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      Sympathetic nervous activation in obesity and the metabolic syndrome—Causes, consequences and therapeutic implications

      , , , ,

      Pharmacology & Therapeutics

      Elsevier BV

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          Abstract

          The world wide prevalence of obesity and the metabolic syndrome is escalating. Contrary to earlier experimental evidence, human obesity is characterised by sympathetic nervous activation, with the outflows to both the kidney and skeletal muscle being activated. While the mechanisms responsible for initiating the sympathetic activation remain to be unequivocally elucidated, hyperinsulinemia, obstructive sleep apnoea, increased circulating adipokines, stress and beta adrenergic receptor polymorphisms are implicated. The pattern of sympathetic activation may be the pathophysiological mechanism underpinning much obesity-related illnesses with the consequences including, amongst others, the development of hypertension, insulin resistance, diastolic dysfunction and renal impairment. While diet and exercise are the first line therapy for the treatment of obesity and the metabolic syndrome, pharmacological interventions targeting the sympathetic nervous system, either directly or indirectly are also likely to be of benefit. Importantly, the benefit may not necessarily be weight related but may be associated with a reduction in end organ damage. Copyright 2010 Elsevier Inc. All rights reserved.

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          Author and article information

          Journal
          Pharmacology & Therapeutics
          Pharmacology & Therapeutics
          Elsevier BV
          01637258
          May 2010
          May 2010
          : 126
          : 2
          : 159-172
          Article
          10.1016/j.pharmthera.2010.02.002
          20171982
          © 2010

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