title: Metabolic Syndrome and the Lung.
abstract: A link between metabolic syndrome (MetS) and lung diseases has been observed in several cross-sectional and longitudinal studies. This syndrome has been identified as an independent risk factor for worsening respiratory symptoms, greater lung function impairment, pulmonary hypertension, and asthma. This review will discuss several potential mechanisms to explain these associations, including dietary factors and the effect of adiposity and fat-induced inflammation on the lungs, and the role of other comorbidities that frequently coexist with MetS, such as OSA and obesity. In contrast to the well-known association between asthma and obesity, the recognition that MetS affects the lung is relatively new. Although some controversy remains as to whether MetS is a unique disease entity, its individual components have independently been associated with changes in pulmonary function or lung disease. There is, however, uncertainty as to the relative contribution that each metabolic factor has in adversely affecting the respiratory system; also, it is unclear how much of the MetS-related lung effects occur independently of obesity. In spite of these epidemiological limitations, the proposed mechanistic pathways strongly suggest that this association is likely to be causal. Given the wide prevalence of MetS in the general population, it is imperative that we continue to further understand how this metabolic disorder impacts the lung and how to prevent its complications.
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Cynthia W
authors.initials: CW
authors.lastname: Baffi
authors.affiliation: Hunter Medical Research Institute and University of Newcastle, NSW, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Wood
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Winnica
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Strollo
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Gladwin
authors.affiliation: Duke University Medical Center, Durham, NC.
authors.forename: Loretta G
authors.initials: LG
authors.lastname: Que
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, PA. Electronic address: holguinf@upmc.edu.
authors.forename: Fernando
authors.initials: F
authors.lastname: Holguin
mesh_terms: D015897:Comorbidity; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D024821:Metabolic Syndrome / Q000453:epidemiology*; D015995:Prevalence; D011315:Preventive Medicine / Q000379:methods; D012129:Respiratory Function Tests / Q000379:methods; D012307:Risk Factors
keywords: COPD; asthma; metabolic syndrome; obesity; obstructive sleep apnea; pulmonary hypertension
references.citation: Am J Respir Crit Care Med. 2012 Jul 1;186(1):41-7
references.pmid: 22492987
references.citation: Am J Respir Crit Care Med. 2005 Dec 15;172(12):1590-5
references.pmid: 16192452
references.citation: Chest. 2008 Oct;134(4):712-8
references.pmid: 18625672
references.citation: Eur Respir J. 2012 May;39(5):1136-43
references.pmid: 22075482
references.citation: Pediatrics. 2014 Aug;134(2):e535-46
references.pmid: 25049351
references.citation: J Allergy Clin Immunol. 2011 May;127(5):1133-40
references.pmid: 21377715
references.citation: J Clin Sleep Med. 2007 Aug 15;3(5):467-72
references.pmid: 17803009
references.citation: Proc Natl Acad Sci U S A. 2010 Oct 12;107(41):17716-20
references.pmid: 20876122
references.citation: Biol Trace Elem Res. 2011 Dec;143(3):1289-301
references.pmid: 21286851
references.citation: Metabolism. 2010 Sep;59(9):1300-6
references.pmid: 20045536
references.citation: J Allergy (Cairo). 2013;2013:627384
references.pmid: 24204385
references.citation: J Am Coll Cardiol. 2013 Aug 20;62(8):697-703
references.pmid: 23810877
references.citation: Metabolism. 2004 Sep;53(9):1197-201
references.pmid: 15334384
references.citation: J Allergy Clin Immunol. 2009 Aug;124(2):230-7, 237.e1-4
references.pmid: 19539983
references.citation: Am J Respir Crit Care Med. 2012 Oct 1;186(7):598-605
references.pmid: 22837379
references.citation: J Gerontol A Biol Sci Med Sci. 2007 Jul;62(7):760-5
references.pmid: 17634324
references.citation: Am J Respir Cell Mol Biol. 2014 Aug;51(2):251-61
references.pmid: 24605871
references.citation: Thorax. 1997 Feb;52(2):166-70
references.pmid: 9059479
references.citation: Pulm Circ. 2015 Jun;5(2):269-78
references.pmid: 26064451
references.citation: Respir Med. 2010 Sep;104(9):1326-35
references.pmid: 20335013
references.citation: J Clin Invest. 2006 Nov;116(11):3015-25
references.pmid: 17053832
references.citation: Diabetes Technol Ther. 2009 Nov;11(11):697-705
references.pmid: 19905885
references.citation: Korean J Fam Med. 2012 Mar;33(2):70-8
references.pmid: 22745890
references.citation: Am J Respir Crit Care Med. 2014 Feb 1;189(3):345-55
references.pmid: 24484330
references.citation: Am J Respir Cell Mol Biol. 2010 Apr;42(4):482-90
references.pmid: 19520921
references.citation: J Clin Hypertens (Greenwich). 2016 Feb;18(2):153-8
references.pmid: 26278919
references.citation: Respir Med. 2010 Jan;104(1):47-51
references.pmid: 19800211
references.citation: PLoS One. 2014 Jun 20;9(6):e98013
references.pmid: 24950070
references.citation: Scand J Clin Lab Invest. 2009;69(2):219-24
references.pmid: 18946779
references.citation: Chest. 2007 Jul;132(1):135-40
references.pmid: 17625082
references.citation: Diabetol Metab Syndr. 2015 Mar 24;7:25
references.pmid: 25834642
references.citation: Cell. 2010 Mar 19;140(6):900-17
references.pmid: 20303879
references.citation: Cardiovasc Diabetol. 2012 Oct 27;11:132
references.pmid: 23101436
references.citation: Circ Heart Fail. 2011 May;4(3):257-65
references.pmid: 21411741
references.citation: J Asthma. 2011 Oct;48(8):811-7
references.pmid: 21942353
references.citation: Metabolism. 2010 Jun;59(6):848-53
references.pmid: 20006363
references.citation: J Biol Chem. 2005 Oct 7;280(40):33917-25
references.pmid: 16107336
references.citation: Chron Respir Dis. 2014 Feb;11(1):41-52
references.pmid: 24431410
references.citation: Antioxid Redox Signal. 2013 May 10;18(14):1797-809
references.pmid: 22871207
references.citation: Am J Respir Cell Mol Biol. 2009 Oct;41(4):494-504
references.pmid: 19213874
references.citation: Nat Rev Endocrinol. 2013 Jun;9(6):346-56
references.pmid: 23568441
references.citation: JAMA. 2006 Nov 8;296(18):2209-16
references.pmid: 17090767
references.citation: J Asthma. 2009 May;46(4):339-42
references.pmid: 19484665
references.citation: Proc Am Thorac Soc. 2008 Feb 15;5(2):207-17
references.pmid: 18250214
references.citation: Am J Respir Cell Mol Biol. 2009 May;40(5):601-9
references.pmid: 18952568
references.citation: Sleep. 2016 Jan 01;39(1):35-41
references.pmid: 26350474
references.citation: Endocrinol Metab Clin North Am. 2014 Mar;43(1):1-23
references.pmid: 24582089
references.citation: Pediatr Res. 2006 Aug;60(2):200-4
references.pmid: 16864704
references.citation: Chest. 2009 Jul;136(1):31-6
references.pmid: 19188551
references.citation: Nat Immunol. 2011 May;12 (5):408-15
references.pmid: 21478880
references.citation: Endocrinol Metab Clin North Am. 2004 Jun;33(2):351-75, table of contents
references.pmid: 15158523
references.citation: J Endocrinol Invest. 2002 Nov;25(10):855-61
references.pmid: 12508947
references.citation: PLoS One. 2015 Feb 06;10(2):e0117725
references.pmid: 25658743
references.citation: J Clin Invest. 2011 Jun;121(6):2111-7
references.pmid: 21633179
references.citation: Endocrinology. 2003 Dec;144(12):5159-65
references.pmid: 12960011
references.citation: J Allergy (Cairo). 2013;2013:349520
references.pmid: 23861690
references.citation: Obesity (Silver Spring). 2006 Sep;14(9):1654-61
references.pmid: 17030977
references.citation: Clinics (Sao Paulo). 2013 Dec;68(12):1495-501
references.pmid: 24473506
references.citation: Eur Respir J. 2012 Mar;39(3):746-67
references.pmid: 21920888
references.citation: Eur Respir J. 2013 Dec;42(6):1495-502
references.pmid: 23845717
references.citation: Int J Obes (Lond). 2008 Jul;32(7):1083-90
references.pmid: 18414418
references.citation: Am J Respir Crit Care Med. 2011 Feb 15;183(4):441-8
references.pmid: 20851922
references.citation: Pediatr Res. 2012 Sep;72 (3):293-8
references.pmid: 22669298
references.citation: Respir Res. 2010 Dec 09;11:176
references.pmid: 21143922
references.citation: J Allergy Clin Immunol. 2015 Aug;136(2):304-11.e8
references.pmid: 25748066
references.citation: J Immunol. 2009 Jan 1;182(1):684-91
references.pmid: 19109202
references.citation: Am J Respir Crit Care Med. 2009 Mar 15;179(6):509-16
references.pmid: 19136371
references.citation: Pediatr Res. 1981 Sep;15(9):1303-7
references.pmid: 7290780
references.citation: Am J Respir Cell Mol Biol. 2014 Apr;50(4):667-77
references.pmid: 24219511
references.citation: Am J Physiol Lung Cell Mol Physiol. 2004 Sep;287(3):L497-502
references.pmid: 15145787
references.citation: Circulation. 2007 Mar 13;115(10 ):1275-84
references.pmid: 17339547
references.citation: Am J Respir Crit Care Med. 2012 Feb 15;185(4):392-9
references.pmid: 22095549
references.citation: Eur Respir J. 1999 Jan;13(1):22-30
references.pmid: 10836318
references.citation: Am J Respir Crit Care Med. 2013 Aug 1;188(3):319-26
references.pmid: 23905525
references.citation: Eur Respir J. 2011 Sep;38(3):594-602
references.pmid: 21310876
references.citation: Clin Exp Allergy. 2007 Aug;37(8):1143-9
references.pmid: 17651143
references.citation: J Heart Lung Transplant. 2011 Aug;30(8):904-11
references.pmid: 21493097