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Smith EC, Patel JN, Wahba A, Cluckey A, Celedonio J, Park J, Hannah L, Lonce S, Shibao CA, Paranjape SY, Diedrich A, McGuinness O, Wasserman DH, Biaggioni I, Gamboa A. Acute Sympathetic Blockade Improves Insulin-Mediated Microvascular Blood Flow in the Forearm of Adult Human Subjects With Obesity. J Am Heart Assoc 2024; 13:e030775. [PMID: 39119951 DOI: 10.1161/jaha.123.030775] [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: 04/26/2023] [Accepted: 06/05/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND Obesity is associated with resistance to the metabolic (glucose uptake) and vascular (nitric-oxide mediated dilation and microvascular recruitment) actions of insulin. These vascular effects contribute to insulin sensitivity by increasing tissue delivery of glucose. Studies by us and others suggest that sympathetic activation contributes to insulin resistance to glucose uptake. Here we tested the hypothesis that sympathetic activation contributes to impaired insulin-mediated vasodilation in adult subjects with obesity. METHODS AND RESULTS In a randomized crossover study, we used a euglycemic hyperinsulinemic clamp in 12 subjects with obesity to induce forearm arterial vasodilation (forearm blood flow) and microvascular recruitment (contrast-enhanced ultrasonography) during an intrabrachial infusion of saline (control) or phentolamine (sympathetic blockade). Insulin increased forearm blood flow on both study days (from 2.21±1.22 to 4.89±4.21 mL/100 mL per min, P=0.003 and from 2.42±0.89 to 7.19±3.35 mL/100 mL per min, P=0.002 for the intact and blocked day, respectively). Sympathetic blockade with phentolamine resulted in a significantly greater increase in microvascular flow velocity (∆microvascular flow velocity: 0.23±0.65 versus 2.51±3.01 arbitrary intensity units (AIU/s) for saline and phentolamine respectively, P=0.005), microvascular blood volume (∆microvascular blood volume: 1.69±2.45 versus 3.76±2.93 AIU, respectively, P=0.05), and microvascular blood flow (∆microvascular blood flow: 0.28±0.653 versus 2.51±3.01 AIU2/s, respectively, P=0.0161). To evaluate if this effect was not due to nonspecific vasodilation, we replicated the study in 6 subjects with obesity comparing intrabrachial infusion of phentolamine to sodium nitroprusside. At doses that produced similar increases in forearm blood flow, insulin-induced changes in microvascular flow velocity were greater during phentolamine than sodium nitroprusside (%microvascular flow velocity=58% versus 29%, respectively, P=0.031). CONCLUSIONS We conclude that sympathetic activation impairs insulin-mediated microvascular recruitment in adult subjects with obesity.
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Affiliation(s)
- Emily C Smith
- Division of Clinical Pharmacology, Department of Medicine Vanderbilt University Medical Center Nashville TN
| | - Jay N Patel
- Division of Cardiology Vanderbilt University Medical Center Nashville TN
| | - Amr Wahba
- Division of Clinical Pharmacology, Department of Medicine Vanderbilt University Medical Center Nashville TN
| | - Andrew Cluckey
- Division of Cardiology Vanderbilt University Medical Center Nashville TN
| | - Jorge Celedonio
- Division of Clinical Pharmacology, Department of Medicine Vanderbilt University Medical Center Nashville TN
| | - JinWoo Park
- Division of Clinical Pharmacology, Department of Medicine Vanderbilt University Medical Center Nashville TN
| | - LaToya Hannah
- Human Metabolic Physiology Core Vanderbilt University Medical Center Nashville TN
| | - Suzanna Lonce
- Division of Clinical Pharmacology, Department of Medicine Vanderbilt University Medical Center Nashville TN
| | - Cyndya A Shibao
- Division of Clinical Pharmacology, Department of Medicine Vanderbilt University Medical Center Nashville TN
| | - Sachin Y Paranjape
- Division of Clinical Pharmacology, Department of Medicine Vanderbilt University Medical Center Nashville TN
| | - Andre Diedrich
- Division of Clinical Pharmacology, Department of Medicine Vanderbilt University Medical Center Nashville TN
| | - Owen McGuinness
- Department of Molecular Physiology and Biophysics Vanderbilt University Nashville TN
| | - David H Wasserman
- Department of Molecular Physiology and Biophysics Vanderbilt University Nashville TN
| | - Italo Biaggioni
- Division of Clinical Pharmacology, Department of Medicine Vanderbilt University Medical Center Nashville TN
- Department of Pharmacology Vanderbilt University Nashville TN
| | - Alfredo Gamboa
- Division of Clinical Pharmacology, Department of Medicine Vanderbilt University Medical Center Nashville TN
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Shin MK, Tang WY, Amorim MR, Sham JSK, Polotsky VY. Carotid body denervation improves hyperglycemia in obese mice. J Appl Physiol (1985) 2024; 136:233-243. [PMID: 38126089 PMCID: PMC11219014 DOI: 10.1152/japplphysiol.00215.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 11/14/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
The carotid bodies (CBs) have been implicated in glucose abnormalities in obesity via elevation of activity of the sympathetic nervous system. Obesity-induced hypertension is mediated by insulin receptor (INSR) signaling and by leptin, which binds to the leptin receptor (LEPRb) in CB and activates transient receptor potential channel subfamily M member 7 (TRPM7). We hypothesize that in mice with diet-induced obesity, hyperglycemia, glucose intolerance, and insulin resistance will be attenuated by the CB denervation (carotid sinus nerve dissection, CSND) and by knockdown of Leprb, Trpm7, and Insr gene expression in CB. In series of experiments in 75 male diet-induced obese (DIO) mice, we performed either CSND (vs. sham) surgeries or shRNA-induced suppression of Leprb, Trpm7, or Insr gene expression in CB, followed by blood pressure telemetry, intraperitoneal glucose tolerance and insulin tolerance tests, and measurements of fasting plasma insulin, leptin, corticosterone, glucagon and free fatty acids (FFAs) levels, hepatic expression of gluconeogenesis enzymes phosphoenolpyruvate carboxykinase (PEPCK) and glucose 6-phosphatase (G-6-Pase) mRNA and liver glycogen levels. CSND decreased blood pressure, fasting blood glucose levels and improved glucose tolerance without any effect on insulin resistance. CSND did not affect any hormone levels and gluconeogenesis enzymes, but increased liver glycogen level. Genetic knockdown of CB Leprb, Trpm7, and Insr had no effect on glucose metabolism. We conclude that CB contributes to hyperglycemia of obesity, probably by modulation of the glycogen-glucose equilibrium. Diabetogenic effects of obesity on CB in mice do not occur via activation of CB Leprb, Trpm7, and Insr.NEW & NOTEWORTHY This paper provides first evidence that carotid body denervation abolishes hypertension and improves fasting blood glucose levels and glucose tolerance in mice with diet-induced obesity. Furthermore, we have shown that this phenomenon is associated with increased liver glycogen content, whereas insulin sensitivity and enzymes of gluconeogenesis were not affected.
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Affiliation(s)
- Mi-Kyung Shin
- Department of Anesthesiology and Critical Care Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
| | - Wan-Yee Tang
- Department of Environmental and Occupational Health, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States
| | - Mateus R Amorim
- Department of Anesthesiology and Critical Care Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
| | - James S-K Sham
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Vsevolod Y Polotsky
- Department of Anesthesiology and Critical Care Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
- Department of Pharmacology and Physiology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
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Kulkarni S, Wilkinson IB. Adrenoceptors and Hypertension. Handb Exp Pharmacol 2024; 285:297-332. [PMID: 38890192 DOI: 10.1007/164_2024_719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Hypertension is a very prevalent condition associated with high mortality and morbidity, secondary to changes resulting in blood vessels and resultant end-organ damage. Haemodynamic changes, including an initial rise in cardiac output followed by an increase in total peripheral resistance, denote the early changes associated with borderline or stage 1 hypertension, especially in young men. Increased sodium reabsorption leading to kidney damage is another mechanism proposed as one of the initial triggers for essential hypertension. The underlying pathophysiological mechanisms include catecholamine-induced α1- and ß1-adrenoceptor stimulation, and renin-angiotensin-aldosterone system activation leading to endothelial dysfunction which is believed to lead to persistent blood pressure elevation.α1 blockers, α2 agonists, and ß blockers were among the first oral anti-hypertensives. They are no longer first-line therapy after outcome trials did not demonstrate any benefits over and above other agents, despite similar blood pressure reductions. Angiotensin-converting enzyme inhibitors (or angiotensin receptor blockers), calcium channel blockers, and thiazide-like diuretics are now considered the first line of therapy, although adrenoceptor agents still have a role as second- or third-line therapy. The chapter also highlights hypertension in specific medical conditions such as pregnancy, phaeochromocytoma, hyperthyroidism, portal hypertension, pulmonary arterial hypertension, and ocular hypertension, to provide an overview for clinicians and researchers interested in the role of adrenoceptors in the pathophysiology and management of hypertension.
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Affiliation(s)
- Spoorthy Kulkarni
- Department of Experimental Medicine and Immunotherapeutics, Vascular Research Clinic, ACCI Level 3, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Ian B Wilkinson
- Department of Experimental Medicine and Immunotherapeutics, Vascular Research Clinic, ACCI Level 3, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
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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.
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Barzilay JI, Tressel W, Biggs ML, Stein PK, Kizer JR, Shitole SG, Bene-Alhasan Y, Mukamal KJ. The Association of Measures of Cardiovascular Autonomic Function, Heart Rate, and Orthostatic Hypotension With Incident Glucose Disorders: The Cardiovascular Health Study. Diabetes Care 2022; 45:2376-2382. [PMID: 35916730 PMCID: PMC9643137 DOI: 10.2337/dc22-0553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/18/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The autonomic nervous system (ANS) innervates pancreatic endocrine cells, muscle, and liver, all of which participate in glucose metabolism. We tested whether measures of cardiovascular ANS function are independently associated with incident diabetes and annual change in fasting glucose (FG) levels as well as with insulin secretion and insulin sensitivity in older adults without diabetes. RESEARCH DESIGN AND METHODS Heart rate (HR) and measures of HR variability (HRV) were derived from 24-h electrocardiographic monitoring. Blood pressure, seated and standing, was measured. Cox proportional hazards models and linear mixed models were used to analyze the associations between HRV, HR, and orthostatic hypotension (SBP >20 mmHg decline) and incident diabetes or longitudinal FG change. RESULTS The mean annual unadjusted FG change was 1 mg/dL. Higher detrended fluctuation analyses (DFA) values, averaged over 4-11 (DFA1) or 12-20 beats (DFA2)-reflecting greater versus less organization of beat-to-beat intervals-were associated with less FG increase over time (per 1-SD increment: DFA1: -0.49 mg/dL/year [-0.96, -0.03]; DFA2: -0.55 mg/dL/year [-1.02, -0.09]). In mutually adjusted analyses, higher SD of the N-N interval (SDNN) was associated with less FG increase over time (per 1-SD increment: SDNN: -0.62 mg/dL/year [-1.22, -0.03]). Higher values of DFA1, DFA2, and SDNN were each associated with greater insulin secretion and insulin sensitivity but not with incident diabetes. We observed no association of HR or orthostatic hypotension with diabetes or FG change. CONCLUSIONS Specific measures of cardiac autonomic function are prospectively related to FG level changes and insulin secretion and action.
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Affiliation(s)
- Joshua I. Barzilay
- Division of Endocrinology, Kaiser Permanente of Georgia, Atlanta, GA
- Division of Endocrinology, Emory School of Medicine, Atlanta, GA
| | - William Tressel
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA
| | - Mary L. Biggs
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA
| | - Phyllis K. Stein
- Cardiovascular Division, Department of Medicine, Washington University in St. Louis School of Medicine, Saint Louis, MO
| | - Jorge R. Kizer
- Cardiology Section, San Francisco VA Health Care System, San Francisco, CA
- Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Sanyog G. Shitole
- Cardiology Section, San Francisco VA Health Care System, San Francisco, CA
- Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Yakubu Bene-Alhasan
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Brookline, MA
| | - Kenneth J. Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Brookline, MA
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Breier NC, Paranjape SY, Scudder S, Mehr SE, Diedrich A, Flynn CR, Okamoto LE, Hartmann B, Gasbjerg LS, Shibao CA. Worsening Postural Tachycardia Syndrome Is Associated With Increased Glucose-Dependent Insulinotropic Polypeptide Secretion. Hypertension 2022; 79:e89-e99. [PMID: 35232225 PMCID: PMC9010371 DOI: 10.1161/hypertensionaha.121.17852] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/16/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Postural tachycardia syndrome (POTS) is characterized by excessive upright tachycardia and disabling presyncopal symptoms, which are exacerbated after consuming a high-carbohydrate meal; it is unknown, however, what is the precise underlying mechanism. We seek to investigate the effect of glucose intake on orthostatic hemodynamic changes and gastrointestinal hormone secretion in POTS. METHODS Prospective, case-control study, 12 women with POTS who reported a postprandial worsening of their POTS symptoms and 13 age-matched female controls received 75-g oral glucose and 20 mg/kg acetaminophen to assess nutrient absorption. Hemodynamic, gastrointestinal hormone and acetaminophen levels were measured for up to 120 minutes postingestion while supine and standing. RESULTS Patients with POTS had significant orthostatic tachycardia, 48.7±11.2 versus 23.3±8.1 bpm, P=0.012 and elevated upright norepinephrine levels, 835.2±368.4 versus 356.9±156.7 pg/mL, P=0.004. After oral glucose, upright heart rate significantly increased in POTS, 21.2±11.9% versus 6.0±19.9%, P=0.033 with a concomitant decline in upright stroke volume, -10.3±11.90% versus 3.3±13.7%, P=0.027; total peripheral resistance, blood pressure and cardiac output remained unaltered. Acetaminophen rate of appearance was similar between groups (P=0.707), indicating comparable nutrient absorption rates. POTS had increased plasma levels of C-peptide (P=0.001), GIP (glucose-dependent insulinotropic polypeptide; P=0.001), peptide YY (P=0.016), and pancreatic polypeptide (P=0.04) following glucose consumption, but only GIP had a time-dependent association with the worsening upright tachycardia and stroke volume fall. CONCLUSIONS The glucose-induced worsening orthostatic tachycardia in POTS was associated with a decline in SV; these changes occurred while GIP, a splanchnic vasodilator, was maximally elevated.
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Affiliation(s)
- Nicholas C Breier
- Department of Medicine, Division of Clinical Pharmacology (N.C.B., S.Y.P., S.S., S.E.M., A.D., L.E.O., C.A.S.), Vanderbilt University Medical Center, Nashville, TN
| | - Sachin Y Paranjape
- Department of Medicine, Division of Clinical Pharmacology (N.C.B., S.Y.P., S.S., S.E.M., A.D., L.E.O., C.A.S.), Vanderbilt University Medical Center, Nashville, TN
| | - Shea Scudder
- Department of Medicine, Division of Clinical Pharmacology (N.C.B., S.Y.P., S.S., S.E.M., A.D., L.E.O., C.A.S.), Vanderbilt University Medical Center, Nashville, TN
| | - Shahram E Mehr
- Department of Medicine, Division of Clinical Pharmacology (N.C.B., S.Y.P., S.S., S.E.M., A.D., L.E.O., C.A.S.), Vanderbilt University Medical Center, Nashville, TN
| | - Andre' Diedrich
- Department of Medicine, Division of Clinical Pharmacology (N.C.B., S.Y.P., S.S., S.E.M., A.D., L.E.O., C.A.S.), Vanderbilt University Medical Center, Nashville, TN
| | - Charles R Flynn
- Department of Surgery (C.R.F.), Vanderbilt University Medical Center, Nashville, TN
| | - Luis E Okamoto
- Department of Medicine, Division of Clinical Pharmacology (N.C.B., S.Y.P., S.S., S.E.M., A.D., L.E.O., C.A.S.), Vanderbilt University Medical Center, Nashville, TN
| | - Bolette Hartmann
- Novo Nordisk Foundation Center for Basic Metabolic Research (B.H.), University of Copenhagen, Denmark
| | - Lærke Smidt Gasbjerg
- Department of Biomedical Science (B.H., L.S.G.), University of Copenhagen, Denmark
| | - Cyndya A Shibao
- Department of Medicine, Division of Clinical Pharmacology (N.C.B., S.Y.P., S.S., S.E.M., A.D., L.E.O., C.A.S.), Vanderbilt University Medical Center, Nashville, TN
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Habitual aerobic exercise in healthy postmenopausal women does not augment basal cardiac autonomic activity yet modulates autonomic-metabolic interactions. Menopause 2022; 29:714-722. [PMID: 35324537 DOI: 10.1097/gme.0000000000001963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of the present study was to examine the effects of habitual exercise training and metabolic health on basal cardiac autonomic function and cardiac autonomic recovery after exercise in healthy postmenopausal women (PMW). METHODS Habitually aerobically trained PMW (PMW-tr; 56 ± 1y; n = 11), and untrained PMW (PMW-un; 57 ± 1y; n = 13) and premenopausal women (PreM; ages 26 ± 1y; n = 14) were studied. Cardiac autonomic function, assessed using heart rate variability (HRV), was measured before and one hour after 45-minutes of moderate-intensity exercise (60% VO2peak). Fast Fourier frequency domain measures of high (HF; 0.15 Hz-0.4 Hz), low (LF; 0.04 Hz-0.15 Hz), very low (VLF; 0.01 Hz-0.04 Hz), and Total (VLF+LF+HF) HRV were assessed. Serum estradiol, insulin, and glucose were determined, and HOMA-IR, an index of insulin resistance, was calculated. RESULTS In PMW groups, body composition and serum markers did not differ (P>0.05). Pre-exercise, heart rate was lower (P<0.05) in PMW-tr than PMW-un, yet HRV did not differ (P>0.05). In PMW-tr only, HF was inversely associated (P<0.05) with insulin (r = -0.738) and HOMA-IR (r = -0.758). In PreM, HRV was higher than PMW (P<0.05) and was positively correlated with estradiol (P<0.05). Postexercise, HRV was decreased within all groups (P<0.05) yet remained higher in PreM (P<0.05), and similar (P>0.05) between PMW. CONCLUSION Basal and postexercise HRV does not differ between habitually aerobically trained and untrained PMW. However, greater insulin sensitivity was associated with higher cardiac parasympathetic tone in trained PMW only. Exercise training may favorably modulate cardiac autonomic-metabolic interactions in PMW.
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2021 Distinguished Scientists of the American Heart Association. Hypertension 2021; 78:1158-1160. [PMID: 34455815 DOI: 10.1161/hypertensionaha.121.18160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Morin R, Mauger JF, Amaratunga R, Imbeault P. The effect of acute intermittent hypoxia on postprandial triglyceride levels in humans: a randomized crossover trial. J Transl Med 2021; 19:268. [PMID: 34158069 PMCID: PMC8220832 DOI: 10.1186/s12967-021-02933-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/09/2021] [Indexed: 12/18/2022] Open
Abstract
Background Obstructive sleep apnea (OSA), a sleep disorder frequently observed in individuals living with obesity, consists of repeated involuntary breathing obstructions during sleep, leading to intermittent hypoxia (IH). In humans, acute continuous hypoxia slightly increases plasma triglycerides (TG). However, no study yet compared the postprandial TG response of individuals with or without OSA under intermittent hypoxia. Methods Using a randomized crossover design, seven individuals diagnosed with moderate OSA and eight healthy individuals without OSA were given a meal after which they were exposed for 6 h to normoxia or intermittent hypoxia (e.g., 15 hypoxic events per hour). Blood lipid levels were measured hourly during each session. Results Peak postprandial TG concentrations tended to be 22% higher under IH irrespective of group (IH × time interaction, p = 0.068). This trend toward higher total plasma TG was attributable to increased levels of denser TG-rich lipoproteins such as very low-density lipoproteins (VLDL) and chylomicrons (CM) remnants. Irrespective of group, the postprandial TG concentrations in denser TG-rich lipoproteins was 20% higher under IH (IH × time interaction, p = 0.036), although IH had virtually no impact on denser TG-rich lipoprotein concentrations in the OSA group. Conclusion Acute intermittent hypoxia tends to negatively affect postprandial TG levels in healthy individuals, which is attributable to an increase in denser TG-carrying lipoprotein levels such as VLDL and CM remnants. This altered postprandial TG response to acute intermittent hypoxia was not observed in individuals with OSA.
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Affiliation(s)
- Renée Morin
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Jean-François Mauger
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Ruwan Amaratunga
- Institut du Savoir Montfort, Hôpital Montfort, Ottawa, ON, Canada
| | - Pascal Imbeault
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada. .,Institut du Savoir Montfort, Hôpital Montfort, Ottawa, ON, Canada. .,Behavioural and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 200 Lees, Ottawa, ON, K1N 6N5, Canada.
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Ye J, Ye X, Jiang W, Lu C, Geng X, Zhao C, Ma Y, Yang P, Man Lam S, Shui G, Yang T, Zhong Li J, Gong Y, Fu Z, Zhou H. Targeted lipidomics reveals associations between serum sphingolipids and insulin sensitivity measured by the hyperinsulinemic-euglycemic clamp. Diabetes Res Clin Pract 2021; 173:108699. [PMID: 33592213 DOI: 10.1016/j.diabres.2021.108699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 01/15/2021] [Accepted: 01/29/2021] [Indexed: 10/22/2022]
Abstract
AIMS Sphingolipids(SPs) and their substrates and constituents, fatty acids (FAs), are implicated in the pathogenesis of various metabolic diseases associated. This study aimed to systematically investigate the associations between serum sphingolipids and insulin sensitivity as well as insulin secretion. METHODS We conducted a lipidomics evaluation of molecularly distinct SPs in the serum of 86 consecutive Chinese adults using LC/MS. The glucose infusion rate over 30 min (GIR30) was measured under steady conditions to assess insulin sensitivity by the gold standard hyperinsulinemic-euglycemic clamp. We created the ROC curves to detect the serum SMs diagnostic value. RESULTS Total and subspecies of serum SMs and globotriaosyl ceramides (Gb3s) were positively related to GIR30, free FAs (FFA 16:1, FFA20:4), some long chain GM3 and complex ceramide GluCers showed strong negative correlations with GIR30. Notably, ROC curves showed that SM/Cer and SM d18:0/26:0 may be good serum lipid predictors of diagnostic indicators of insulin sensitivity close to conventional clinical indexes such as 1/HOMA-IR (areas under the curve > 0.80) based on GIR30 as standard diagnostic criteria, and (SM/Cer)/(BMI*LDLc) areas under the curve = 0.93) is the best. CONCLUSIONS These results provide novel associations between serum sphingolipid between insulin sensitivity measured by the hyperinsulinemic-euglycemic clamp and identify two specific SPs that may represent prognostic biomarkers for insulin sensitivity.
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Affiliation(s)
- Jingya Ye
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu, China
| | - Xuan Ye
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu, China
| | - Wanzi Jiang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu, China
| | - Chenyan Lu
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu, China
| | - Xiaomei Geng
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu, China
| | - Chenxi Zhao
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu, China
| | - Yizhe Ma
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu, China
| | - Panpan Yang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu, China
| | - Sin Man Lam
- Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Guanghou Shui
- Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Tao Yang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu, China
| | - John Zhong Li
- Department of Biochemistry and Molecular Biology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yingyun Gong
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu, China.
| | - Zhenzhen Fu
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu, China.
| | - Hongwen Zhou
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu, China.
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11
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Willmes DM, Daniels M, Kurzbach A, Lieske S, Bechmann N, Schumann T, Henke C, El-Agroudy NN, Da Costa Goncalves AC, Peitzsch M, Hofmann A, Kanczkowski W, Kräker K, Müller DN, Morawietz H, Deussen A, Wagner M, El-Armouche A, Helfand SL, Bornstein SR, de Cabo R, Bernier M, Eisenhofer G, Tank J, Jordan J, Birkenfeld AL. The longevity gene mIndy (I'm Not Dead, Yet) affects blood pressure through sympathoadrenal mechanisms. JCI Insight 2021; 6:136083. [PMID: 33491666 PMCID: PMC7934862 DOI: 10.1172/jci.insight.136083] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 12/02/2020] [Indexed: 12/14/2022] Open
Abstract
Reduced expression of the plasma membrane citrate transporter INDY (acronym I’m Not Dead, Yet) extends life span in lower organisms. Deletion of the mammalian Indy (mIndy) gene in rodents improves metabolism via mechanisms akin to caloric restriction, known to lower blood pressure (BP) by sympathoadrenal inhibition. We hypothesized that mIndy deletion attenuates sympathoadrenal support of BP. Continuous arterial BP and heart rate (HR) were reduced in mINDY-KO mice. Concomitantly, urinary catecholamine content was lower, and the decreases in BP and HR by mIndy deletion were attenuated after autonomic ganglionic blockade. Catecholamine biosynthesis pathways were reduced in mINDY-KO adrenals using unbiased microarray analysis. Citrate, the main mINDY substrate, increased catecholamine content in pheochromocytoma cells, while pharmacological inhibition of citrate uptake blunted the effect. Our data suggest that deletion of mIndy reduces sympathoadrenal support of BP and HR by attenuating catecholamine biosynthesis. Deletion of mIndy recapitulates beneficial cardiovascular and metabolic responses to caloric restriction, making it an attractive therapeutic target. Deletion of mIndy reduces blood pressure and heart rate by attenuating catecholamine biosynthesis and recapitulates beneficial cardiovascular and metabolic responses to caloric restriction.
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Affiliation(s)
- Diana M Willmes
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Martin Daniels
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.,Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, University of Tübingen, Tübingen, Germany.,Department of Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tübingen, Germany
| | - Anica Kurzbach
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.,Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, University of Tübingen, Tübingen, Germany.,Department of Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tübingen, Germany.,Department of Diabetes, School of Life Course Science, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Stefanie Lieske
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and
| | - Nicole Bechmann
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Tina Schumann
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Christine Henke
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Nermeen N El-Agroudy
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.,Department of Diabetes, School of Life Course Science, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | | | - Mirko Peitzsch
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Anja Hofmann
- Division of Vascular Endothelium and Microcirculation, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Waldemar Kanczkowski
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Department of Diabetes, School of Life Course Science, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Kristin Kräker
- Experimental and Clinical Research Center, Max Delbruck Center for Molecular Medicine and Charité - University Hospital Berlin, Berlin, Germany
| | - Dominik N Müller
- Experimental and Clinical Research Center, Max Delbruck Center for Molecular Medicine and Charité - University Hospital Berlin, Berlin, Germany
| | - Henning Morawietz
- Division of Vascular Endothelium and Microcirculation, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Andreas Deussen
- Department of Physiology, Medical Faculty Carl Gustav Carus, and
| | - Michael Wagner
- Department of Pharmacology and Toxicology, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Ali El-Armouche
- Department of Pharmacology and Toxicology, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Stephen L Helfand
- Department of Molecular Biology, Cell Biology & Biochemistry, Division of Biology and Medicine, Brown University, Providence, Rhode Island, USA
| | - Stephan R Bornstein
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Department of Diabetes, School of Life Course Science, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Rafael de Cabo
- Translational Gerontology Branch, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, Maryland, USA
| | - Michel Bernier
- Translational Gerontology Branch, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, Maryland, USA
| | - Graeme Eisenhofer
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Institute of Clinical Chemistry and Laboratory Medicine, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Jens Tank
- Aerospace Medicine, University of Cologne, Cologne, Germany
| | - Jens Jordan
- Aerospace Medicine, University of Cologne, Cologne, Germany.,Institute for Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Andreas L Birkenfeld
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital and Medical Faculty Carl Gustav Carus and.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technical University Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.,Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, University of Tübingen, Tübingen, Germany.,Department of Internal Medicine IV, Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tübingen, Germany.,Department of Diabetes, School of Life Course Science, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
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12
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Wang W, Zheng Y, Li M, Lin S, Lin H. Recent Advances in Studies on the Role of Neuroendocrine Disorders in Obstructive Sleep Apnea-Hypopnea Syndrome-Related Atherosclerosis. Nat Sci Sleep 2021; 13:1331-1345. [PMID: 34349578 PMCID: PMC8326525 DOI: 10.2147/nss.s315375] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/19/2021] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular disease is a common cause of death worldwide, and atherosclerosis (AS) and obstructive sleep apnea-hypopnea syndrome (OSAHS) critically contribute to the initiation and progression of cardiovascular diseases. OSAHS promotes endothelial injury, vascular smooth muscle cell (VSMC) proliferation, abnormal lipid metabolism, and elevated arterial blood pressure. However, the exact OSAHS mechanism that causes AS remains unclear. The nervous system is widely distributed in the central and peripheral regions. It regulates appetite, energy metabolism, inflammation, oxidative stress, insulin resistance, and vasoconstriction by releasing regulatory factors and participates in the occurrence and development of AS. Studies showed that OSAHS can cause changes in neurophysiological plasticity and affect modulator release, suggesting that neuroendocrine dysfunction may be related to the OSAHS mechanism causing AS. In this article, we review the possible mechanisms of neuroendocrine disorders in the pathogenesis of OSAHS-induced AS and provide a new basis for further research on the development of corresponding effective intervention strategies.
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Affiliation(s)
- Wanda Wang
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, People's Republic of China
| | - Yanli Zheng
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, People's Republic of China
| | - Meimei Li
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, People's Republic of China
| | - Shu Lin
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, People's Republic of China.,Centre of Neurological and Metabolic Research, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, People's Republic of China.,Diabetes and Metabolism Division, Garvan Institute of Medical Research, Sydney, NSW, 2010, Australia
| | - Huili Lin
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, People's Republic of China
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13
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Cao Q, Liu L, Hu Y, Jiang N, Wang Y, Chen J, Zhou Q, Guo R. Irradiation of carotid baroreceptor with low-intensity pulsed ultrasound exerts different metabolic protection in perirenal, epididymal white adipose tissue and interscapular brown adipose tissue of obese rats. FASEB J 2020; 34:15431-15447. [PMID: 32954572 DOI: 10.1096/fj.202001550r] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/30/2020] [Accepted: 09/09/2020] [Indexed: 12/13/2022]
Abstract
This study was designed to clarify whether the irradiation of carotid baroreceptor (CB) with low-intensity pulsed ultrasound (LIPUS) protects against obesity by rebalancing the autonomic nervous system (ANS). Obesity was induced using a high-fat diet (HFD) for 8 weeks in Sprague-Dawley rats. Irradiation with LIPUS was daily (20 minutes a day) applied to the right CB. In our study, LIPUS significantly ameliorated metabolic disorders in obese rats. LIPUS partly restored norepinephrine (NE) and acetylcholine (ACH) levels in the perirenal white adipose tissue (PWAT), epididymal white adipose tissue (EWAT), interscapular brown adipose tissue (IBAT), and plasma of obese rats. LIPUS partially rectified the dysregulated AMP-activated protein kinase (AMPK)/peroxisome proliferator-activated receptor (PPAR) α/ɣ pathway in the PWAT, EWAT, and IBAT of obese rats. PPARγ and PPARγ target genes respond more sensitively to HFD and LIPUS in PWAT and EWAT than in IBAT. NE, ACH, uncoupling protein-1, phosphorylated AMPK, PPARα, and PPARα target genes respond more sensitively to HFD and LIPUS in IBAT than in PWAT and EWAT. Conclusion: LIPUS irradiation of CB exerts different metabolic protection in PWAT, EWAT, and IBAT by rebalancing the ANS and rectifying the AMPK/PPARα/ɣ pathway in obese rats.
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Affiliation(s)
- Quan Cao
- Echo lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China.,3D-Printing & AI Lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lian Liu
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yugang Hu
- Echo lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China.,3D-Printing & AI Lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China
| | - Nan Jiang
- Echo lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China.,3D-Printing & AI Lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yijia Wang
- Echo lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China.,3D-Printing & AI Lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jinling Chen
- Echo lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China.,3D-Printing & AI Lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qing Zhou
- Echo lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China.,3D-Printing & AI Lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ruiqiang Guo
- Echo lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China.,3D-Printing & AI Lab, Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China
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14
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Kakutani-Hatayama M, Kadoya M, Morimoto A, Miyoshi A, Kosaka-Hamamoto K, Kusunoki Y, Shoji T, Koyama H. Associations of sleep quality, sleep apnea and autonomic function with insulin secretion and sensitivity: HSCAA study. Metabol Open 2020; 6:100033. [PMID: 32812920 PMCID: PMC7424809 DOI: 10.1016/j.metop.2020.100033] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/13/2020] [Accepted: 03/15/2020] [Indexed: 01/23/2023] Open
Abstract
RATIONALE AND PURPOSE Although sleep disorders are shown to be involved in occurrence of diabetes, impacts of several quantitative parameters related to sleep on insulin secretion and sensitivity is yet to be elucidated. We cross-sectionally examined relationships among quantitative sleep quality, sleep apnea, and autonomic function with insulin secretion and sensitivity in 399 patients without previous diagnosed diabetes who underwent 75-g oral glucose tolerance test (75gOGTT). METHOD Poor sleep quality (PSQ) was defined as an activity index ≥50 by actigraphy. Sleep apnea was measured by apnomonitor, while standard deviation of all normal-to-normal R-R intervals (SDNN) was measured by active tracer. Parameters of insulin secretion and sensitivity were measured by 75gOGTT. RESULTS Patients with PSQ exhibited significantly lower insulinogenic index (r = 0.155, p < 0.01), a parameter of insulin secretion, with the association independent of other clinical factors including apnea and SDNN (β = -0.156, p < 0.01). In contrast, presence of sleep apnea (r = -0.143, p < 0.05) and the lower SDNN (r = -0.150, p < 0.01) were significantly and inversely associated with BIGTT-S, an insulin sensitivity parameter, with the association of SDNN with BIGTT-S remaining significant even after adjustments for PSQ and sleep apnea (β = -0.111, p < 0.05). CONCLUSION Poor sleep quality is an independent predictor of pancreatic β-cell function, which could be involved in occurrence of type 2 diabetes.
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Affiliation(s)
- Miki Kakutani-Hatayama
- Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Manabu Kadoya
- Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Akiko Morimoto
- Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Akio Miyoshi
- Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Kae Kosaka-Hamamoto
- Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Yoshiki Kusunoki
- Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Takuhito Shoji
- Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Hidenori Koyama
- Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
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15
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Murabayashi M, Daimon M, Murakami H, Fujita T, Sato E, Tanabe J, Matsuhashi Y, Takayasu S, Yanagimachi M, Terui K, Kageyama K, Tokuda I, Sawada K, Ihara K. Association between higher urinary normetanephrine and insulin resistance in a Japanese population. PLoS One 2020; 15:e0228787. [PMID: 32053635 PMCID: PMC7018048 DOI: 10.1371/journal.pone.0228787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/22/2020] [Indexed: 01/25/2023] Open
Abstract
Since activation of the sympathetic nervous system is associated with both impaired insulin secretion and insulin resistance, or namely with diabetes, evaluation of such activation in ordinary clinical settings may be important. Therefore, we evaluated the relationships between urinary concentrations of the catecholamine metabolites, urinary normetanephrine (U-NM) and urinary metanephrine (U-M), and glucose metabolism in a general population. From 1,148 participants in the 2016 population-based Iwaki study of Japanese, enrolled were 733 individuals (gender (M/F): 320/413; age: 52.1±15.1), who were not on medication affecting serum catecholamines, not diabetic, and had complete data-set and blood glucose levels appropriate for the evaluation of insulin secretion and resistance, using homeostasis model assessment (HOMA-β and HOMA-R, respectively). Univariate linear regression analyses revealed significant correlations between both U-NM and U-M, and HOMA-β, but adjustment for multiple factors correlated with HOMA indices abolished these (β = -0.031, p = 0.499, and β = -0.055, p = 0.135, respectively). However, the correlation between U-NM and HOMA-R observed using univariate linear regression analysis (β = 0.132, p<0.001) remained significant even after these adjustments (β = 0.107, p = 0.007), whereas U-M did not correlate with HOMA-R. Furthermore, use of the optimal cut-off value of U-NM for the prediction of insulin resistance (HOMA-R >1.6) determined by ROC analysis (0.2577 mg/gCr) showed that individuals at risk had an odds ratio of 2.65 (confidence interval: 1.42–4.97) after adjustment for the same factors used above. Higher U-NM concentrations within the physiologic range are a significant risk factor for increased insulin resistance in a general Japanese population.
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Affiliation(s)
- Masaya Murabayashi
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Makoto Daimon
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
- * E-mail:
| | - Hiroshi Murakami
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Tomoyuki Fujita
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Eri Sato
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Jutaro Tanabe
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Yuki Matsuhashi
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Shinobu Takayasu
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Miyuki Yanagimachi
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Ken Terui
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Kazunori Kageyama
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Itoyo Tokuda
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Kaori Sawada
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
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16
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Dennis PA, Neal JM, Travis E, Watkins LL, Calhoun PS, Dennis MF, Beckham JC. Negative Affect-Related Autonomic Arousal Mediates the Association between Baroreflex Dysfunction and Insulin Resistance in Non-Diabetic Young Adults. J PSYCHOPHYSIOL 2019; 33:243-253. [PMID: 31666757 DOI: 10.1027/0269-8803/a000226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Autonomic dysfunction, in particular under-regulation of heart rate (HR) by the baroreflex, is implicated in development of insulin resistance (IR). According to reactivity hypothesis, sympathetic response to stressors may be more sensitive at predicting IR than baroreceptor sensitivity (BRS), a baseline measure of baroreflex functioning. Using ecological momentary assessment (EMA) of negative affect coupled with minute-to-minute HR and heart-rate variability (HRV) monitoring, we examined whether negative affect (NA)-related autonomic arousal mediates the association of BRS with IR. At baseline, BRS was measured, and fasting serum glucose and insulin levels were collected from 178 young adults (18-39 years old), from which homeostasis model assessment of IR (HOMA-IR) and beta-cell functioning (HOMA %B) were derived. Participants subsequently underwent one day of Holter HR and HRV monitoring while reporting negative affect levels via EMA. Multilevel modeling was used to assess the associations of momentary negative affect with HR and low- (LF) and high-frequency (HF) HRV during the 5-minute intervals following each EMA reading. Structural equation modeling was then used to determine whether individual differences in these associations mediated the association of BRS with IR, measured by HOMA-IR, HOMA %B, and insulin levels. As predicted, BRS was negatively associated with the IR (β = -.17, p = .024). However, NA-related autonomic arousal mediated their association, accounting for 56% of the covariance between BRS and IR. Not only do these results provide support for reactivity hypothesis, they reveal a potential point of intervention in the treatment of affective dysregulation.
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Affiliation(s)
- Paul A Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Julia M Neal
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| | - Emili Travis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA
| | - Lana L Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Patrick S Calhoun
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA.,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA.,Durham Veterans Affairs Center for Health Services Research in Primary Care, Durham, NC, 27705, USA
| | - Michelle F Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Jean C Beckham
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA.,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
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17
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Abstract
Synchronization of molecular, metabolic, and cardiovascular circadian oscillations is fundamental to human health. Sleep-disordered breathing, which disrupts such temporal congruence, elicits hemodynamic, autonomic, chemical, and inflammatory disturbances with acute and long-term consequences for heart, brain, and circulatory and metabolic function. Sleep apnea afflicts a substantial proportion of adult men and women but is more prevalent in those with established cardiovascular diseases and especially fluid-retaining states. Despite the experimental, epidemiological, observational, and interventional evidence assembled in support of these concepts, this substantial body of work has had relatively modest pragmatic impact, thus far, on the discipline of cardiology. Contemporary estimates of cardiovascular risk still are derived typically from data acquired during wakefulness. The impact of sleep-related breathing disorders rarely is entered into such calculations or integrated into diagnostic disease-specific algorithms or therapeutic recommendations. Reasons for this include absence of apnea-related symptoms in most with cardiovascular disease, impediments to efficient diagnosis at the population level, debate as to target, suboptimal therapies, difficulties mounting large randomized trials of sleep-specific interventions, and the challenging results of those few prospective cardiovascular outcome trials that have been completed and reported. The objectives of this review are to delineate the bidirectional interrelationship between sleep-disordered breathing and cardiovascular disease, consider the findings and implications of observational and randomized trials of treatment, frame the current state of clinical equipoise, identify principal current controversies and potential paths to their resolution, and anticipate future directions.
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Affiliation(s)
- John S Floras
- From the University Health Network and Sinai Health System Division of Cardiology, Department of Medicine, University of Toronto, Ontario, Canada.
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18
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Intermittent energy restriction is comparable to continuous energy restriction for cardiometabolic health in adults with central obesity: A randomized controlled trial; the Met-IER study. Clin Nutr 2019; 39:1753-1763. [PMID: 31409509 DOI: 10.1016/j.clnu.2019.07.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/02/2019] [Accepted: 07/19/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS Short bouts of severe energy restriction may have additional, beneficial cardiometabolic effects beyond that of weight loss. We aimed to assess the short-term effects of intermittent fasting on insulin sensitivity and related cardiometabolic mechanisms. METHODS This parallel arm, randomized controlled trial compared the short-term effects of intermittent and continuous energy restriction (IER and CER) diets on markers of cardiometabolic health in individuals with central obesity, aiming for equivalent weight loss on both diets. Outcomes were assessed in non-smoking men and women (35-75 y), following 4-wk IER (48 h 600 kcal/d followed by 5-day healthy eating advice) or CER diets (-500 kcal/d healthy eating advice). The primary outcome was the revised quantitative insulin sensitivity check index (R-QUICKI), an indirect estimate of insulin sensitivity. Secondary outcomes included ambulatory blood pressure (ABP), indicators of sympathetic activity (heart rate variability (HRV) and normetanephrine), and markers of glucose homeostasis/insulin resistance, adiposity, lipids and inflammation. RESULTS Forty-three participants completed the study. Reductions in body weight were equivalent in both groups: mean loss (%) -2.6; 95% CI -3.3, -1.9 and -2.9; -3.6, -2.1 for CER and IER, respectively, P = 0.464). R-QUICKI increased following IER and CER, with no between-diet differences (overall mean increase (%) 6.6; 3.6, 9.6). Fasting plasma glucose concentrations decreased after CER but not after IER (mean difference CER-IER - 4.8% (0.7, 8.9), P < 0.05) and fasting plasma non-esterified fatty acid concentrations were lower after IER compared to CER (mean difference CER-IER 0.15 mmol/L (0.06, 0.24), P < 0.005). There were no differences in lipids, adipokine/inflammatory markers, ABP or HRV between diets. CONCLUSIONS Short-term CER or IER diets are comparable in their effects on most markers of cardiometabolic risk, although adaptive changes in glucose and fatty acid metabolism occur. This study is registered at clinicaltrials.gov as NCT02679989.
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19
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Cao Q, Zhang J, Yu Q, Wang J, Dai M, Zhang Y, Luo Q, Bao M. Carotid baroreceptor stimulation in obese rats affects white and brown adipose tissues differently in metabolic protection. J Lipid Res 2019; 60:1212-1224. [PMID: 31126973 DOI: 10.1194/jlr.m091256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 05/23/2019] [Indexed: 11/20/2022] Open
Abstract
The sympathetic nervous system (SNS) regulates the functions of white adipose tissue (WAT) and brown adipose tissue (BAT) tightly. Carotid baroreceptor stimulation (CBS) efficiently inhibits SNS activation. We hypothesized that CBS would protect against obesity. We administered CBS to obese rats and measured sympathetic and AMP-activated protein kinase (AMPK)/ PPAR pathway responses as well as changes in perirenal WAT (PWAT), epididymal WAT (EWAT), and interscapular BAT (IBAT). CBS alleviated obesity-related metabolic changes, improving insulin resistance; reducing adipocyte hypertrophy, body weight, and adipose tissue weights; and decreasing norepinephrine but increasing acetylcholine in plasma, PWAT, EWAT, and IBAT. CBS also downregulated fatty acid translocase (CD36), fatty acid transport protein (FATP), phosphorylated and total hormone sensitive lipase, phosphorylated and total protein kinase A, and PPARγ in obese rats. Simultaneously, CBS upregulated phosphorylated adipose triglyceride lipase, phosphorylated and total AMPK, and PPARα in PWAT, EWAT, and IBAT. However, BAT and WAT responses differed; although many responses were more sensitive in IBAT, responses of CD36, FATP, and PPARγ were more sensitive in PWAT and EWAT. Overall, CBS decreased chronically activated SNS and ameliorated obesity-related metabolic disorders by regulating the AMPK/PPARα/γ pathway.
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Affiliation(s)
- Quan Cao
- Department of Cardiology, Renmin Hospital of Wuhan University.,Cardiovascular Research Institute Wuhan University.,Hubei Key Laboratory of Cardiology Wuhan 430060, China
| | - Junxia Zhang
- Department of Endocrinology, Wuhan General Hospital of the Chinese People's Liberation Army, Wuhan 430060, China
| | - Qiao Yu
- Department of Cardiology, Renmin Hospital of Wuhan University.,Cardiovascular Research Institute Wuhan University.,Hubei Key Laboratory of Cardiology Wuhan 430060, China
| | - Jing Wang
- Department of Cardiology, Renmin Hospital of Wuhan University.,Cardiovascular Research Institute Wuhan University.,Hubei Key Laboratory of Cardiology Wuhan 430060, China
| | - Mingyan Dai
- Department of Cardiology, Renmin Hospital of Wuhan University.,Cardiovascular Research Institute Wuhan University
| | - Yijie Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University.,Cardiovascular Research Institute Wuhan University.,Hubei Key Laboratory of Cardiology Wuhan 430060, China
| | - Qiang Luo
- Department of Cardiology, Renmin Hospital of Wuhan University.,Cardiovascular Research Institute Wuhan University.,Hubei Key Laboratory of Cardiology Wuhan 430060, China
| | - Mingwei Bao
- Department of Cardiology, Renmin Hospital of Wuhan University .,Cardiovascular Research Institute Wuhan University.,Hubei Key Laboratory of Cardiology Wuhan 430060, China
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20
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Hansen CS, Færch K, Jørgensen ME, Malik M, Witte DR, Brunner EJ, Tabák AG, Kivimäki M, Vistisen D. Heart Rate, Autonomic Function, and Future Changes in Glucose Metabolism in Individuals Without Diabetes: The Whitehall II Cohort Study. Diabetes Care 2019; 42:867-874. [PMID: 30940642 PMCID: PMC6905499 DOI: 10.2337/dc18-1838] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 01/22/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Autonomic nervous system dysfunction is associated with impaired glucose metabolism, but the temporality of this association remains unclear in individuals without diabetes. We investigated the association of autonomic function with 5-year changes in glucose metabolism in individuals without diabetes. RESEARCH DESIGN AND METHODS Analyses were based on 9,000 person-examinations for 3,631 participants without diabetes in the Whitehall II cohort. Measures of autonomic function included 5-min resting heart rate and six heart rate variability (HRV) indices. Associations between baseline autonomic function measures and 5-year changes in fasting and 2-h plasma glucose, serum insulin concentrations, insulin sensitivity (insulin sensitivity index [ISI0-120] and HOMA of insulin sensitivity), and β-cell function (HOMA of β-cell function) were estimated in models adjusting for age, sex, ethnicity, metabolic factors, and medication. RESULTS A 10-bpm higher resting heart rate was associated with 5-year changes in fasting and 2-h insulin and ISI0-120 of 3.3% change (95% CI 1.8; 4.8), P < 0.001; 3.3% change (1.3; 5.3), P = 0.001; and -1.4% change (-2.4; -0.3), P = 0.009, respectively. In models adjusted for age, sex, and ethnicity, higher baseline values of several HRV indices were associated with a 5-year decrease in fasting and 2-h insulin and ISI0-120. However, significance was lost by full adjustment. A majority of HRV indices exhibited a trend toward higher values being associated with lower insulin levels and higher insulin sensitivity. CONCLUSIONS Higher resting heart rate in individuals without diabetes is associated with future unfavorable changes in insulin levels and insulin sensitivity. Associations may be mediated via autonomic function; however, results are inconclusive. Resting heart rate may be a risk marker for future pathophysiological changes in glucose metabolism.
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Affiliation(s)
| | | | - Marit Eika Jørgensen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- National Institute of Public Health, Southern Denmark University, Odense, Denmark
| | - Marek Malik
- National Heart and Lung Institute, Imperial College, London, U.K
| | - Daniel R Witte
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Diabetes Academy, Odense, Denmark
| | - Eric J Brunner
- Department of Epidemiology and Public Health, University College London, London, U.K
| | - Adam G Tabák
- Department of Epidemiology and Public Health, University College London, London, U.K
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, U.K
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21
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Kopp W. How Western Diet And Lifestyle Drive The Pandemic Of Obesity And Civilization Diseases. Diabetes Metab Syndr Obes 2019; 12:2221-2236. [PMID: 31695465 PMCID: PMC6817492 DOI: 10.2147/dmso.s216791] [Citation(s) in RCA: 347] [Impact Index Per Article: 69.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/13/2019] [Indexed: 12/12/2022] Open
Abstract
Westernized populations are plagued by a plethora of chronic non-infectious degenerative diseases, termed as "civilization diseases", like obesity, diabetes, cardiovascular diseases, cancer, autoimmune diseases, Alzheimer's disease and many more, diseases which are rare or virtually absent in hunter-gatherers and other non-westernized populations. There is a growing awareness that the cause of this amazing discrepancy lies in the profound changes in diet and lifestyle during recent human history. This paper shows that the transition from Paleolithic nutrition to Western diets, along with lack of corresponding genetic adaptations, cause significant distortions of the fine-tuned metabolism that has evolved over millions of years of human evolution in adaptation to Paleolithic diets. With the increasing spread of Western diet and lifestyle worldwide, overweight and civilization diseases are also rapidly increasing in developing countries. It is suggested that the diet-related key changes in the developmental process include an increased production of reactive oxygen species and oxidative stress, development of hyperinsulinemia and insulin resistance, low-grade inflammation and an abnormal activation of the sympathetic nervous system and the renin-angiotensin system, all of which play pivotal roles in the development of diseases of civilization. In addition, diet-related epigenetic changes and fetal programming play an important role. The suggested pathomechanism is also able to explain the well-known but not completely understood close relationship between obesity and the wide range of comorbidities, like type 2 diabetes mellitus, cardiovascular disease, etc., as diseases of the same etiopathology. Changing our lifestyle in accordance with our genetic makeup, including diet and physical activity, may help prevent or limit the development of these diseases.
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Affiliation(s)
- Wolfgang Kopp
- Retired Head, Diagnostikzentrum Graz, Graz8043, Austria
- Correspondence: Wolfgang Kopp Mariatrosterstraße 41, Graz8043, Austria Email
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22
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Kopp W. Diet-Induced Hyperinsulinemia as a Key Factor in the Etiology of Both Benign Prostatic Hyperplasia and Essential Hypertension? Nutr Metab Insights 2018; 11:1178638818773072. [PMID: 30455570 PMCID: PMC6238249 DOI: 10.1177/1178638818773072] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 04/04/2018] [Indexed: 01/09/2023] Open
Abstract
Benign prostatic hyperplasia and hypertension are common age-related comorbidities. Although the etiology of benign prostatic hyperplasia (BPH) is still largely unresolved and poorly understood, a significant age-independent association was found between BPH and hypertension, indicating a common pathophysiological factor for both diseases. It has previously been suggested that the development of essential hypertension may be related to diet-induced hyperinsulinemia. This study follows the question, whether BPH may develop due to the same mechanism, thereby explaining the well-known comorbidity of these 2 disorders. The scientific evidence presented shows that BPH and hypertension share the same pathophysiological changes, with hyperinsulinemia as the driving force. It further shows that significant dietary changes during human history cause disruption of a finely tuned metabolic balance that has evolved over millions of years of evolution: high-insulinemic food, typical of current “Western” diets, has the potential to cause hyperinsulinemia and insulin resistance, as well as an abnormally increased activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system, alterations that play a pivotal role in the pathogenesis of BPH and hypertension.
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Affiliation(s)
- Wolfgang Kopp
- Former head of the Diagnostikzentrum Graz, Graz, Austria
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23
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Guarino D, Nannipieri M, Iervasi G, Taddei S, Bruno RM. The Role of the Autonomic Nervous System in the Pathophysiology of Obesity. Front Physiol 2017; 8:665. [PMID: 28966594 PMCID: PMC5606212 DOI: 10.3389/fphys.2017.00665] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 08/22/2017] [Indexed: 12/18/2022] Open
Abstract
Obesity is reaching epidemic proportions globally and represents a major cause of comorbidities, mostly related to cardiovascular disease. The autonomic nervous system (ANS) dysfunction has a two-way relationship with obesity. Indeed, alterations of the ANS might be involved in the pathogenesis of obesity, acting on different pathways. On the other hand, the excess weight induces ANS dysfunction, which may be involved in the haemodynamic and metabolic alterations that increase the cardiovascular risk of obese individuals, i.e., hypertension, insulin resistance and dyslipidemia. This article will review current evidence about the role of the ANS in short-term and long-term regulation of energy homeostasis. Furthermore, an increased sympathetic activity has been demonstrated in obese patients, particularly in the muscle vasculature and in the kidneys, possibily contributing to increased cardiovascular risk. Selective leptin resistance, obstructive sleep apnea syndrome, hyperinsulinemia and low ghrelin levels are possible mechanisms underlying sympathetic activation in obesity. Weight loss is able to reverse metabolic and autonomic alterations associated with obesity. Given the crucial role of autonomic dysfunction in the pathophysiology of obesity and its cardiovascular complications, vagal nerve modulation and sympathetic inhibition may serve as therapeutic targets in this condition.
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Affiliation(s)
- Daniela Guarino
- Department of Clinical and Experimental Medicine, University of PisaPisa, Italy.,Institute of Clinical Physiology of CNRPisa, Italy.,Scuola Superiore Sant'AnnaPisa, Italy
| | - Monica Nannipieri
- Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | | | - Stefano Taddei
- Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
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24
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Rodrigues S, Cepeda FX, Toschi-Dias E, Dutra-Marques ACB, Carvalho JC, Costa-Hong V, Alves MJNN, Rondon MUPB, Bortolotto LA, Trombetta IC. The role of increased glucose on neurovascular dysfunction in patients with the metabolic syndrome. J Clin Hypertens (Greenwich) 2017; 19:840-847. [PMID: 28868764 DOI: 10.1111/jch.13060] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/13/2017] [Accepted: 05/21/2017] [Indexed: 12/11/2022]
Abstract
Metabolic syndrome (MetS) causes autonomic alteration and vascular dysfunction. The authors investigated whether impaired fasting glucose (IFG) is the main cause of vascular dysfunction via elevated sympathetic tone in nondiabetic patients with MetS. Pulse wave velocity, muscle sympathetic nerve activity (MSNA), and forearm vascular resistance was measured in patients with MetS divided according to fasting glucose levels: (1) MetS+IFG (blood glucose ≥100 mg/dL) and (2) MetS-IFG (<100 mg/dL) compared with healthy controls. Patients with MetS+IFG had higher pulse wave velocity than patients with MetS-IFG and controls (median 8.0 [interquartile range, 7.2-8.6], 7.3 [interquartile range, 6.9-7.9], and 6.9 [interquartile range, 6.6-7.2] m/s, P=.001). Patients with MetS+IFG had higher MSNA than patients with MetS-IFG and controls, and patients with MetS-IFG had higher MSNA than controls (31±1, 26±1, and 19±1 bursts per minute; P<.001). Patients with MetS+IFG were similar to patients with MetS-IFG but had higher forearm vascular resistance than controls (P=.008). IFG was the only predictor variable of MSNA. MSNA was associated with pulse wave velocity (R=.39, P=.002) and forearm vascular resistance (R=.30, P=.034). In patients with MetS, increased plasma glucose levels leads to an adrenergic burden that can explain vascular dysfunction.
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Affiliation(s)
- Sara Rodrigues
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Felipe X Cepeda
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Edgar Toschi-Dias
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Akothirene C B Dutra-Marques
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jefferson C Carvalho
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Valéria Costa-Hong
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Maria Janieire N N Alves
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Luiz A Bortolotto
- Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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25
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Ghasemi A, Jeddi S. Anti-obesity and anti-diabetic effects of nitrate and nitrite. Nitric Oxide 2017; 70:9-24. [PMID: 28804022 DOI: 10.1016/j.niox.2017.08.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 07/02/2017] [Accepted: 08/08/2017] [Indexed: 02/06/2023]
Abstract
Prevalence of obesity is increasing worldwide and type 2 diabetes to date is the most devastating complication of obesity. Decreased nitric oxide bioavailability is a feature of obesity and diabetes that links these two pathologies. Nitric oxide is synthesized both by nitric oxide synthase enzymes from l-arginine and nitric oxide synthase-independent from nitrate/nitrite. Nitric oxide production from nitrate/nitrite could potentially be used for nutrition-based therapy in obesity and diabetes. Nitric oxide deficiency also contributes to pathogeneses of cardiovascular disease and hypertension, which are associated with obesity and diabetes. This review summarizes pathways for nitric oxide production and focuses on the anti-diabetic and anti-obesity effects of the nitrate-nitrite-nitric oxide pathway. In addition to increasing nitric oxide production, nitrate and nitrite reduce oxidative stress, increase adipose tissue browning, have favorable effects on nitric oxide synthase expression, and increase insulin secretion, all effects that are potentially promising for management of obesity and diabetes. Based on current data, it could be suggested that amplifying the nitrate-nitrite-nitric oxide pathway is a diet-based strategy for increasing nitric oxide bioavailability and the management of these two interlinked conditions. Adding nitrate/nitrite to drugs that are currently used for managing diabetes (e.g. metformin) and possibly anti-obesity drugs may also enhance their efficacy.
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Affiliation(s)
- Asghar Ghasemi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Sajad Jeddi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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26
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da Silva Franco N, Lubaczeuski C, Guizoni DM, Victorio JA, Santos-Silva JC, Brum PC, Carneiro EM, Davel AP. Propranolol treatment lowers blood pressure, reduces vascular inflammatory markers and improves endothelial function in obese mice. Pharmacol Res 2017; 122:35-45. [DOI: 10.1016/j.phrs.2017.05.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 04/25/2017] [Accepted: 05/17/2017] [Indexed: 12/26/2022]
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27
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Biaggioni I. The Pharmacology of Autonomic Failure: From Hypotension to Hypertension. Pharmacol Rev 2017; 69:53-62. [PMID: 28011746 DOI: 10.1124/pr.115.012161] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Primary neurodegenerative autonomic disorders are characterized clinically by loss of autonomic regulation of blood pressure. The clinical picture is dominated by orthostatic hypotension, but supine hypertension is also a significant problem. Autonomic failure can result from impairment of central autonomic pathways (multiple system atrophy) or neurodegeneration of peripheral postganglionic autonomic fibers (pure autonomic failure, Parkinson's disease). Pharmacologic probes such as the ganglionic blocker trimethaphan can help us in the understanding of the underlying pathophysiology and diagnosis of these disorders. Conversely, understanding the pathophysiology is crucial in the development of effective pharmacotherapy for these patients. Autonomic failure patients provide us with an unfortunate but unique research model characterized by loss of baroreflex buffering. This greatly magnifies the effect of stimuli that would not be apparent in normal subjects. An example of this is the discovery of the osmopressor reflex: ingestion of water increases blood pressure by 30-40 mm Hg in autonomic failure patients. Animal studies indicate that the trigger of this reflex is related to hypo-osmolality in the portal circulation involving transient receptor potential vanilloid 4 receptors. Studies in autonomic failure patients have also revealed that angiotensin II can be generated through noncanonical pathways independent of plasma renin activity to contribute to hypertension. Similarly, the mineralocorticoid receptor antagonist eplerenone produces acute hypotensive effects, highlighting the presence of non-nuclear mineralocorticoid receptor pathways. These are examples of careful clinical research that integrates pathophysiology and pharmacology to advance our knowledge of human disease.
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Affiliation(s)
- Italo Biaggioni
- Division of Clinical Pharmacology, Departments of Medicine and Pharmacology, Vanderbilt University, Nashville, Tennessee
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28
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Straznicky NE, Grima MT, Sari CI, Eikelis N, Nestel PJ, Dixon JB, Lambert GW, Schlaich MP, Phillips SE, Lambert EA. Neck Circumference Is Associated with Muscle Sympathetic Nerve Activity in Overweight and Obese Men but Not Women. Front Physiol 2017; 8:203. [PMID: 28428756 PMCID: PMC5382191 DOI: 10.3389/fphys.2017.00203] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 03/20/2017] [Indexed: 11/28/2022] Open
Abstract
Background: Neck circumference (NC) is a predictor of cardiometabolic risk. The objective of this study was to explore the relationship of NC to muscle sympathetic nerve activity (MSNA) within an overweight and obese population. Methods: The study design was a retrospective cross-sectional analysis. Un-medicated persons (72 men, 53 postmenopausal women) aged 56 ± 1 years (mean ± SEM) with body mass index (BMI) 32.8 ± 0.4 kg/m2, were studied. NC was measured together with traditional anthropometric measures, supine blood pressure, fasting blood lipids, insulin, and glucose. Insulin sensitivity was assessed by homeostasis model (HOMA-IR) and Matsuda Insulin Sensitivity Index (ISI) derived from 75-g oral glucose tolerance test. Resting multiunit MSNA was recorded by microneurography in the peroneal nerve and expressed as burst frequency and burst incidence. Results: Men within the highest tertile of NC had significantly higher fasting and post-glucose plasma insulin levels (insulin AUC0−120), HOMA-IR, non-esterified fatty acids, MSNA (45 ± 2 vs. 36 ± 2 bursts per min; 69 ± 3 vs. 58 ± 3 bursts per 100 hb) and heart rate, and lower Matsuda ISI compared to men in the lowest tertile (P all <0.05). In stepwise regression analyses, NC alone explained 12%, and together with insulin AUC0−120 it accounted for 22%, of the variance in MSNA in men. In women, NC was associated with anthropometric measures but not with MSNA or metabolic indices. Conclusions: Among overweight and obese men, NC was independently associated with elevated MSNA and hyperinsulinemia, and thus may be relevant to cardiometabolic risk prediction. The biological basis of gender differences merits further elucidation.
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Affiliation(s)
- Nora E Straznicky
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia
| | - Mariee T Grima
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia
| | - Carolina I Sari
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia
| | - Nina Eikelis
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia
| | - Paul J Nestel
- Cardiovascular Nutrition Laboratory, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia
| | - John B Dixon
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia.,Department of Primary Health Care, Monash UniversityMelbourne, VIC, Australia
| | - Gavin W Lambert
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash UniversityMelbourne, VIC, Australia
| | - Markus P Schlaich
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia.,Royal Perth Hospital Unit, School of Medicine and Pharmacology, University of Western AustraliaCrawley, WA, Australia
| | - Sarah E Phillips
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia
| | - Elisabeth A Lambert
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes InstituteMelbourne, VIC, Australia.,Faculty of Health, Arts and Design, Iverson Health Innovation Research Institute, Swinburne University of TechnologyMelbourne, VIC, Australia
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29
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Taylor KS, Murai H, Millar PJ, Haruki N, Kimmerly DS, Morris BL, Tomlinson G, Bradley TD, Floras JS. Arousal From Sleep and Sympathetic Excitation During Wakefulness. Hypertension 2016; 68:1467-1474. [DOI: 10.1161/hypertensionaha.116.08212] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/05/2016] [Accepted: 09/11/2016] [Indexed: 02/07/2023]
Abstract
Obstructive apnea during sleep elevates the set point for efferent sympathetic outflow during wakefulness. Such resetting is attributed to hypoxia-induced upregulation of peripheral chemoreceptor and brain stem sympathetic function. Whether recurrent arousal from sleep also influences daytime muscle sympathetic nerve activity is unknown. We therefore tested, in a cohort of 48 primarily nonsleepy, middle-aged, male (30) and female (18) volunteers (age: 59±1 years, mean±SE), the hypothesis that the frequency of arousals from sleep (arousal index) would relate to daytime muscle sympathetic burst incidence, independently of the frequency of apnea or its severity. Polysomnography identified 24 as having either no or mild obstructive sleep apnea (apnea–hypopnea index <15 events/h) and 24 with moderate-to-severe obstructive sleep apnea (apnea–hypopnea index >15 events/h). Burst incidence correlated significantly with arousal index (
r
=0.53;
P
<0.001), minimum oxygen saturation (
r
=−0.43;
P
=0.002), apnea–hypopnea index (
r
=0.41;
P
=0.004), age (
r
=0.36;
P
=0.013), and body mass index (
r
=0.33;
P
=0.022) but not with oxygen desaturation index (
r
=0.28;
P
=0.056). Arousal index was the single strongest predictor of muscle sympathetic nerve activity burst incidence, present in all best subsets regression models. The model with the highest adjusted
R
2
(0.456) incorporated arousal index, minimum oxygen saturation, age, body mass index, and oxygen desaturation index but not apnea–hypopnea index. An apnea- and hypoxia-independent effect of sleep fragmentation on sympathetic discharge during wakefulness could contribute to intersubject variability, age-related increases in muscle sympathetic nerve activity, associations between sleep deprivation and insulin resistance or insomnia and future cardiovascular events, and residual adrenergic risk with persistence of hypertension should therapy eliminate obstructive apneas but not arousals.
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Affiliation(s)
- Keri S. Taylor
- From the University Health Network and Mount Sinai Hospital Department of Medicine, University of Toronto, Ontario, Canada
| | - Hisayoshi Murai
- From the University Health Network and Mount Sinai Hospital Department of Medicine, University of Toronto, Ontario, Canada
| | - Philip J. Millar
- From the University Health Network and Mount Sinai Hospital Department of Medicine, University of Toronto, Ontario, Canada
| | - Nobuhiko Haruki
- From the University Health Network and Mount Sinai Hospital Department of Medicine, University of Toronto, Ontario, Canada
| | - Derek S. Kimmerly
- From the University Health Network and Mount Sinai Hospital Department of Medicine, University of Toronto, Ontario, Canada
| | - Beverley L. Morris
- From the University Health Network and Mount Sinai Hospital Department of Medicine, University of Toronto, Ontario, Canada
| | - George Tomlinson
- From the University Health Network and Mount Sinai Hospital Department of Medicine, University of Toronto, Ontario, Canada
| | - T. Douglas Bradley
- From the University Health Network and Mount Sinai Hospital Department of Medicine, University of Toronto, Ontario, Canada
| | - John S. Floras
- From the University Health Network and Mount Sinai Hospital Department of Medicine, University of Toronto, Ontario, Canada
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Gamboa A, Figueroa R, Paranjape SY, Farley G, Diedrich A, Biaggioni I. Autonomic Blockade Reverses Endothelial Dysfunction in Obesity-Associated Hypertension. Hypertension 2016; 68:1004-10. [PMID: 27528067 DOI: 10.1161/hypertensionaha.116.07681] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 07/19/2016] [Indexed: 01/04/2023]
Abstract
Impaired nitric oxide (NO) vasodilation (endothelial dysfunction) is associated with obesity and thought to be a factor in the development of hypertension. We previously found that NO synthesis inhibition had similar pressor effects in obese hypertensives compared with healthy control during autonomic blockade, suggesting that impaired NO vasodilation is secondary to sympathetic activation. We tested this hypothesis by determining the effect of autonomic blockade (trimethaphan 4 mg/min IV) on NO-mediated vasodilation (increase in forearm blood flow to intrabrachial acetylcholine) compared with endothelial-independent vasodilation (intrabrachial sodium nitroprusside) in obese hypertensive subjects (30<body mass index<40 kg/m(2)). Acetylcholine and sodium nitroprusside were given at equipotent doses (10, 30, and 50 μg/min and 1, 2, and 3 μg/min, respectively) to 14 obese subjects (49±3.6 years, 34±1 kg/m(2), 165/94±7/6 mm Hg), on separate occasions 1 month apart, randomly assigned. Autonomic blockade increased basal forearm blood flow (from 3.9±0.7 to 5.2±1.2 mL/100 mL per minute, P=0.078). As expected, NO-mediated vasodilation was blunted on the intact day compared with NO-independent vasodilation; forearm blood flow increased from 3.6±0.6 to 10.1±1.1 with the highest dose of nitroprusside, but only from 3.7±0.4 to 7.2±0.8 mL/100 mL per minute with the highest dose of acetylcholine, P<0.05. In contrast, forearm blood flow responses to acetylcholine were restored by autonomic blockade and were no longer different to nitroprusside (from 6.2±1.1 to 11.4±1.6 mL/100 mL per minute and from 5.2±0.9 to 12.5±0.9, respectively, P=0.58). Our results support the concept that sympathetic activation contributes to the impairment in NO-mediated vasodilation seen in obesity-associated hypertension and provides further rationale to explore it as a therapeutic target.
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Affiliation(s)
- Alfredo Gamboa
- From the Division of Clinical Pharmacology (A.G., R.F., S.Y.P., G.F., A.D., I.B.), Departments of Medicine (A.G., R.F., S.Y.P., G.F., A.D., I.B.), and Pharmacology (I.B.), Vanderbilt University, Nashville, TN.
| | - Rocío Figueroa
- From the Division of Clinical Pharmacology (A.G., R.F., S.Y.P., G.F., A.D., I.B.), Departments of Medicine (A.G., R.F., S.Y.P., G.F., A.D., I.B.), and Pharmacology (I.B.), Vanderbilt University, Nashville, TN
| | - Sachin Y Paranjape
- From the Division of Clinical Pharmacology (A.G., R.F., S.Y.P., G.F., A.D., I.B.), Departments of Medicine (A.G., R.F., S.Y.P., G.F., A.D., I.B.), and Pharmacology (I.B.), Vanderbilt University, Nashville, TN
| | - Ginnie Farley
- From the Division of Clinical Pharmacology (A.G., R.F., S.Y.P., G.F., A.D., I.B.), Departments of Medicine (A.G., R.F., S.Y.P., G.F., A.D., I.B.), and Pharmacology (I.B.), Vanderbilt University, Nashville, TN
| | - Andre Diedrich
- From the Division of Clinical Pharmacology (A.G., R.F., S.Y.P., G.F., A.D., I.B.), Departments of Medicine (A.G., R.F., S.Y.P., G.F., A.D., I.B.), and Pharmacology (I.B.), Vanderbilt University, Nashville, TN
| | - Italo Biaggioni
- From the Division of Clinical Pharmacology (A.G., R.F., S.Y.P., G.F., A.D., I.B.), Departments of Medicine (A.G., R.F., S.Y.P., G.F., A.D., I.B.), and Pharmacology (I.B.), Vanderbilt University, Nashville, TN
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31
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Abstract
Abdominal obesity and elevated blood pressure commonly occur in the same patient and are key components of the metabolic syndrome. However, the association between obesity and increased blood pressure is variable. We review mechanisms linking cardiovascular and metabolic disease in such patients including altered systemic and regional hemodynamic control, neurohumoral activation, and relative natriuretic peptide deficiency. Moreover, we discuss recent results using omics techniques providing insight in molecular pathways linking adiposity, metabolic disease, and arterial hypertension. Recognition of the mechanisms orchestrating the crosstalk between cardiovascular and metabolic regulation in individual patients may lead to better and more precise treatments. It is reassuring that recently developed cardiovascular and metabolic medications may in fact ameliorate, both, cardiovascular and metabolic risks.
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Affiliation(s)
- Jens Jordan
- Institute for Clinical Pharmacology, Medical School Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Andreas L Birkenfeld
- Section of Metabolic Vascular Medicine, Medical Clinic III, Dresden University School of Medicine, Dresden, TU, Germany
- Center for Clinical Studies, GWT-TUD GmbH, Dresden, Germany
- Paul Langerhans Institute Dresden (PLID), A Member of the German Center for Diabetes Research (DZD e.V.), Dresden, Germany
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32
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Okamoto LE, Raj SR, Gamboa A, Shibao CA, Arnold AC, Garland EM, Black BK, Farley G, Diedrich A, Biaggioni I. Sympathetic activation is associated with increased IL-6, but not CRP in the absence of obesity: lessons from postural tachycardia syndrome and obesity. Am J Physiol Heart Circ Physiol 2015; 309:H2098-107. [PMID: 26453329 DOI: 10.1152/ajpheart.00409.2015] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 10/06/2015] [Indexed: 12/24/2022]
Abstract
Sympathetic activation is thought to contribute to the inflammatory process associated with obesity, which is characterized by elevated circulating C-reactive protein (hsCRP) and interleukin-6 (IL-6). To evaluate whether sympathetic activation is associated with inflammation in the absence of obesity, we studied patients with postural tachycardia syndrome (POTS), a condition characterized by increased sympathetic tone in otherwise healthy individuals. Compared with 23 lean controls, 43 lean female POTS had greater vascular sympathetic modulation (low-frequency blood pressure variability, LFSBP, 3.2 ± 0.4 vs. 5.5 ± 0.6 mmHg(2), respectively, P = 0.006), lower cardiac parasympathetic modulation (high-frequency heart rate variability, 1,414 ± 398 vs. 369 ± 66 ms(2), P = 0.001), and increased serum IL-6 (2.33 ± 0.49 vs. 4.15 ± 0.54 pg/ml, P = 0.011), but this was not associated with increases in hsCRP, which was low in both groups (0.69 ± 0.15 vs. 0.82 ± 0.16 mg/l, P = 0.736). To explore the contribution of adiposity to inflammation, we then compared 13 obese female POTS patients and 17 obese female controls to matched lean counterparts (13 POTS and 11 controls). Compared with lean controls, obese controls had increased LFSBP (3.3 ± 0.5 vs. 7.0 ± 1.1 mmHg(2); P = 0.016), IL-6 (2.15 ± 0.58 vs. 3.92 ± 0.43 pg/ml; P = 0.030) and hsCRP (0.69 ± 0.20 vs. 3.47 ± 0.72 mg/l; P = 0.001). Obese and lean POTS had similarly high IL-6 but only obese POTS had increased hsCRP (5.76 ± 1.99 mg/l vs. 0.65 ± 0.26; P < 0.001). In conclusion, sympathetic activation in POTS is associated with increased IL-6 even in the absence of obesity. The coupling between IL-6 and CRP, however, requires increased adiposity, likely through release of IL-6 by visceral fat.
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Affiliation(s)
- Luis E Okamoto
- Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tennessee; Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Satish R Raj
- Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tennessee; Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Pharmacology, Vanderbilt University School of Medicine; and
| | - Alfredo Gamboa
- Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tennessee; Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Cyndya A Shibao
- Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tennessee; Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Amy C Arnold
- Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tennessee; Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Emily M Garland
- Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tennessee; Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Bonnie K Black
- Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tennessee; Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Ginnie Farley
- Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tennessee; Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - André Diedrich
- Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tennessee; Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Biomedical Engineering, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Italo Biaggioni
- Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tennessee; Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Pharmacology, Vanderbilt University School of Medicine; and
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Celedonio JE, Arnold AC, Dupont WD, Ramirez CE, Diedrich A, Okamoto LE, Raj SR, Robertson D, Peltier AC, Biaggioni I, Shibao CA. Residual sympathetic tone is associated with reduced insulin sensitivity in patients with autonomic failure. Clin Auton Res 2015; 25:309-15. [PMID: 26359268 DOI: 10.1007/s10286-015-0307-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 06/18/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE Parkinson disease, an α-synucleinopathy, is associated with reduced insulin sensitivity, impaired glucose tolerance, and diabetes mellitus. Importantly, these metabolic alterations have been shown to contribute to disease progression. The purpose of this study was to determine if reduced insulin sensitivity is also present in other α-synucleinopathies associated with autonomic failure. METHODS We studied 19 patients with multiple system atrophy and 26 patients with pure autonomic failure. For comparison, we studied 8 healthy controls matched for body mass index. Insulin sensitivity and beta cell function were calculated using fasting glucose and insulin levels according to the homeostatic model assessment 2. A multiple linear regression model was performed to determine factors that predict insulin sensitivity in autonomic failure. RESULTS There was a significant difference in insulin sensitivity among groups (P = 0.048). This difference was due to lower insulin sensitivity in multiple system atrophy patients: 64% [interquartile range (IQR), 43 to 117] compared to healthy controls 139% (IQR, 83 to 212), P = 0.032. The main factor that contributed to the reduced insulin sensitivity was the presence of supine hypertension and residual sympathetic tone. CONCLUSIONS Multiple system atrophy patients have reduced insulin sensitivity that is associated with residual sympathetic activation and supine hypertension. These patients may therefore be at high risk for development of impaired glucose tolerance and diabetes mellitus.
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Affiliation(s)
- Jorge E Celedonio
- Division of Clinical Pharmacology, Department of Medicine, The Autonomic Dysfunction Center, Vanderbilt University School of Medicine, 562 Preston Research Building, Nashville, TN, 37232, USA
| | - Amy C Arnold
- Division of Clinical Pharmacology, Department of Medicine, The Autonomic Dysfunction Center, Vanderbilt University School of Medicine, 562 Preston Research Building, Nashville, TN, 37232, USA
| | - William D Dupont
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, USA
| | - Claudia E Ramirez
- Division of Clinical Pharmacology, Department of Medicine, The Autonomic Dysfunction Center, Vanderbilt University School of Medicine, 562 Preston Research Building, Nashville, TN, 37232, USA
| | - André Diedrich
- Division of Clinical Pharmacology, Department of Medicine, The Autonomic Dysfunction Center, Vanderbilt University School of Medicine, 562 Preston Research Building, Nashville, TN, 37232, USA
| | - Luis E Okamoto
- Division of Clinical Pharmacology, Department of Medicine, The Autonomic Dysfunction Center, Vanderbilt University School of Medicine, 562 Preston Research Building, Nashville, TN, 37232, USA
| | - Satish R Raj
- Division of Clinical Pharmacology, Department of Medicine, The Autonomic Dysfunction Center, Vanderbilt University School of Medicine, 562 Preston Research Building, Nashville, TN, 37232, USA
| | - David Robertson
- Division of Clinical Pharmacology, Department of Medicine, The Autonomic Dysfunction Center, Vanderbilt University School of Medicine, 562 Preston Research Building, Nashville, TN, 37232, USA
| | - Amanda C Peltier
- Department of Neurology, The Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, USA
| | - Italo Biaggioni
- Division of Clinical Pharmacology, Department of Medicine, The Autonomic Dysfunction Center, Vanderbilt University School of Medicine, 562 Preston Research Building, Nashville, TN, 37232, USA
| | - Cyndya A Shibao
- Division of Clinical Pharmacology, Department of Medicine, The Autonomic Dysfunction Center, Vanderbilt University School of Medicine, 562 Preston Research Building, Nashville, TN, 37232, USA.
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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.
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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
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Chang WH, Tsai YL, Huang CY, Hsieh CC, Chaunchaiyakul R, Fang Y, Lee SD, Kuo CH. Null effect of ginsenoside Rb1 on improving glycemic status in men during a resistance training recovery. J Int Soc Sports Nutr 2015; 12:34. [PMID: 26300710 PMCID: PMC4545376 DOI: 10.1186/s12970-015-0095-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 08/12/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ginsenoside Rb1, a principle active ingredients of Panax ginseng, has been shown to lower blood glucose in animals and increase insulin secretion in cultured insulinoma cells. The aim of this study was to determine the effects of daily ginsenoside Rb1 supplementation on circulating glucose and insulin levels in men during a 5-day recovery period after an acute bout of resistance exercise. METHODS Twelve gymnasts (20.5 ± 0.3 years of age) participated in this double blind placebo-controlled crossover trial. They were challenged by a lower-limb resistance exercise at a weight load of 85 % one-repetition maximal (1-RM) for 10 repetitions, six sets of the movement. Rb1 (1 ng/kg) or Placebo was orally delivered to participants daily during a 5-day recovery period after challenge. Circulating insulin, glucose and heart rate variability (HRV) were measured under fasted condition in the morning at Days 1, Day 3, and Day 5 during recovery. RESULTS No significant effect of Rb1 on circulating glucose and insulin levels were found among participants during the 5-day recovery period. A persistent elevation in sympathetic nervous activity, indicated by increased HRV-low frequency/high frequency (HRV-LF/HF) power, during the Rb1 trial was observed. CONCLUSIONS The result of the study suggests that the null effect of Rb1 supplementation on lowering glucose and insulin levels of participants may be associated with chronic sympathetic activation.
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Affiliation(s)
- Wei-Hsiang Chang
- Department of Sports Sciences, Laboratory of Exercise Biochemistry, University of Taipei, Taipei, Taiwan.,Department of Physical Education, National Hsinchu University of Education, Hsinchu, Taiwan.,Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan, Taiwan
| | - Ying-Lan Tsai
- Department of Physical Education, National Hsinchu University of Education, Hsinchu, Taiwan
| | - Chih-Yang Huang
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan.,Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan
| | - City C Hsieh
- Department of Physical Education, National Hsinchu University of Education, Hsinchu, Taiwan
| | | | - Yu Fang
- Department of Sports Sciences, Laboratory of Exercise Biochemistry, University of Taipei, Taipei, Taiwan
| | - Shin-Da Lee
- Department of Rehabilitation Science, China Medical University, Taichung, Taiwan.,Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Chia-Hua Kuo
- Department of Sports Sciences, Laboratory of Exercise Biochemistry, University of Taipei, Taipei, Taiwan.,Department of Rehabilitation Science, China Medical University, Taichung, Taiwan
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37
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Abstract
Several articles have dealt with the importance and mechanisms of the sympathetic nervous system alterations in experimental animal models of hypertension. This review addresses the role of the sympathetic nervous system in the pathophysiology and therapy of human hypertension. We first discuss the strengths and limitations of various techniques for assessing the sympathetic nervous system in humans, with a focus on heart rate, plasma norepinephrine, microneurographic recording of sympathetic nerve traffic, and measurements of radiolabeled norepinephrine spillover. We then examine the evidence supporting the importance of neuroadrenergic factors as promoters and amplifiers of human hypertension. We expand on the role of the sympathetic nervous system in 2 increasingly common forms of secondary hypertension, namely hypertension associated with obesity and with renal disease. With this background, we examine interventions of sympathetic deactivation as a mode of antihypertensive treatment. Particular emphasis is given to the background and results of recent therapeutic approaches based on carotid baroreceptor stimulation and radiofrequency ablation of the renal nerves.
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Affiliation(s)
- Guido Grassi
- From the Clinica Medica, Dipartimento di Scienze della Salute, Università Milano-Bicocca, Milano, Italy (G.G.); IRCCS Multimedica, Sesto San Giovanni, Milano, Italy (G.G.); Carver College of Medicine, University of Iowa, Iowa City (A.M.); and Baker IDI Heart and Diabetes Institute, Melbourne, Australia (M.E.).
| | - Allyn Mark
- From the Clinica Medica, Dipartimento di Scienze della Salute, Università Milano-Bicocca, Milano, Italy (G.G.); IRCCS Multimedica, Sesto San Giovanni, Milano, Italy (G.G.); Carver College of Medicine, University of Iowa, Iowa City (A.M.); and Baker IDI Heart and Diabetes Institute, Melbourne, Australia (M.E.)
| | - Murray Esler
- From the Clinica Medica, Dipartimento di Scienze della Salute, Università Milano-Bicocca, Milano, Italy (G.G.); IRCCS Multimedica, Sesto San Giovanni, Milano, Italy (G.G.); Carver College of Medicine, University of Iowa, Iowa City (A.M.); and Baker IDI Heart and Diabetes Institute, Melbourne, Australia (M.E.)
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