 DOI: 10.3389/fnins.2014.00232] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 07/14/2014] [Indexed: 01/31/2023] Open
Abstract
Leptin is a hormone released from adipose tissue. While this hormone normally acts to reduce feeding behavior and increase energy expenditure, in obesity, resistance to these effects occurs even though the hormone is released in large amounts. Although leptin no longer works to suppress feeding in the obese, leptin retains its potent effects on other autonomic functions such as blood pressure regulation. Leptin has been associated with hypertension and increased sympathetic autonomic activity. Therefore, leptin is emerging as a major contributor to the hypertensive state observed in obesity. Sympathetic control of blood pressure is maintained principally by autonomic reflex control circuits in the caudal brainstem. The rostral ventral-lateral medulla (RVLM) is the primary regulator of the sympathetic nervous system, sending excitatory fibers to sympathetic preganglionic neurons to regulate sympathetic control over resistance vessels and blood pressure. Previous studies from our laboratory have shown that neurons in the ventral lateral medulla express leptin receptors (ObRb). Our present study using pseudo-rabies multi-synaptic retrograde tract tracing and immunohistochemical methods revealed that neurons within the RVLM that send sympathetic projections to the kidney express leptin receptors. Acute microinjection of leptin (1 and 3 μg; 40 nL) into the RVLM evoked a significant increase in Mean Arterial Pressure (MAP) and renal sympathetic nerve activity (RSNA). When the 3 μg dose of leptin was preceded with a leptin antagonist, (SLAN-4; 1 ng), it attenuated the cardiovascular response of leptin. Taken together, these data suggest that leptin's actions within the RVLM may influence blood pressure and renal sympathetic nerve activity.
Collapse
Affiliation(s)
- Maria J Barnes
- Nutrition and Neural Signaling Laboratory, Pennington Biomedical Research Center Baton Rouge, LA, USA
| | - David H McDougal
- Neurobiology of Metabolic Dysfunction Laboratory, Pennington Biomedical Research Center Baton Rouge, LA, USA
| |
Collapse
|
49
|
Affiliation(s)
- Kamal Rahmouni
- Department of Pharmacology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| |
Collapse
|
50
|
Pétervári E, Rostás I, Soós S, Tenk J, Mikó A, Füredi N, Székely M, Balaskó M. Age versus nutritional state in the development of central leptin resistance. Peptides 2014; 56:59-67. [PMID: 24680735 DOI: 10.1016/j.peptides.2014.03.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 03/05/2014] [Accepted: 03/09/2014] [Indexed: 02/06/2023]
Abstract
Leptin, a catabolic adiposity signal acts in the hypothalamus via suppressing food intake and inducing hypermetabolism. Age and obesity are accompanied by leptin resistance. The present study aimed to clarify which components of the catabolic leptin effects are influenced most strongly by aging and which ones by nutritional state-induced alterations in body composition. In our biotelemetric study the effects of a 7-day intracerebroventricular leptin infusion on various parameters of energy balance (food intake, body weight, oxygen consumption, heart rate and body temperature) were analyzed in male Wistar rats of different age-groups (from 3 to 24 months) and nutritional states (normally fed, diet-induced obese and calorie-restricted). Leptin resistance of older animals affected hypermetabolic actions, whereas leptin induced anorexia in all age-groups. Weight reducing effect of leptin diminished in middle-aged and aging animals to become significant again in the oldest group. In diet-induced obese rats leptin-induced hypermetabolism of the young rats and hypermetabolism plus anorexia of the aging ones were suppressed. Calorie-restriction reduced body weight and fat mass to a similar extent in all age-groups. It strongly enhanced leptin-induced hypermetabolism at all ages and prevented the manifestation of anorexigenic actions of leptin with the exception of the oldest group. This latter finding suggests an unexpected increase of responsiveness to anorexigenic leptin actions in old rats. Accordingly, anorexia and hypermetabolism change in disparate ways with aging. Nutritional state predominantly influences hypermetabolic leptin actions. Resistance to both hypermetabolic and anorexigenic actions were promoted by obesity, while calorie-restriction enhanced responsiveness to leptin, especially in old rats.
Collapse
Affiliation(s)
- Erika Pétervári
- Department of Pathophysiology and Gerontology, Medical School, University of Pécs, Hungary, 12. Szigeti str., H-7624 Pécs, Hungary
| | - Ildikó Rostás
- Department of Pathophysiology and Gerontology, Medical School, University of Pécs, Hungary, 12. Szigeti str., H-7624 Pécs, Hungary
| | - Szilvia Soós
- Department of Pathophysiology and Gerontology, Medical School, University of Pécs, Hungary, 12. Szigeti str., H-7624 Pécs, Hungary
| | - Judit Tenk
- Department of Pathophysiology and Gerontology, Medical School, University of Pécs, Hungary, 12. Szigeti str., H-7624 Pécs, Hungary
| | - Alexandra Mikó
- Department of Pathophysiology and Gerontology, Medical School, University of Pécs, Hungary, 12. Szigeti str., H-7624 Pécs, Hungary
| | - Nóra Füredi
- Department of Pathophysiology and Gerontology, Medical School, University of Pécs, Hungary, 12. Szigeti str., H-7624 Pécs, Hungary
| | - Miklós Székely
- Department of Pathophysiology and Gerontology, Medical School, University of Pécs, Hungary, 12. Szigeti str., H-7624 Pécs, Hungary.
| | - Márta Balaskó
- Department of Pathophysiology and Gerontology, Medical School, University of Pécs, Hungary, 12. Szigeti str., H-7624 Pécs, Hungary
| |
Collapse
|