Effects of sympathetic modulation in metabolic disease. Issue 1 (19th August 2019) - Carnagarin, Revathy
Abstract: Sympathetic overdrive contributes to the derangement of glucose metabolism evident in clinical conditions, such as obesity, metabolic syndrome, type 2 diabetes, obstructive sleep apnea, and others. Targeting the sympathetic nervous system directly therefore appears as an attractive therapeutic approach to restore impaired glucose metabolism. Indeed, lifestyle interventions, including healthier diets and exercise, have been shown to exert their beneficial effects at least in part by reducing sympathetic nervous system activity. Pharmacologic inhibition of exaggerated central sympathetic outflow has also been demonstrated to beneficially impact on body weight and glucose and lipid metabolism. More recently, catheter‐based renal denervation, an intervention applied predominantly to lower elevated blood pressure in patients with resistant hypertension, revealed salutary effects on glucose metabolism. Here, we review the mechanisms that contribute to the beneficial effects of targeting the sympathetic nervous system directly and discuss how these approaches may best be embedded in routine clinical practice. Abstract : Sympathetic overdrive contributes to the derangement of glucose metabolism seen in obesity, metabolic syndrome, type 2 diabetes, obstructive sleep apnea, etc. Targeting the sympathetic nervous system directly is therefore an attractive therapeutic approach to restore impaired glucose metabolism. Our review discusses the mechanisms that contribute to the beneficial effects of this approach and how it may best be embedded in routine clinical practice.