Acta Scientific Medical Sciences (ISSN: 2582-0931)

Research Article Volume 4 Issue 2

Psychosomatic Molecular Mechanisms of Metabolic Syndrome and Type 2 Diabetes. Part 2. Psychosomatic Mechanism of Metabolic Syndrome (a Theory)

András Sikter MD*

Internal Medicine, Municipal Clinic of Szentendre, Szentendre, Hungary, Europe

*Corresponding Author: András Sikter MD, Internal Medicine, Municipal Clinic of Szentendre, Szentendre, Hungary, Europe. E-mail: andrassikter3@gmail.com

Received: December 27, 2019; Published: January 10, 2020

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Abstract

  The author had hypothesized that the prevailing Momentary Intracellular Ion-Pattern as a whole has an essential, perhaps the primary signaling function. (See Part 1.) The concentration of intracellular H+ (pHi) is the most critical of all ions to maintain homeostasis; that is why regulation wants to preserve the permanence of pHi. Recent researches have shown that caged rodents can be well-modelizing for human hypoarousal diseases of civilization, which may correspond to Metabolic Syndrome or Depression. Repeated Social Defeat results in such psychic mechanisms that induce persistent hypoventilation among most of the observed rodent populations. Hypoventilation continued for weeks, even after stress, and presumably associated with hypercapnia. It may correspond to a larval version of the freeze response well known in the animal world, but it becomes chronic at people. The author., et al. previously presented in their papers how social or mental stress can be converted into an increased or decreased arousal by the body's closed-loop systems. Human 'low-grade hypercapnia' usually lasts for decades - to the end of life. One of the results is the Metabolic Syndrome, which often tends to the classic Type 2 Diabetes or other Related Disorders. Persistent elevation of the pCO2 level launches a compensational cascade through chemical and hormonal-humoral alterations that can lead to various forms of readjustment. The Metabolic Syndrome is a latent, stealth catabolic state of the body that develops due to slight but chronic hypercapnic acidosis. Although chronic hypercapnia is usually compensated, a moderate intracellular acidotic state persists in continuing. Metabolic Syndrome is often the result of a learned 'civilized behavior'; the Social Defeat can also develop in captive animals due to chronic or repeated stress. The point is that this type of load does not increase but decreases arousal through hypercapnic acidosis, which can also cause Depression. Slight cytosolic acidosis also results in reduced metabolism, which is associated with moderately reduced anabolic and increased catabolic activity in the body with insulin resistance and reduced ATP producing capacity. As a consequence, the whole metabolism has become remodeled and dysregulated because of the disturbed Intracellular Ion Pattern.

Keywords: Diseases of Civilization; Low-Grade Chronic Hypercapnia; Metabolic Remodeling; Pathogenesis of Metabolic Syndrome (a Hypothesis); Social Defeat Theory

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References

  1. Goldstein DS and Kopin IJ. “Evolution of concept of stress”. Stress 10 (2007): 109-120.
  2. Zimmet P. et al. “The Circadian Syndrome: is the Mtabolic Syndrome and much more!”. Journal of Internal Medicine 288 (2019): 181-191.
  3. Brouillard C. et al. “Long-lasting bradypnea induced by repeated social defeat”. American Journal of Physiology – Regulatory, Integrative Comparative Physiology, American Physiological Society, 311.2 (2016): R352-R364.
  4. Bilu C., et al. “Linking type 2 diabetes mellitus, cardiac hypertrophy and depression in a diurnal animal model”. Scientific Reports 9.1 (2019): 11865. 
  5. Sikter A., et al. “New aspects in the pathomechanism of diseases of civilization, particularly psychosomatic disorders. Part 1. Theoretical background of a hypothesis”. Neuropsychopharmacologia Hungarica 9.2 (2017): 95-105.
  6. Sikter A., et al. “New aspects in the pathomechanism of diseases of civilization, particularly psychosomatic disorders. Part 2. Chronic hypocapnia and hypercapnia in the medical practice”. Neuropsychopharmacologia Hungarica 19.3 (2017): 159-169.
  7. Bracha HS., et al. “Does ’fight or flight’ need updating?” Psychosomatics 45 (2004): 448-449.
  8. Appelberg J and Sundström G. “Ventilatory response to CO2 in patients with snoring, obstructive hypopnoea and obstructive apnoea”. Clinical Physiology 17.5 (1997):497-507.
  9. Garay SM., et al. “Regulation in Obstructive Sleep Apnea Syndrome”. American Review od Respiratory Disease 124.4 (1981): 451-457.
  10. Weitzenblum E., et al. “Daytime hypoventilation in obstructive sleep apnea syndrome”. Sleep Medicine Reviews 3 (1999): 79-93. 
  11. Verbraeken J and McNickolas W. “Respiratory mechanics and ventilatory control in overlap syndrome and obesity hypoventilation”. Respiratory Research 14 (2013): 132. 
  12. BaHammam A., et al. “Sleep-related breathing disorders in obese patients presenting with acute respiratory failure”. Respiratory Medicine 99 (2005): 718-725. 
  13. Berthon-Jones M and Sullivan CE. “Time course of change in ventilatory response to CO2 with long-term CPAP therapy for obstructive sleep apnea”. The American Review of Respiratory Disease 135.1 (1987):144-147.
  14. Schwartz DJ and Karatinos G. “For individuals with obstructive sleep apnea, institution of CPAP therapy is associated with an amelioration of symptoms of depression which is sustained long term”. Journal of Clinical Sleep Medicine 3.6 (2007): 631-635.
  15. Ejaz SM., et al. “Obstructive Sleep Apnea and Depression: a Review”. Innovation in Clinical Neuroscience 8.8 (2011): 17-25.
  16. Pamidi S and Tasali E. “Obstructive sleep apnea and type 2 diabetes: is there a link?” Frontiers in Neurology 3 (2012):126. 
  17. Casalino-Matsuda SM., et al. “Hypercapnia Alters Expression of Immune Response, Nucleosome Assembly and Lipid Metabolism Genes in Differentiated Human Bronchial Epithelial Cells”. Scientific Reports 8.1 (2018):13508. 
  18. Barbagallo M., et al. “Diabetes mellitus, hypertension and ageing: the ionic hypothesis of ageing and cardiovascular-metabolic diseases”. Diabetes and Metabolism 23 (1997): 281-294.
  19. McEwen BS and Stellar E. “Stress, adaptation and the individual. Mechanisms leading to disease”. Archives of Internal Medicine 153 (1993): 2093-2101.
  20. Vgontzas AN. et al. “Sleep apnea is a manifestation of the metabolic syndrome”. Sleep Medicine Reviews 9 (2005): 211-224.
  21. Drager LF., et al. “The impact of obstructive sleep apnea on metabolic and inflammatory markers in consecutive patients with metabolic syndrome”. PLoS One 5.8 (2010): e12065. 
  22. Bradley MM., et al. “Emotion and Motivation I: Defensive and Appetitive Reactions in Picture Processing”. Emotion 1 (2001): 276-298.
  23. Cuffee Y., et al. “Psychosocial risk factors for hypertension: an update of the literature”. Current Hypertension Reports 16.10 (2014): 483. 
  24. Scuteri A., et al. “Anger inhibition potentiates the association of high end-tidal CO₂ with blood pressure in women”. Psychosomatic Medicine 63 (2001): 470-475.
  25. Roelofs K., et al. “Facing freeze: social threat induces bodily freeze in humans”. Psychological Science 21 (2010): 1575-1581.
  26. Kim EJ and Dimsdale JR. “The effect of psychosocial stress on sleep: A review of polysomnographic evidence”. Behavioral Sleep Medicine 5 (2007): 256-278.
  27. Kinkead R. et al. “Neonatal maternal separation disrupts regulation of sleep and breathing in adult male rats”. Sleep 32.12 (2009): 1611-1620.
  28. Sikter A., et al. “The role of carbon dioxide (and intracellular pH) in the pathomechanism of several mental disorders. Are the diseases of civilization caused by learnt behaviour, not the stress itself?” Neuropsychopharmacologia Hungarica 11.3 (2009): 161-173.
  29. Walmsley RN and White GH. “Mixed Acid-Base Disorders” Clinical Chemistry 31.2 (1985): 321-325.
  30. Boron WF. “Regulation of intracellular pH”. Advances in Physiology Education 28 (2004): 160-179.
  31. Casey JR., et al. “Sensors and regulators of intracellular pH”. Nature Reviews. Molecular Cell Biology 11.1 (2010): 50-61. 
  32. Packer M. “Activation and Inhibition of Sodium-Hydrogen Exchanger Is a Mechanism That Links the Pathophysiology and Treatment of Diabetes Mellitus With That of Heart Failure”. Circulation 136.6 (2017): 1548-1559. 
  33. Tresguerres M., et al. “Physiological carbon dioxide, bicarbonate, and pH sensing”. Pflügers Archiv 460.6 (2010): 953-964.
  34. Parati G., et al. “Sleep apnea: epidemiology, pathophysiology, and realtion to cardiovascular risk”. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology 293.4 (2007): R1671-R1683.
  35. Punjabi NM. “The epidemiology of adult obstructive sleep apnea”. Proceedings of the American Thoracic Society 5.2 (2008): 136-143.
  36. Park JG., et al. “Updates on definition, consequences, and management of obstructive sleep apnea”. Mayo Clinic Proceedings 86.6 (2011): 549-554.
  37. Chau EH., et al. “Obesity hypoventilation syndrome: a review of epidemiology, pathophysiology, and perioperative considerations”. Anesthesiology 117.1 (2012): 188-205.
  38. Mozumdar A and Liguori G. “Persistent increase of prevalence of metabolic syndrome among U.S. adults: NHANES III to NHANES 1999-2006”. Diabetes Care 34.1 (2011): 216-219.
  39. Gupta R., et al. “Prevalence of metabolic syndrome in an Indian urban population”. International Journal of Cardiology 97.2 (2004): 257-261.
  40. Castaneda A., et al. “Correlation between metabolic syndrome and sleep apnea”. World Journal of Diabetes 9.4 (2018): 66-71.
  41. Watz H., et al. “The metabolic syndrome in patients with chronic bronchitis and COPD: frequency and associated consequences for systemic inflammation and physical inactivity”. Chest 136.4 (2009): 1039-1046.
  42. Palaniappan L., et al. “Predictors of the incident metabolic syndrome in adults: the Insulin Resistance Atherosclerosis Study”. Diabetes Care 27.3 (2004): 788-793.
  43. Eckert DJ., et al. “Defining phenotypic causes of obstructive sleep apnea. Identification of novel therapeutic targets”. American Journal of Respiratory and Critical Care Medicine 188.8 (2013): 996-1004.
  44. Sikter A. “Hypocapnia and mental stress can trigger vicious circles in critically ill patients due to energy imbalance: a hypothesis presented through cardiogenic pulmonary oedema”. Neuropsychopharmacologia Hungarica 20.2 (2018): 65-74.
  45. Kapetanakis T., et al. “Metabolic acidosis may be as protective as hypercapnic acidosis in an ex-vivo model of severe ventilator-induced lung injury: a pilot study”. BMC Anesthesiology 11 (2011): 8. 
  46. Epel ES. “Psychological and metabolic stress: a recipe for accelerated cellular aging?” Hormones (Athens) 8.1 (2009): 7-22.
  47. Dhokalia A., et al. “Resting end-tidal CO2 association with age, gender, and personality”. Psychosomatic Medicine 60.1 (1998): 33-37.
  48. Frassetto L and Sebastian A. “Age and systemic acid-base equilibrium: analysis of published data”. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 51.1 (1996): B91-B99.
  49. Souto G., et al. “Metabolic acidosis-induced insulin resistance and cardiovascular risk”. Metabolic Syndrome and Related Disorders 9.4 (2011): 247-253.
  50. Barone MTU and Menna-Barreto L. “Diabetes and sleep: A complex cause-and-effect relationship”. Diabetes Research and Clinical Practice Diabetes 91.2 (2011): 129-137.
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Citation

Citation: András Sikter. “Psychosomatic Molecular Mechanisms of Metabolic Syndrome and Type 2 Diabetes. Part 2. Psychosomatic Mechanism of Metabolic Syndrome (a Theory)". Acta Scientific Medical Sciences 4.2 (2020): 98-107.




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