Metabolic Syndrome and Insulin Resistance: Underlying Causes and Modification by Exercise Training

Abstract

Metabolic syndrome (MS) is a collection of cardiometabolic risk factors that includes obesity, insulin resistance, hypertension, and dyslipidemia. Although there has been significant debate regarding the criteria and concept of the syndrome, this clustering of risk factors is unequivocally linked to an increased risk of developing type 2 diabetes and cardiovascular disease. Regardless of the true definition, based on current population estimates, nearly 100 million have MS. It is often characterized by insulin resistance, which some have suggested is a major underpinning link between physical inactivity and MS. The purpose of this review is to: (i) provide an overview of the history, causes and clinical aspects of MS, (ii) review the molecular mechanisms of insulin action and the causes of insulin resistance, and (iii) discuss the epidemiological and intervention data on the effects of exercise on MS and insulin sensitivity.

The Prevalence of Metabolic Syndrome In Chronic Obstructive Pulmonary Disease: A Systematic Review

“…Studies assessing individual MetS components or insulin resistance as the cornerstone of MetS might help unveil the background of increased cardiometabolic risk in COPD patients and allow us to specifically target these factors. While the relative influence of lifestyle versus disease specific determinants and medication is still unclear, we know that exercise training may improve MetS in other risk populations (50). Pulmonary rehabilitation is an established intervention in COPD focusing on exercise training but the effects on modification of MetS is surprisingly not yet investigated in detail.…”

Introductory Chapter: Recent Trends in Cardiovascular Risk Factors

“…To enhance the adoption of such a policy in developing countries, an additional strategy by the WHO and International Society of Hypertension was developed by deriving both laboratoryand nonlaboratory-based CVD risk prediction charts for low-and medium-resource setings in countries in diferent WHO subregions. Signiicant researches have suggested that a vascular segment gives us a clue of atherosclerotic lesions, namely endothelial dysfunctions, macrophage activation, cellular proliferation and thrombosis, and they respond diferently on medication [8]. Therapeutic approach of the atherogenic dyslipidemia imposes the correlation with proatherogenic individual tendencies in order to correct the further risks [9].…”

Carvedilol versus beta-1 blockers as anti-hypertensive drugs in type-2 diabetes mellitus and pre-diabetic patients with features of metabolic syndrome: a meta-analysis

“…Development of insulin resistance (fasting serum insulin level of >25 mIU/l) is the major initial patho-physiological event responsible for mediating subsequent events and complications of metabolic syndrome. 2,3 Hyper-insulinemia induced due to decreased tissue sensitivity to insulin is responsible for sodium retention, sympathetic nervous system stimulation, vascular smooth muscle hypertrophy and oxidative stress. 2,3 Hence insulin resistance represents the mechanism or basis for development of hypertension in type-2 DM and vice-versa.…”

“…2,3 Hyper-insulinemia induced due to decreased tissue sensitivity to insulin is responsible for sodium retention, sympathetic nervous system stimulation, vascular smooth muscle hypertrophy and oxidative stress. 2,3 Hence insulin resistance represents the mechanism or basis for development of hypertension in type-2 DM and vice-versa. Major complication of metabolic syndrome in pre-diabetics is risk of onset of type-2 DM and in existing diabetics the higher incidences of cardiovascular related events like myocardial infarction, stroke etc.…”

“…Major complication of metabolic syndrome in pre-diabetics is risk of onset of type-2 DM and in existing diabetics the higher incidences of cardiovascular related events like myocardial infarction, stroke etc. 2,3 Theoretically, anti-hypertensive drugs preferred in treating diabetic and especially pre-diabetic patient with metabolic syndrome are those with neutral or favourable metabolic effects. The favourable metabolic effect of an anti-hypertensive drug may become quite significant in preventing risk of onset of type-2 DM in a pre-diabetic patient.…”