Csaba Varga, PhD, Anikó Pósa, PhD, Krisztina Kedvesné Kupai: The metabolic syndrome
- The metabolic syndrome
- I. Introduction
- II. Historical survey
- III. Physiological basics
- III.1. Energy storage
- III.2. Regulation of lipid metabolism
- III.2.A. Adipose tissue distribution
- III.2.B. The endocrine function of adipose tissue
- III.2.B.a. Adiponectin
- III.2.B.b. Leptin
- III.2.B.c. Resistin
- III.2.B.d. Retinol binding protein 4 (RBP4)
- III.2.B.e. The complement system
- III.2.B.f. Interleukin-6 (IL-6)
- III.2.B.g. Monocyte chemoattractant protein-1 (MCP-1)
- III.2.B.h. Tumor necrosis factor-alpha (TNF-α)
- III.2.B.i. Plasminogen activator inhibitor type 1 (PAI-1)
- III.2.B.j. Angiotensinogen
- III.3. The glucose metabolism
- III.3.A. Transporters playing a role in Glu uptake and release
- III.3.B. Role of the pancreas
- III.3.C. Effects of catecholamines
- III.3.D. The renin-angiotensin-aldosterone system (RAAS)
- III.3.E. The effect of the growth hormone on the blood glucose level
- III.3.F. The effects of glucocorticoids
- III.3.G. The effects of thyroid hormones
- III.3.H. Regulation of the blood glucose level
- III.4. Hormonal regulation of the gastrointestinal system
- III.4.A. Gastrin
- III.4.B. Secretin
- III.4.C. Cholecystokinin (CCK)
- III.4.D. Gastric inhibitory peptide (GIP)
- III.4.E. Vasoactive intestinal peptide (VIP)
- III.4.F. Peptide histidine methionine
- III.4.G. Glucagon and enteroglucagon
- III.4.H. Pancreatic polypeptide (PP)
- III.4.I. Neuropeptide Y (NPY)
- III.4.J. Peptide tyrosine-tyrosine (PYY)
- III.4.K. Opioid peptides
- III.4.L. Motilin
- III.4.M. Metabolic effects of hormones
- III.5. The regulation of eating
- IV. Definition of the metabolic syndrome
- V. Parameters influencing the metabolic syndrome
- VI. Endothelial dysfunction in the metabolic syndrome
- VII. Cardiovascular risk factors
- VII.1. Hyperinsulinemia
- VII.2. ACE gene polymorphism
- VII.3. Microalbuminuria (MA)
- VII.4. Impaired glucose tolerance (IGT)
- VII.5. Type 2 diabetes mellitus (T2DM)
- VII. 6. Hyperlipidemia
- VII.7. Dyslipidemia
- VII.8. High cholesterol level
- VII.9. Nonalcoholic fatty liver disease (NAFLD)
- VII.10. Atherothrombosis and atherosclerosis
- VII.11. High blood pressure
- VII.12. Malnutrition
- VII.13. Lipoprotein a (Lpa)
- VII.14. Homocysteine (Hcy)
- VII.15. Hyperuricemia
- VII.16. Smoking
- VII.17. Stress
- VII.18. Depression
- VII.19. Age and sex
- VII.20. Lack of sleep
- VII.21. Obstructive sleep apnea (OSA)
- VII.22. Physical inactivity
- VIII. Cardiovascular complications
- IX. Inflammation and the metabolic syndrome
- X. The diagnostic parameters of the Metabolic syndrome
- XI. Prevention of the metabolic syndrome
- XII. Treatment of the metabolic syndrome
- XIII. Abbreviations
- XIV. References
- XV. Acknowledgments
VII.1. Hyperinsulinemia
An increased insulin level (hyperinsulinemia) is a predictor of insulin resistance. Hyperinsulinemia impairs the endothelial function and the BP rises (hypertension). Hypertension is enhanced by sympathetic adrenergic activation, increased tubular Na+ and water reabsorption, an increase of the RAAS system, and decreased levels of vasodilators (e.g. prostacyclin).
An increased insulin level enhances the GH and IGF-1 levels, which leads to elevated vasoconstriction through thickening of the vessel walls and an increased BP.
Upper body obesity, high TG, low HDL levels and high BP are frequent in hyperinsulinemic patients.
Készült az Új generációs sporttudományi képzés és tartalomfejlesztés, hazai és nemzetközi hálózatfejlesztés és társadalmasítás a Szegedi Tudományegyetemen c. pályázat támogatásával. Pályázati azonosító: TÁMOP-4.1.2.E-15/1/Konv-2015-0002