The role of metabolic syndrome factors in the pathogenesis of respiratory disorders

For clinical medicine the problem of complications associated with the metabolic syndrome is significant and requires a multidisciplinary approach, since the metabolic syndrome itself has long since moved from the sphere of interest of endocrinologists and cardiologists to general medical practice. Most commonly, the metabolic syndrome leads to cardiovascular and cerebrovascular complications. One of the topics currently under discussion is the question of the influence of the components of the metabolic syndrome on the condition of the respiratory system. An epidemiological association between visceral obesity and insulin resistance with chronic obstructive pulmonary disease, bronchial asthma, and obstructive sleep apnea/hypopnea syndrome has been established. Although respiratory disorders are common in patients with clinical equivalents of the metabolic syndrome, their pathogenesis is not well understood. Aim of the study was to analyze the role of individual most significant components (pathogenetic factors) of the metabolic syndrome in the pathogenesis of respiratory disorders. Conclusion. Clinical and laboratory equivalents of the metabolic syndrome, such as obesity, hyperglycemia, and hyperinsulinemia, contribute to respiratory function impairment. The most discussed process that combines the components of the metabolic syndrome and its associated complications is chronic systemic inflammation. The review presents a conceptual scheme of the pathogenesis of respiratory disease in the metabolic syndrome and highlights the role of its factors in the development of qualitative changes in the air-blood barrier and a decrease in the diffusion capacity of the lungs. The authors pointed out a number of unresolved issues in the pathogenesis of respiratory disorders in the metabolic syndrome and also emphasized the relevance of experimental studies of early mechanisms of lung disease development using animal models.

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