Obesity as the main factor of metabolic syndrome influencing on respiratory function

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Abstract

In the review, a generalized analysis of current scientific data explaining the physiological mechanisms of the influence of obesity on respiratory system is carried out. The multifactorial nature of the respiratory effect of obesity, including mechanical and inflammatory effects, is emphasized. The consequences of restrictive and obstructive changes in the biomechanics of respiration, changes in the topographic distribution of lung ventilation, mismatch of ventilation and perfusion, and a decrease in the efficiency of the respiratory muscles are considered. Elucidation of the central mechanisms of the respiratory action of proinflammatory mediators expressed by adipose tissue cells is recognized as a promising area of research. Special attention is paid to the action of leptin, which is the main regulator of metabolism and respiratory control in obesity. Its ability to modulate the central respiratory chemosensitive is discussed. It is assumed that an increase in pulmonary ventilation due to an increase in leptin production in obesity has a compensatory character and allows obese patients to maintain normocapnia despite an increase in mechanical load on respiration system. Whereas leptin resistance and suppressed hypercapnic ventilation response play a key role in the development of obesity–hypoventilation syndrome. It is concluded that it is necessary to further study the physiological mechanisms of the influence of obesity on the respiratory function in order to find new effective therapeutic methods for the treatment of diseases associated with obesity, which is the main factor in the development of metabolic syndrome.

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N. P. Aleksandrova

Pavlov Institute of Physiology of the Russian Academy of Sciences

Author for correspondence.
Email: aleks@infran.ru
Russian Federation, St. Petersburg, 199034

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