Chest
Recent Advances in Chest MedicineMetabolic Syndrome and the Lung
Section snippets
Metabolic Syndrome and Obstructive Airway Diseases
The definition of metabolic syndrome (MetS) has evolved over time; MetS is currently defined by a grouping of clinical characteristics including abdominal obesity, hyperglycemia, hypertriglyceridemia, hypertension, and low high-density lipoprotein cholesterol levels. Data from the National Health and Nutrition Examination Survey spanning 1999 to 2010 indicate that although the age-adjusted prevalence decreased from 25.5% in 1999 to 2000 to 22.9% in 2009 to 2010 in the United States, MetS is
MetS and OSA
There is a robust association between OSA and MetS, either as a whole or with its individual components.18, 56 The prevalence of MetS in patients with OSA is 60%, which is considerably higher than in the general population.57 This association is partly explained by the fact that patients with OSA are more likely to have greater visceral adiposity, in addition to abnormal glucose metabolism. In the Wisconsin sleep study the OR for having a diagnosis of DM increased in relation to the degree of
MetS and Pulmonary Hypertension
MetS, advancing age, and female sex are strongly associated with the development of pulmonary venous hypertension (group II pulmonary hypertension classification), defined by an increase in mean pulmonary artery pressures (≥25 mm Hg) but with high left ventricular filling pressures (pulmonary artery occlusion pressures >15 mm Hg).19
Pulmonary venous hypertension most commonly occurs in the setting of left ventricular diastolic dysfunction with preserved left heart systolic function, referred
Conclusions
Each MetS component contributes to lung disease. It is unclear whether treating MetS will reduce its effects on the respiratory system. Despite this uncertainty, optimally treating each component of MetS is a sensible way to minimize the risk of respiratory comorbidity.
Acknowledgments
Author contributions: C. W. B. wrote the manuscript with input from F. H., including the section on metabolic syndrome and obstructive lung diseases. P. J. S. wrote the section addressing metabolic syndrome and obstructive sleep apnea. L. W. wrote the section regarding diet and obesity as it relates to airway diseases. D. W. and L. G. Q. provided critical oversight of the review and contributed to writing the manuscript. M. T. G. wrote the section discussing pulmonary vasculature as it relates
References (77)
- et al.
Prevalence and trends of metabolic syndrome in the adult U.S. population, 1999-2010
J Am Coll Cardiol
(2013) - et al.
The metabolic syndrome: prevalence in worldwide populations
Endocrinol Metab Clin North Am
(2004) - et al.
Metabolic syndrome
Endocrinol Metab Clin North Am
(2014) - et al.
Lung function, coronary artery calcification, and metabolic syndrome in 4905 Korean males
Respir Med
(2010) - et al.
Baseline forced expiratory volume in the first second as an independent predictor of development of the metabolic syndrome
Metabolism
(2010) - et al.
Metabolic syndrome and risk of pulmonary involvement
Respir Med
(2010) - et al.
Association between low pulmonary function and metabolic risk factors in Korean adults: the Korean National Health and Nutrition Survey
Metabolism
(2010) - et al.
Association of the metabolic syndrome with pulmonary venous hypertension
Chest
(2009) - et al.
Insulin resistance, metabolic syndrome, and lung function in US adolescents with and without asthma
J Allergy Clin Immunol
(2015) - et al.
Elevated circulating plasma adiponectin in underweight patients with COPD
Chest
(2007)
In vivo regulation of plasma free fatty acids in insulin resistance
Metabolism
Endoplasmic reticulum stress and the inflammatory basis of metabolic disease
Cell
Tumor necrosis factor alpha (TNFalpha) induces the unfolded protein response (UPR) in a reactive oxygen species (ROS)-dependent fashion, and the UPR counteracts ROS accumulation by TNFalpha
J Biol Chem
A high-fat challenge increases airway inflammation and impairs bronchodilator recovery in asthma
J Allergy Clin Immunol
The impact of metabolic syndrome on metabolic, pro-inflammatory and prothrombotic markers according to the presence of high blood pressure criterion
Clinics (Sao Paulo)
Unrecognized glucose intolerance is common in pulmonary arterial hypertension
J Heart Lung Transplant
Lung function impairment and metabolic syndrome: the critical role of abdominal obesity
Am J Respir Crit Care Med
Metabolic syndrome and incidence of asthma in adults: the HUNT study
Eur Respir J
Metabolic abnormalities in children with asthma
Am J Respir Crit Care Med
The relationship between metabolic syndrome and pulmonary function
Korean J Fam Med
Asthma-like symptoms are increased in the metabolic syndrome
J Asthma
Metabolic syndrome biomarkers predict lung function impairment: a nested case-control study
Am J Respir Crit Care Med
The association between metabolic syndrome and restrictive ventilatory dysfunction in older persons
J Gerontol A Biol Sci Med Sci
Impaired lung function is associated with obesity and metabolic syndrome in adults
Obesity (Silver Spring)
A possible association between suspected restrictive pattern as assessed by ordinary pulmonary function test and the metabolic syndrome
Chest
Prevalence of metabolic syndrome in COPD patients and its consequences
PLoS One
Relationship of metabolic syndrome and obstructive sleep apnea
J Clin Sleep Med
Body mass index is a stronger predictor than the metabolic syndrome for future asthma in women. The longitudinal CARDIA study
Am J Respir Crit Care Med
Chronic obstructive pulmonary disease and glucose metabolism: a bitter sweet symphony
Cardiovasc Diabetol
Insulin receptors in the fetal rat lung. A transient characteristic of fetal cells?
Pediatr Res
Insulin and the lung: connecting asthma and metabolic syndrome
J Allergy (Cairo)
Maternal obesity in pregnancy, gestational weight gain, and risk of childhood asthma
Pediatrics
Insulin-induced laminin expression promotes a hypercontractile airway smooth muscle phenotype
Am J Respir Cell Mol Biol
Targeting insulin-like growth factor-I and insulin-like growth factor-binding protein-3 signaling pathways. A novel therapeutic approach for asthma
Am J Respir Cell Mol Biol
Hyperinsulinemia potentiates airway responsiveness to parasympathetic nerve stimulation in obese rats
Am J Respir Cell Mol Biol
Safety and efficacy of inhaled human insulin (exubera) during discontinuation and readministration of therapy in adults with type 2 diabetes: a 3-year randomized controlled trial
Diabetes Technol Ther
The association of normal range glycated hemoglobin with restrictive lung pattern in the general population
PLoS One
Obesity and asthma: an inflammatory disease of adipose tissue not the airway
Am J Respir Crit Care Med
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FUNDING/SUPPORT: This study was funded by the National Institutes of Health [Grant NIHMS-ID: 752972].