Metabolic Syndrome and the Lung

Abstract

A link between metabolic syndrome (MetS) and lung diseases has been observed in several cross-sectional and longitudinal studies. This syndrome has been identified as an independent risk factor for worsening respiratory symptoms, greater lung function impairment, pulmonary hypertension, and asthma. This review will discuss several potential mechanisms to explain these associations, including dietary factors and the effect of adiposity and fat-induced inflammation on the lungs, and the role of other comorbidities that frequently coexist with MetS, such as OSA and obesity. In contrast to the well-known association between asthma and obesity, the recognition that MetS affects the lung is relatively new. Although some controversy remains as to whether MetS is a unique disease entity, its individual components have independently been associated with changes in pulmonary function or lung disease. There is, however, uncertainty as to the relative contribution that each metabolic factor has in adversely affecting the respiratory system; also, it is unclear how much of the MetS-related lung effects occur independently of obesity. In spite of these epidemiological limitations, the proposed mechanistic pathways strongly suggest that this association is likely to be causal. Given the wide prevalence of MetS in the general population, it is imperative that we continue to further understand how this metabolic disorder impacts the lung and how to prevent its complications.

Glucagon-like peptide 1: A potential anti-inflammatory pathway in obesity-related asthma

“…Suggested links include chronic inflammation, mitochondrial dysfunction,, Th17-induced neutrophilia, macrophage dysregulation, hormonal changes, lipid metabolism, insulin resistance, and body mechanics (Baffi et al, 2016; Chesne et al, 2014; Shore and Cho, 2016). Other well-described abnormalities in obesity and metabolic syndrome, accelerated formation of advanced glycation end products (AGEs) and alterations in arginine metabolism may also play a crucial role in asthma pathogenesis and may be modulated by the anti-inflammatory incretin, GLP-1 (Figure 1) (Holguin, 2013; Milutinovic et al, 2012; Ojima et al, 2013; Singh et al, 2015; Uribarri et al, 2015).…”

Insulin resistance modifies the association between obesity and current asthma in adults

“…Several studies have suggested that each of the individual components of the metabolic syndrome are indeed associated with asthma, independently of obesity [18–20]. However, the relative contribution of each component of the metabolic syndrome to a more severe asthma phenotype has not been established, as recently reviewed by Baffi et al [21]. Whether components of the metabolic syndrome are also effect modifiers of the association between obesity and asthma is unclear.…”

Metabolic Disorder in Chronic Obstructive Pulmonary Disease (COPD) Patients: Towards a Personalized Approach Using Marine Drug Derivatives

“…The CMA provides oxygen and nutrients to the body. A link between metabolic syndrome (MetS code E88.81), or better to metabolic disorder (MetD), and lung diseases has been reported by several cross-sectional and longitudinal studies (as reviewed, recently, by Baffi et al [12]). The concept of MetS evolved over time to MetD; indeed, MetD is a complex disorder thought as a cluster of conditions sustaining a “ disorder in energy use and storage ” characterized by central obesity, dyslipidemia, high blood sugar levels (hyperglycemia), hypertriglyceridemia, and low high-density lipoprotein cholesterol levels.…”