Structured lifestyle intervention in patients with the metabolic syndrome mitigates oxidative stress but fails to improve measures of cardiovascular autonomic neuropathy
Open accessAbstract
Aims To assess the role of oxidative stress in mediating adverse outcomes in metabolic syndrome (MetS) and resultant cardiovascular autonomic neuropathy (CAN), and to evaluate the effects of lifestyle interventions on measures of oxidative stress and CAN in subjects with MetS. Methods Pilot study in 25 non-diabetic subjects with MetS (age 49±10years, 76% females) participating in a 24-week lifestyle intervention (supervised aerobic exercise/Mediterranean diet), and 25 age-matched healthy controls. CAN was assessed by cardiovascular reflex tests, heart rate variability (HRV) and PET imaging with sympathetic analog [11 C] meta-hydroxyephedrine ([11 C]HED). Specific oxidative fingerprints were measured by liquid-chromatography/mass-spectrometry (LC/MS). Results At baseline, MetS subjects had significantly higher oxidative stress markers [3-nitrotyrosine (234±158 vs. 54±47μmol/mol tyrosine), ortho-tyrosine (59±38 vs. 18±10μmol/molphenylalanine, all P<0.0001], and impaired HRV at rest and during deep breathing (P=0.039 and P=0.021 respectively) compared to controls. Twenty-four-week lifestyle intervention significantly reduced all oxidative stress markers (all P<0.01) but did not change any of the CAN measures. Conclusions Subjects with MetS present with signs of CAN and increased oxidative stress in the absence of diabetes. The 24-week lifestyle intervention was effective in ameliorating oxidative stress, but did not improve measures of CAN. Larger clinical trials with longer duration are required to confirm these findings.
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In MetS subjects, protein-bound 3-NT levels are higher compared to healthy subjects (plasma, LC-ESI-MS/MS).
“Higher protein-bound 3-NT levels in MetS subjects”
From Protein oxidation - Formation mechanisms, detection and relevance as biomarkers in human diseases (2021) · cites this paper as [247]
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- Authors
- Pennathur, S., Jaiswal, M., Vivekanandan-Giri, A., White, E. A., Ang, L., Raffel, D. M., Rubenfire, M., & Pop-Busui, R.
- Affiliations
- University of Michigan (US)
- ORCID
- Venue
- Journal of Diabetes and its Complications
- Publisher
- Elsevier BV
- Published
- 2017-09
- Volume
- 31
- Issue
- 9
- Pages
- 1437-1443
- ISSN
- 0891-6632 (ISSN-L)
- 1056-8727
- PMC
- PMC5580245
- OpenAlex
- W2610264252
- Cited by
- 21
- References
- 58
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 6 · 2018: 1 · 2017: 1
- FWCI
- 2.12
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Diabetes and its Complications (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK020572)
- 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 › Biochemistry › Antioxidant Activity and Oxidative Stress
- Keywords
- metabolic syndrome, cardiac autonomic neuropathy, oxidative stress, lifestyle intervention, aerobic exercise, Mediterranean diet, heart rate variability, sympathetic nervous system, nitrotyrosine, cardiovascular reflex tests
- MeSH terms
- Adult, Autonomic Nervous System, Autonomic Nervous System Diseases, Cardiovascular Diseases, Cardiovascular System, Cross-Sectional Studies, Female, Humans, Life Style, Male, Middle Aged, Pilot Projects, Risk Factors, Exercise, Treatment Outcome, Oxidative Stress, Metabolic Syndrome, Diet, Mediterranean, Risk Reduction Behavior, Weight Reduction Programs
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