Dysregulation of the Autonomic Nervous System in the Mechanisms of Metabolic Syndrome Development

Abstract

The concept of metabolic syndrome as a cluster of risk factors for type 2 diabetes and cardiovascular diseases has undergone a number of evolutionary transformations over the past years. Incorporation of autonomic nervous system dysfunction into the pathogenesis of metabolic syndrome opens an opportunity for inclusion of a number of clinical entities in the cluster of metabolic syndrome as they mutually affect the course and clinical manifestations of pathologies involved in metabolic syndrome. To confirm this notion, a cross-sectional transverse study of a continuous sample of 158 patients with metabolic syndrome was performed. The study showed that, in the presence of metabolic syndrome, the incidence of cardiac autonomic neuropathy reaches 37.5%. A number of features of gastroesophageal reflux disease in patients with metabolic syndrome were found in the structure of complaints where regurgitation predominated. Fibrogastroduodenoscopy demonstrated endoscopically negative form of the disease in 38%, and, according to high DeMeester index by daily pH-metry, the alkaline reflux was present in patients in lying position over 25% of time. Young men with metabolic syndrome had high incidence of prostatic enlargement (increased prostate size and volume) as well as high incidence of the IPSS questionnaire score corresponding to the initial manifestations of prostatic hyperplasia in the presence of insulin resistance and normal androgen levels. The study showed that dysfunction of the autonomic nervous system (along with insulin resistance) was the main converging point in the development of metabolic syndrome. This suggests that cardiac autonomic neuropathy, lower urinary tract symptoms, and gastroesophageal reflux disease may be included in the metabolic syndrome cluster.

Stress before exams as a risk factor causing functional disorders in the cardiovascular system in students with different metabolic status

“…It was also noted that vegetative nervous system dysfunction (just as resistance to insulin) was a primary reason for MS development. Integration of vegetative dysfunction in MS pathogenesis provides an opportunity to include certain nosologies into MS cluster [22]. Despite there are multiple scores for assessing CVD risks occurrence (the Framingham Risk Score, PROCAM, SCORE, UKPDS, ULSAM, and others), none of them allows precise prediction of CVD risks for young people aged 18-35 without any clinical signs of atherosclerosis; however, there have been multiple attempts to adapt some of predictive models for assessing risks of CVD occurrence among young people [23].…”

Correlation between adipocytokine profile and heart rate variability in patients with obesity

“…Известно, что метаболиче ски нездоровый фенотип ожирения ассо циируется с развитием артериальной гипертензии (АГ), ишемической болезни сердца (ИБС) и сахарного диабета 2 го типа (СД 2), в чем немаловажную роль кроме ин сулинорезистентности играют гормоны, синтезируемые в жировой ткани: адипонек тин, лептин, резистин [2]. Доказано, что на рушение автономной регуляции ритма серд ца у больных СД 2, АГ, ИБС приводит к уве личению сердечно сосудистой смертности [3]. Изучение вариабельности ритма сердца (ВРС) является неинвазивным методом оценки автономной вегетативной регуляции сер дечного ритма [4].…”