Neuroadrenergic and reflex abnormalities in patients with metabolic syndrome
Open accessAbstract
Aims/hypothesis Previous studies have shown that alterations in vascular, metabolic, inflammatory and haemocoagulative functions characterise the metabolic syndrome. Whether this is also the case for sympathetic function is not clear. We therefore aimed to clarify this issue and to determine whether metabolic or reflex mechanisms might be responsible for the possible adrenergic dysfunction.Methods In 43 healthy control subjects (age 48.2+/-1.0 years, mean+/-SEM) and in 48 untreated age-matched subjects with metabolic syndrome (National Cholesterol Education Program's Adult Treatment Panel III Report criteria) we measured, along with anthropometric and metabolic variables, blood pressure (Finapres), heart rate (ECG) and efferent postganglionic muscle sympathetic nerve activity (microneurography) at rest and during baroreceptor manipulation (vasoactive drug infusion technique).Results Compared with control subjects, subjects with metabolic syndrome had higher BMI, waist circumference, blood pressure, cholesterol, triglycerides, insulin and homeostasis model assessment (HOMA) index values but lower HDL cholesterol values. Sympathetic nerve traffic was significantly greater in subjects with metabolic syndrome than in control subjects (61.1+/-2.6 vs 43.8+/-2.8 bursts/100 heartbeats, p<0.01), the presence of sympathetic activation also being detectable when the metabolic syndrome did not include hypertension as a component. Muscle sympathetic nerve traffic correlated directly and significantly with waist circumference (r=0.46, p<0.001) and HOMA index (r=0.49, p<0.001) and was inversely related to baroreflex sensitivity (r=-0.44, p<0.001), which was impaired in the metabolic syndrome.Conclusions/interpretation These data provide evidence that the metabolic syndrome is characterised by sympathetic activation and that this abnormality (1) is also detectable when blood pressure is normal and (2) depends on insulin resistance as well as on reflex alterations.
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Inflammation in CNS tissues enhances sympathetic outflow, increases blood pressure and SGLT-2 expression in kidney, causing hypertension or metabolic syndrome.
“Evidence from recent studies show that inflammation in the CNS tissues enhances sympathetic outflow, increases BP and SGLT-2 expression in kidney, causing hypertension or metabolic syndrome.60,61”
From <p>Dapagliflozin Activates Neurons in the Central Nervous System and Regulates Cardiovascular Activity by Inhibiting SGLT-2 in Mice</p> (2020) · cites this paper as [60]
Muscle sympathetic nerve activity correlates directly with waist circumference in subjects with the metabolic syndrome.
“Muscle sympathetic nerve activity correlates directly with waist circumference in subjects with the metabolic syndrome6.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [6]
Obese humans with the metabolic syndrome have elevated muscle sympathetic nerve traffic values even in the absence of hypertension.
“Obese humans with the metabolic syndrome have elevated muscle sympathetic nerve traffic values even in the absence of hypertension6.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [6]
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- Authors
- Grassi, G., Dell’Oro, R., Quarti-Trevano, F., Scopelliti, F., Seravalle, G., Paleari, F., Gamba, P. L., & Mancia, G.
- Affiliations
- University of Milano-Bicocca (IT)
- IRCCS Istituto Auxologico Italiano (IT)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Corresponding author
- Mancia, G.
- Venue
- Diabetologia
- Published
- 2005-06-03
- Volume
- 48
- Issue
- 7
- Pages
- 1359-1365
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2082784704
- Cited by
- 294
- References
- 48
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 6 · 2023: 8 · 2022: 6 · 2021: 10 · 2020: 9 · 2019: 11 · 2018: 18 · 2017: 12 · 2016: 24 · 2015: 16 · 2014: 21 · 2013: 18 · 2012: 21
- FWCI
- 11.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- metabolic syndrome, sympathetic nervous system, muscle sympathetic nerve activity, baroreflex sensitivity, insulin resistance, HOMA index, waist circumference, hypertension, adrenergic dysfunction, reflex mechanisms
- MeSH terms
- Adult, Blood Glucose, Blood Pressure, Epinephrine, Female, Heart Rate, Homeostasis, Humans, Male, Middle Aged, Norepinephrine, Reference Values, Reflex, Sympathetic Nervous System, Metabolic Syndrome
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