Desequilíbrio autonômico e síndrome metabólica: parceiros patológicos em uma pandemia global emergente

Abstract

This review will examine the importance of the autonomic nervous system both in the pathophysiology and complications of the metabolic syndrome. Metabolic syndrome refers to a constellation of risk factors related to insuline resistance and obesity with a pattern of central fat distribution. While the insulin resistance syndrome has been attracting attention over the last three decades, the metabolic syndrome achieved heightened prominence after the publication and review of the World Health Organization (WHO) Expert Committee Report on the diagnosis and classification of diabetes mellitus, in 1998, and the National Cholesterol Education Program guidelines (Adult Treatment Panel [ATP] III) in 2001, in the United states [1][2][3] . Although definitions provided differ somewhat, both anticipate a significant increase in the risk of coronary heart disease and cardiovascular disease in general [4][5][6] .The metabolic syndrome affects a substantial proportion of adults in societies characterized by excessive calorie intake, use of labor-saving devices, and passive leisure activities. This syndrome is liable to become a pandemic, because obesity has been growing dramatically as the world's population ages 7 . Its costs, both in health and financial terms, are extremely high and can be more devastating than the largest armed conflict.This review focuses primarily on the role of the sympathetic nervous system in the metabolic syndrome, providing a gamut of information and directing its efforts rationally to prevent and treat the health consequences of this increasingly prevalent condition effectivelly. Metabolic syndrome DefinitionThe WHO and ATP-III definitions of the metabolic syndrome are not similar1-3 (Tab. 1). Associated risk factorsThis syndrome is associated with postprandial hyperinsulinemia, insulin resistance with reduced glucose and fatty acids, higher levels of denser LDL-cholesterol particles

Resistência insulínica e sua relação com os componentes da síndrome metabólica

“…Moreover, the behavior of each component and their relationship vary according to ethnicity. In African-Americans, although the increase in waist circumference is related to a faster increase of cardiovascular factors than in Hispanics and Caucasians, the relationship between triglycerides and insulin resistance is reversed, i.e., as insulin resistance increases, triglycerides decrease 26 .…”

Síndrome metabólica em hipertensos de Cuiabá - MT: prevalência e fatores associados

“…From the initial description and studies by Reaven (1988), MS has been defined as the combination of several metabolic and hemodynamic abnormalities in the same individual, and which share the same pathophysiological basis: resistance to insulin 1 . These factors are: blood pressure (BP) ≥ 130 x 85mmHg; insulin resistance; changes in the metabolism of glucose (fasting plasma glucose > 100 mg/dl, or type 2 diabetes); central obesity (waist circumference ≥ 102 cm in men and 88 ≥ cm in women);l abnormal lipid levels (HDL < 40 mg/dl in men or < 50 mg/dl in women; triglycerides > 150 mg/dl); blood clotting disorders; pro-inflammatory state; and microalbuminuria [2][3][4] . The term Metabolic Syndrome, proposed by the World Health Organization (WHO) in 1998, helped reformulate the understanding that multiple cardiovascular risk factors, not related by chance, concurrently affect the development of atherosclerosis.…”

Impacts of low or vigorous levels of physical activity on body composition, hemodynamics and autonomic modulation in Down syndrome subjects

“…This fact can be partially explained due to the sedentary state attested among this population 29 . Both sedentary state and overweight have been correlated with autonomic control imbalance, strongly promoting cardiovascular diseases and pathologies 30 . Previous studies have suggested that the abnormal autonomic function and hemodynamics in obesity are related to hyperinsulinemia 29,31 .…”