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This version published online on August 9, 2005
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-0961
A more recent version of this article appeared on November 1, 2005
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Submitted on May 2, 2005
Accepted on August 1, 2005

Effects of Dietary Weight Loss on Sympathetic Activity and Cardiac Risk Factors Associated with the Metabolic Syndrome

Nora E. Straznicky*, Elisabeth A. Lambert, Gavin W. Lambert, Kazuko Masuo, Murray D. Esler, and Paul J. Nestel

Laboratories of Cardiovascular Nutrition (N.E.S., P.J.N.) and *Human Neurotransmitters (E.A.L., G.W.L., K.M., M.D.E.), Baker Heart Research Institute, P.O. Box 6492, St Kilda Road Central, Melbourne, Victoria 8008, AUSTRALIA

* To whom correspondence should be addressed. E-mail: Nora.Straznicky{at}baker.edu.au.

Context: Weight reduction, the first-line treatment for the metabolic syndrome (MetS), improves insulin sensitivity and associated metabolic and cardiovascular abnormalities but there is a paucity of data regarding its effect on sympathetic nervous system (SNS) activity in this clinical setting.

Objectives: 1. To test the hypothesis that dietary weight loss attenuates both insulin resistance and SNS activity. 2. To examine the relationships between SNS activity and MetS components.

Design: Single-sample, repeated-measures design

Setting: Tertiary referral center

Participants: Twenty-three MetS subjects (age, 58 ± 2 yr; body mass index 33.3 ± 0.8 kg/m2, mean ± SEM).

Intervention: Hypocaloric modified DASH diet (26% fat, 22% protein, 51% carbohydrate, 100 mmol/day sodium) consumed for 3 months.

Main Outcome Measures: Postganglionic muscle sympathetic nerve activity (MSNA, microneurography at a peroneal nerve), whole-body plasma norepinephrine spillover rate, spontaneous cardiac baroreflex function and insulin sensitivity.

Results: The hypocaloric diet significantly reduced body weight by 7% and improved all MetS components. Norepinephrine spillover decreased from 877 ± 180 to 503 ± 39 ng/min (P = 0.005) and MSNA from 40.6 ± 2.1 to 34.6 ± 2.4 bursts per minute (P = 0.01), while cardiac baroreflex sensitivity increased by 23.0 ± 8.0% (P = 0.02). Change in norepinephrine spillover rate correlated positively and independently with change in plasma leptin concentration (r= 0.49, P = 0.03).

Conclusion: Weight loss by a hypocaloric diet with moderate sodium restriction diminishes SNS activity in MetS subjects. This may be due to the consequences of decreased leptin concentration, enhanced insulin sensitivity or improvements in cardiac baroreflex function.
Key words: sympathetic nervous system • weight loss • metabolic syndrome • obesity • insulin resistance




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