Premium
Effects of sympathetic modulation in metabolic disease
Author(s) -
Carnagarin Revathy,
Lambert Gavin W.,
Kiuchi Marcio G.,
Nolde Janis M.,
Matthews Vance B.,
Eikelis Nina,
Lambert Elisabeth A.,
Schlaich Markus P.
Publication year - 2019
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/nyas.14217
Subject(s) - sympathetic nervous system , medicine , denervation , endocrinology , carbohydrate metabolism , diabetes mellitus , autonomic nervous system , obesity , obstructive sleep apnea , disease , sleep apnea , blood pressure , heart rate
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.