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The Inter-relationship Between Insulin Resistance And Hypertension.

The Relationship Between Insulin Resistance And The Cardiovascular Biomarker Growth Differentiation Factor-15 In Obese Patients

The Relationship Between Insulin Resistance And The Cardiovascular Biomarker Growth Differentiation Factor-15 In Obese Patients

BACKGROUND: Growth differentiation factor-15 (GDF-15) is a stress-responsive cytokine linked to obesity comorbidities such as cardiovascular disease, inflammation, and cancer. GDF-15 also has adipokine properties and recently emerged as a prognostic biomarker for cardiovascular events. METHODS: We evaluated the relationship of plasma GDF-15 concentrations with parameters of obesity, inflammation, and glucose and lipid metabolism in a cohort of 118 morbidly obese patients [mean (SD) age 37.2 (12) years, 89 females, 29 males] and 30 age- and sex-matched healthy lean individuals. All study participants underwent a 75-g oral glucose tolerance test; 28 patients were studied before and 1 year after Roux-en-Y gastric bypass surgery. RESULTS: Obese individuals displayed increased plasma GDF-15 concentrations (P < 0.001), with highest concentrations observed in patients with type 2 diabetes. GDF-15 was positively correlated with age, waist-to-height ratio, mean arterial blood pressure, triglycerides, creatinine, glucose, insulin, C-peptide, hemoglobin A1c, and homeostatic model assessment insulin resistance index and negatively correlated with oral glucose insulin sensitivity. Age, homeostatic model assessment index, oral glucose insulin sensitivity, and creatinine were independent predictors of GDF-15 concentrations. Roux-en-Y gastric bypass led to a significant reduction in weight, leptin, insulin, and insulin resistance, but further increased GDF-15 concentrations (P < 0.001). CONCLUSIONS: The associations between circulating GDF-15 concentrations and age, insulin resistance, and creatinine might account for the additional cardiovascular predictive information of GDF-15 compared to traditional risk factors. Nevertheless, GDF-15 changes following bariatric surgery suggest an i Continue reading >>

Cross-sectional Analysis Of Inter-relationship Between Insulin Resistance And Hypertension Among Patients At Liaquat University Hospital

Cross-sectional Analysis Of Inter-relationship Between Insulin Resistance And Hypertension Among Patients At Liaquat University Hospital

CROSS-SECTIONAL ANALYSIS OF INTER-RELATIONSHIP BETWEEN INSULIN RESISTANCE AND HYPERTENSION AMONG PATIENTS AT LIAQUAT UNIVERSITY HOSPITAL Muhammad Iqbal Shah*, Abdul Ghaffar Memon , Sohail Ahmed Almani, Aatir H. Rajput, Muhammad Muneeb and Syed Jehangir Background: Insulin resistance and hypertension often stem from the same genotypic and phenotypic phenomenon. It is well established that a sedentary lifestyle, and a plentiful diet rich in sodium and energy are the likely culprits that over the years have contributed to the rise of both ailments. However, the inter-relationship too is worthy of exploration. Objective: This research hopes to study the inter-relationship between insulin resistance and hypertension among patients by eyeing the co-presentation of both diseases in patients and by evaluating the time elapsed in diagnosis of each disease to assess which disease preceded the other. Methods: This observational was carried out on patients presenting at the medicine outpatient department of Liaquat University Hospital with a joint complaint of insulin resistance and hypertension from 1st Dec 2015 to 10th February 2016. Data was collected using an interview based structured questionnaire administered to the patients after taking written informed consent. The data was analyzed in SPSS v. 16.0. Results: During the course of the study, a total of 248 patients presented with the complaint of insulin resistance, 356 patients presented with the complaint of hypertension. While 136 patients presented with a joint complaint of insulin resistance and hypertension. Majority (70.588%) of the patients reportedly developed insulin resistance prior to developing hypertension. The chief complaint of 120 (88.24%) of the patients was insulin resistance. 42 (30.88%) of the patients, Continue reading >>

Aspects Of The Interrelation Between Hypertension And Insulin Resistance: A Preliminary Study

Aspects Of The Interrelation Between Hypertension And Insulin Resistance: A Preliminary Study

JavaScript is disabled for your browser. Some features of this site may not work without it. Aspects of the interrelation between hypertension and insulin resistance: a preliminary study Background: It is well known that some genetic factors and dietary factors, such as excessive salt intake and excessive caloric intake (resulting in obesity) are risk factors for hypertension. Fifty percent of all hypertensive patients are also insulin resistant. Both hypertension and insulin resistance are again risk factors for other cardiovascular diseases such as atherosclerosis and heart failure. The nature of the association between hypertension and insulin resistance has not been clearly elucidated. Spontaneously hypertensive rats are the ideal models to study the aspects of the relationships between hypertension and insulin resistance. Models of high-fat feeding induce obesity,hypertension and insulin resistance and are thus used extensively to study hypertension because these models closely mimic some of the renal and cardiovascular changes found in human hypertensive patients. The present study was initiated to evaluate if insulin resistance will develop within 6 weeks in a model of high-fat diet induced hypertension and if so, to determine whether captopril will affect the presence of insulin resistance.This model should in future be used to study vascular reactivity to phenylephrine (PHE),acetylcholine (ACH) and sodium nitroprusside (SNP) in hypertensive animals in theabsence or presence of insulin resistance and in normotensive insulin resistant animals. Methods: In a series of experiments, rats were divided into four groups that received different treatments: (i) laboratory pellets, (ii) high-fat diet, (iii) high-fat diet plus captopril and (iv) high-fat diet plus vehicle Continue reading >>

The Inter-relationship Between Insulin Resistance And Hypertension

The Inter-relationship Between Insulin Resistance And Hypertension

, Volume 46, Supplement2 , pp 149159 | Cite as The Inter-Relationship between Insulin Resistance and Hypertension Insulin resistance and compensatory hyperinsulinaemia commonly occur in patients with untreated essential hypertension. The coexistence of insulin resistance and hypertension can be viewed as a cause-effect relationship (insulin resistance as a cause of hypertension or vice versa) or as a noncausal association. Insulin can increase blood pressure via several mechanisms: increased renal sodium reabsorption, activation of the sympathetic nervous system, alteration of transmembrane ion transport, and hypertrophy of resistance vessels. Conversely, hypertension can cause insulin resistance by altering the delivery of insulin and glucose to skeletal muscle cells, resulting in impaired glucose uptake. For example, hypertension can impair vasodilation of skeletal muscle as a result of vascular structural changes and rarefaction, and increased response to vasoconstrictor stimuli. Also, the prevalence of muscle type 2b fibres (fast twitch fibres) may contribute to the development of insulin resistance. The common pathogenetic mechanism for both insulin resistance and hypertension could be activation of the sympathetic nervous system. This results in vasoconstriction, and may contribute to the genesis of vascular structural changes and increase the number of fast twitch fibres. Finally, hypertension and insulin resistance can be viewed as a noncausal association, according to the following hypotheses: 1) they may represent 2 independent consequences of the same metabolic disorder (intracellular free calcium accumulation), or 2) insulin resistance is a genetic marker and/or a pathogenetic mechanism of multiple metabolic abnormalities frequently associated with hyperten Continue reading >>

Hypertension And Insulin Resistance

Hypertension And Insulin Resistance

For years, doctors have been telling their patients with high blood pressure to cut down on sodium. And for those who are salt sensitive—about 50 percent of those affected with hypertension—this is great advice. In these individuals, even small amounts of sodium can trigger rises in blood pressure. But sodium isn’t the only dietary factor in blood pressure. I want to focus on an aspect of hypertension that is largely ignored by conventional physicians: insulin resistance. The Case for Insulin Resistance Insulin is the hormone that ushers glucose and other nutrients into the cells. When there is insufficient insulin or when the cells are resistant to insulin’s attempts to let glucose in, blood sugar levels climb and you have diabetes. In type 2 (insulin-resistant) diabetes the body responds by producing even more insulin, resulting in elevated levels of both glucose and insulin. More than 20 million Americans have type 2 diabetes caused by insulin resistance. However, millions more—an estimated 25 to 40 percent of the entire population—have earlier stages of insulin resistance. In these individuals, glucose levels are not elevated, but their high insulin levels cause other things to go wrong. Excess insulin is associated with increased body fat and obesity. It upsets the normal metabolism of fats, raising cholesterol and triglyceride levels. It disrupts intercellular communication, including blood pressure-regulating signals. It can provoke the sympathetic nervous system, causing the heart to pump with more intensity and the arteries to constrict. And it creates an imbalance in sodium and potassium (which increases blood volume) and calcium and magnesium (which causes arterial constriction), driving up blood pressure and increasing the risk of heart disease. Continue reading >>

Dietary Intake And Cardiometabolic Biomarkers In Relation To Insulin Resistance And Hypertension In A Middle-aged And Elderly Population In Beijing, China

Dietary Intake And Cardiometabolic Biomarkers In Relation To Insulin Resistance And Hypertension In A Middle-aged And Elderly Population In Beijing, China

Applied Physiology, Nutrition, and Metabolism Dietary intake and cardiometabolic biomarkers in relation to insulin resistance and hypertension in a middle-aged and elderly population in Beijing, China Jia Wang, Zhongxin Hong, Li Wu, Bingjie Ding, Yanxia Bi, Zhongyi Gu, Wei Li Department of Nutrition, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Street, Xicheng District, Beijing 100050, China. Corresponding author: Zhongxin Hong (email: [email protected] Copyright remains with the author(s) or their institution(s). Permission for reuse (free in most cases) can be obtained from RightsLink . Received November30, 2016. Accepted April20, 2017. Applied Physiology, Nutrition, and Metabolism, 2017, 42(8): 869-875, This study investigated the relationships of dietary intake and cardiometabolic biomarkers with insulin resistance and hypertension in rural middle-aged and elderly people in China. One hundred and eight middle-aged and elderly adults were recruited in Zhangfang village in May 2014. We measured blood pressure, anthropometric parameters, and biochemical indexes, including high-sensitivity C-reactive protein (hsCRP), soluble intercellular adhesion molecule-1 (sICAM-1), glucose, insulin, and blood lipids. Homeostasis model assessment of insulin resistance index (HOMA-IR) was assessed on the basis of fasting glucose and insulin. We recorded participant demographic characteristics, dietary intake, and lifestyle using questionnaires. Hypertensive participants had higher levels of triglycerides (TG), hsCRP, sICAM-1, body fat percentage (BF%), arm muscle circumference (AMC) and HOMA-IR than nonhypertensive individuals. Hypertensive participants had higher carbohydrate intake but lower intakes of protein and fat. Carbohydrate intake was positively co Continue reading >>

Hypertension And Hyperinsulinemia

Hypertension And Hyperinsulinemia

Hypertension is defined as the sustained elevation of either or both systolic and diastolic blood pressure while at rest. There are several different classifications of hypertension, but the two main categories are primary, also called essential hypertension, and secondary hypertension. The majority of all those diagnosed with hypertension fall under the primary category while only a small percentage are classified as secondary hypertensive. Secondary hypertension is the result of some other condition or disease where as primary Hypertension is said, by conventional medicine, to have no identifiable cause for development. An overwhelming number of studies have revealed that diet, obesity and vitamin and mineral deficiencies are related to primary hypertension. Changes in lifestyle and the uses of specific supplements have proven to be extremely effective in the treatment and reversal of mild primary hypertension and could be considered prior to the use of prescription drugs Hypertension is strongly associated with the development of cardiovascular disease and is one of the major factors in the incidences of heart attacks in both the diabetic and non-diabetic population. It can also contribute to the progression of atherosclerosis. Numerous studies show a definite correlation between hypertension, diabetes, hyperglycemia, atherosclerosis and cardiovascular disease.[i] [ii] We are most interested in the links between diabetes and hypertension and how to prevent and or treat them accordingly. Type I diabetes patients usually develop secondary hypertension while Type II patients are associated with primary hypertension. Secondary hypertension in Type I patients is usually the result of nephropathy often caused by chronic hyperglycemia. Type II diabetes patients can also dev Continue reading >>

Link Between Insulin Resistance And Hypertension: What Have Welearned From Our Ancestors?

Link Between Insulin Resistance And Hypertension: What Have Welearned From Our Ancestors?

Insulin resistance is typically defined as decreased sensitivity and/or responsiveness to the metabolic actions of insulin that promote glucose disposal. Obesity, physical inactivity, hypertension, hyperlipidemia and aging, which are independent risk factors for cardiovascular disease, contribute to the complex interaction between genetic and environmental factors required for impaired insulin signaling [ 1 ]. Clinical studies have shown that hypertension and insulin resistance often coexist and their association increases cardiovascular risk and the incidence of new onset type 2 diabetes [ 2 , 3 ]. Although the association between insulin resistance and hypertension has long been recognized, a direct relationship between insulin resistance and blood pressure remains controversial. Medical research is generally concerned with mechanistic questions pertaining to how diseases develop, particularly cellular signaling pathways of disease production. In contrast, evolutionary research addresses why diseases develop by studying the ancestral origins of modern diseases, particularly the evolutionary advantage of certain genotypes that now are maladaptive and promote disease. Evolutionary medicine may provide some important clues for medical research to unravel novel mechanisms of disease. Hypertension and insulin resistance are considered prototypical diseases of civilization that are only manifested in modern world environments where food is plentiful and people are sedentary; these diseases did not exist in pre-modern times [ 4 ]. The following is a review of evolutionary aspects of insulin resistance and hypertension. Obesity is a common cause of insulin resistance. The epidemic-like rise in the prevalence of obesity constitutes an undoubted and serious global health probl Continue reading >>

Link Between Insulin Resistance And Hypertension: What Is The Evidence From Evolutionary Biology?

Link Between Insulin Resistance And Hypertension: What Is The Evidence From Evolutionary Biology?

Abstract Insulin resistance and hypertension are considered as prototypical “diseases of civilization” that are manifested in the modern environment as plentiful food and sedentary life. The human propensity for insulin resistance and hypertension is a product, at least in part, of our evolutionary history. Adaptation to ancient lifestyle characterized by a low sodium, low-calorie food supply and physical stress to injury response has driven our evolution to shape and preserve a thrifty genotype, which is favorite with energy-saving and sodium conservation. As our civilization evolved, a sedentary lifestyle and sodium- and energy-rich diet, the thrifty genotype is no longer advantageous, and may be maladaptive to disease phenotype, such as hypertension, obesity and insulin resistance syndrome. This article reviews human evolution and the impact of the modern environment on hypertension and insulin resistance. Background Diminished tissue sensitivity to insulin is a characteristic of various pathological conditions termed the insulin resistance syndrome, also known as the metabolic syndrome or cardiometabolic syndrome [1]. The metabolic syndrome is not a single disease, but rather a complex cluster of symptoms that include a large waist circumference, hypertension, hyperglycermia, dyslipidemia and insulin resistance, all of which are commonly associated with increased risk of obesity and Type 2 Diabetes [2]. Since patients with metabolic syndrome are commonly afflicted with cardiovascular morbidities, the metabolic syndrome and cardiovascular diseases share common pathways including increased oxidative stress, defective glucose, lipid metabolism, low grade inflammation, hypercoagulability and endothelial damage. Previously, investigators proposed to use the “circul Continue reading >>

What Is Insulin Resistance, Blood Pressure Hypertension

What Is Insulin Resistance, Blood Pressure Hypertension

For years, doctors have been telling their patients with high blood pressure to cut down on sodium. And for those who are salt sensitiveabout 50 percent of those affected with hypertensionthis is great advice. In these individuals, even small amounts of sodium can trigger rises in blood pressure. But sodium isnt the only dietary factor in blood pressure. I want to focus on an aspect of hypertension that is largely ignored by conventional physicians: insulin resistance. Insulin is the hormone that ushers glucose and other nutrients into the cells. When there is insufficient insulin or when the cells are resistant to insulins attempts to let glucose in, blood sugar levels climb and you have diabetes. In type 2 (insulin-resistant) diabetes the body responds by producing even more insulin, resulting in elevated levels of both glucose and insulin. More than 20 million Americans have type 2 diabetes caused by insulin resistance. However, millions morean estimated 25 to 40 percent of the entire populationhave earlier stages of insulin resistance. In these individuals, glucose levels are not elevated, but their high insulin levels cause other things to go wrong. Excess insulin is associated with increased body fat and obesity. It upsets the normal metabolism of fats, raising cholesterol and triglyceride levels. It disrupts intercellular communication, including blood pressure-regulating signals. It can provoke the sympathetic nervous system, causing the heart to pump with more intensity and the arteries to constrict. And it creates an imbalance in sodium and potassium (which increases blood volume) and calcium and magnesium (which causes arterial constriction), driving up blood pressure and increasing the risk of heart disease. If you have type 2 diabetes , you certainly have Continue reading >>

The Inter-relationship Between Insulin Resistance And Hypertension

The Inter-relationship Between Insulin Resistance And Hypertension

p> Background : Diabetes mellitus is one of the most widespread endocrine disorder in female and its complications are increasing all over the world, leading to life threatening medical problems like cardiovascular diseases, stroke and end stage renal diseases. An association between hypertension and diabetes mellitus has been identified.Objectives: The study was carried out to observe the association of hypertension with diabetes mellitus in adult female subjects.Methods : This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka, during the period of January 2011 to December 2011. A total number of one hundred female subjects were selected with age ranging from30 to50 years. Among them 50 diabetic female subjects were included from out-patient department of Endocrinology, Dhaka Medical College Hospital, Dhaka as study group(B) and 50 apparently healthy female were taken as control group(A) for comparison. Fasting serum insulin level was measured by ELISA method in the Department of Laboratory of National Institute of ENT, Dhaka and fasting blood glucose was estimated by glucose oxidase method in Department of Dhaka Medical College in both groups. Systolic blood pressure and diastolic blood pressure of all participants were recorded by standard method. Data was analyzed by Unpaired Students- test and Pearsons correlation co-efficient (r) test as applicable.Results: The value of fasting serum insulin level was significantly higher in diabetic subjects than those of non-diabetic subjects. Fasting blood glucose level was significantly higher diabetic patient in comparison to those of non-diabetic subjects. In diabetic subjects fasting serum insulin and fasting blood glucose levels were higher and showed positive correlation wi Continue reading >>

Interrelationship Between Insulin Resistance And Portal Haemodynamic Abnormality In Cirrhosis

Interrelationship Between Insulin Resistance And Portal Haemodynamic Abnormality In Cirrhosis

Int J Med Sci 2017; 14(3):240-245. doi:10.7150/ijms.17738 Interrelationship between insulin resistance and portal haemodynamic abnormality in cirrhosis , Kazufumi Kobayashi, Soichiro Kiyono, Osamu Yokosuka Department of Gastroenterology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba, 260-8670, Japan This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License . See for full terms and conditions. Maruyama H, Kobayashi K, Kiyono S, Yokosuka O. Interrelationship between insulin resistance and portal haemodynamic abnormality in cirrhosis. Int J Med Sci 2017; 14(3):240-245. doi:10.7150/ijms.17738. Available from Click on Go to download the file. In EndNote Library, go to File Import. Select the file that you have just downloaded and select import option Reference Manager (RIS). Click on Import.File import instruction Background: There are only limited data regarding the effect of impaired portal circulation on the glucose metabolism. The study prospectively examined the interrelationship between insulin resistance (IR) and portal haemodynamic abnormality in cirrhosis. Methods: There were 53 cirrhosis patients (61.6 13.0 years) all presenting gastroesophageal varices. Portal haemodynamics by both hepatic venous catheterisation and Doppler ultrasound were examined with respect to the homeostasis model assessment (HOMA)-IR and HOMA2-IR. The IR was defined by HOMA-IR > 3.0 or HOMA2-IR > 2.0. Results: Forty-two patients (79.2%) had collateral vessels, 38 with left gastric vein, 12 with short/posterior gastric vein, 9 with splenorenal shunt, and 3 with inferior mesenteric vein. Multivariate analysis provided significant factors; wedged hepatic venous pressure (HR1.183, 95% CI 1.012-1.383, p=0.035 Continue reading >>

The Relationship Between Hyperinsulinemia, Hypertension And Progressive Renal Disease

The Relationship Between Hyperinsulinemia, Hypertension And Progressive Renal Disease

The Relationship between Hyperinsulinemia, Hypertension and Progressive Renal Disease Department of Internal Medicine, University of Missouri-Columbia and H. S. Truman VAMC, Columbia, Missouri; Divisions of Cardiovascular Medicine and Endocrinology, Diabetes and Hypertension, Department of Medicine, State University of New York-Downstate Medical Center, Brooklyn, New York; USA and VA Medical Center, Brooklyn, New York. Correspondence to Dr. James R. Sowers, Professor of Medicine and Physiology, University of Missouri-Columbia, Department of Internal Medicine, MA410 Health Science Center, One Hospital Drive, Columbia, MO 65212. Phone: 5738842013; Fax: 5738841996; E-mail: Sowersj{at}health.missouri.edu The incidence of end-stage renal disease (ESRD) has risen dramatically in the past decade, mainly due to the increasing prevalence of diabetes mellitus, and both impaired glucose tolerance and hypertension are important contributors to rising rates of ESRD. Obesity, especially the visceral type, is associated with peripheral resistance to insulin actions and hyperinsulinemia, which predisposes to development of diabetes. A common genetic predisposition to insulin resistance and hypertension and the coexistence of these two disorders predisposes to premature atherosclerosis. A constellation of metabolic and cardiovascular derangements, which also includes dyslipidemia, dysglycemia, endothelial dysfunction, fibrinolytic and inflammatory abnormalities, left ventricular hypertrophy, microalbuminuria, and increased oxidative stress, is referred to as the cardiometabolic syndrome. The components of this syndrome, individually and interdependently, substantially increase the risk of renal disease, cardiovascular disease (CVD) and mortality. Similar findings and cardiorenal risk f Continue reading >>

The Inter-relationship Between Insulin Resistance And Hypertension.

The Inter-relationship Between Insulin Resistance And Hypertension.

The inter-relationship between insulin resistance and hypertension. Salvetti A(1), Brogi G, Di Legge V, Bernini GP. (1)Cattedra di Medicina Interna, University of Pisa, Italy. Insulin resistance and compensatory hyperinsulinaemia commonly occur in patients with untreated essential hypertension. The coexistence of insulin resistance and hypertension can be viewed as a cause-effect relationship (insulin resistance as a cause of hypertension or vice versa) or as a noncausal association. Insulin canincrease blood pressure via several mechanisms: increased renal sodiumreabsorption, activation of the sympathetic nervous system, alteration oftransmembrane ion transport, and hypertrophy of resistance vessels. Conversely,hypertension can cause insulin resistance by altering the delivery of insulin andglucose to skeletal muscle cells, resulting in impaired glucose uptake. Forexample, hypertension can impair vasodilation of skeletal muscle as a result ofvascular structural changes and rarefaction, and increased response tovasoconstrictor stimuli. Also, the prevalence of muscle type 2b fibres (fasttwitch fibres) may contribute to the development of insulin resistance. Thecommon pathogenetic mechanism for both insulin resistance and hypertension could be activation of the sympathetic nervous system. This results invasoconstriction, and may contribute to the genesis of vascular structuralchanges and increase the number of fast twitch fibres. Finally, hypertension and insulin resistance can be viewed as a noncausal association, according to thefollowing hypotheses: 1) they may represent 2 independent consequences of thesame metabolic disorder (intracellular free calcium accumulation), or 2) insulin resistance is a genetic marker and/or a pathogenetic mechanism of multiplemetabolic ab Continue reading >>

Obstructive Sleep Apnea And Insulin Resistance: A Role For Microcirculation?

Obstructive Sleep Apnea And Insulin Resistance: A Role For Microcirculation?

Obstructive sleep apnea and insulin resistance: a role for microcirculation? Apnia obstrutiva do sono e resistncia insulina: qual o papel da microcirculao? Nicolas Wiernsperger; Pierre Nivoit; Eliete Bouskela Department of Physiological Sciences, State University of Rio de Janeiro - Rio de Janeiro/RJ, Brazil. Email: [email protected] Obstructive sleep apnea is an increasingly recognized medical problem. The recent attention to its frequency in the general population and its important role in metabolic, vascular, and behavioral aspects have sharply increased the number and nature of investigations, thereby revealing new aspects that open new approaches in research. Whereas obstructive sleep apnea is a well-known phenomenon accompanying obesity and diabetes, new findings strongly suggest that this close relationship may also operate in the opposite direction. Indeed obstructive sleep apnea may be a primary feature inducing or aggravating a series of vascular and metabolic disturbances closely resembling the metabolic syndrome. This review will discuss established and potential mechanisms responsible for these changes. Obstructive sleep apnea indeed appears to gather all the elements necessary to induce insulin resistance, hypertension, and possibly heart failure. After careful analysis of these modifications and considering how they are intertwined, we propose that microcirculation could represent the common denominator mediating the progression of this pathology, as it is eventually the case in the metabolic syndrome and diabetes domain. This plausible hypothesis is discussed in detail and should be verified by appropriate preclinical and clinical protocols, which are now achievable by using noninvasive techniques in humans. Keywords: Obstructive sleep apnea. Continue reading >>

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