Spring 2007 - American Academy of Anti-Aging Medicine

196 Pages·2007·21.49 MB·English

SPRING
M THE OFFICIAL MAGAZINE OF THE AMERICAN ACADEMY OF ANTI-AGING MEDICINE
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IN THIS ISSUE:
A4M 2007-2008 Worldwide Official Educational Programs 2
Report from the Medical Committee for Aging Research &
Education (Issue 1, 2007):
Lifespan Literature Scan 4
Obesity and Longevity 6
Research Recaps:
Dementia and Alzheimerʼs Disease:
A Scientific Literature Review 12
Program of the 15th Annual Congress on Anti-Aging Medicine
& Regenerative Biomedical Technologies, Spring 2007 Session:
Schedule at a Glance 16
Educational Affiliates 26
Board Certification 28
Faculty Biographies 29
Faculty Disclosures 51
Abstracts 53
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Welcome
Dear Attendee:
The American Academy of Anti-Aging Medicine (A4M) welcomes you to Florida for the 15th Annual
International Congress on Anti-Aging Medicine and Regenerative Biomedical Technologies, Spring 2007
Session.
The American Academy of Anti-Aging Medicine (A4M) is among the fastest growing medical societies in
the world today, growing from twelve doctors in 1993 to a current membership of 20,000-plus. The A4M
conferences have grown to become the largest worldwide in the area of preventative medicine.
A4M conferences have achieved what to our knowledge no other medical group in history in any specialty
has accomplished, growing in three years from just two international conferences to more than 30 annual
international conferences around the world on all continents in 2007, many with the support of governments,
ministries of health and international sports federation organizations.
The worth and value of A4M and its scientifi c conferences has been decided and validated by the practicing
physicians around the world, who elect to attend its worldwide co-supported/co-sponsored academic events.
The A4M has on-site trained 100,000 physicians and health professionals to date and provides online
continuing medical education to more 500,000 physicians and health professionals annually.
We commend you for attending this premier educational event in the anti-aging medical specialty, where more
than 60 of the worldʼs most recognized clinicians and researchers in anti-aging and regenerative medicine
present the very latest data and fi ndings that advance a new paradigm of innovations in advanced preventive
medicine.
With warm regards,
Dr. Ronald Klatz, MD, DO Dr. Robert Goldman, MD, PhD, DO, FAASP
President, A4M Chairman, A4M
IMPORTANT NOTICE: PLEASE READ
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To restrict this free exchange of thought, both conventional and unconventional, would eliminate true opportunities for breakthrough and discovery vital to
our new science. Indeed, freedom of thought is the essential foundation upon which the advancement of health care itself is based.
Spring(cid:3)2007(cid:3) Anti-Aging(cid:3)Medical(cid:3)News(cid:3)•(cid:3)1
A4M Co-Sponsored/
Anti-Aging / Regenerative
April 16-17, 2007
London, England
September 14-16, 2007
London, England*,†
15th Annual 16th Annual
International Congress International Congress September 12-14, 2008
Summer 2007 Session Summer 2008 Session London, England*,†
August 2-4, 2007 August 7-9, 2008
Chicago, ILUSA*,**, † Chicago, ILUSA*,**, †
Anti-Aging
World Congress
March 22-24, 2007
15th Annual International 16th Annual International Monaco*,†
Congress Congress
Anti-Aging
Winter 2007 Session Winter 2008 Session
World Congress
December 12-15, 2007 December 3-6, 2008
March 27-29, 2008
Las Vegas, NVUSA*,**, † Las Vegas, NVUSA*,**, †
Monaco*,†
October 5-7, 2007
Madrid, Spain
October 3-5, 2008
Madrid, Spain
Sept. 19-22, 2007
Estoril, Portugal
Sept. 17-20, 2008
Estoril, Portugal
October 27-29, 2007 15th Annual
Guadalajara, Mexico International Congress
Spring 2007 Session
October 25-27, 2008
April 26-28, 2007
Guadalajara, Mexico
Orlando, FLUSA*,†
October 5-7, 2007
Cancun, Mexico
16th Annual
October 3-5, 2008
International Congress
Cancun, Mexico
Spring 2008 Session
April 24-26, 2008
Orlando, FLUSA*,†
August 2007§
Sao Paulo, Brazil
Information on upcoming August 2008§
Sao Paulo, Brazil
conferences at:
www.worldhealth.net
Co-Supported Events in
Medicine ~ 2007-2008 Calendar
February 15-17, 2007
Moscow, Russia
September 15, 2007 June 1-3, 2007
Zurich, Switzerland Munich, Germany April 20-22, 2007 September 7-9, 2007
Moscow, Russia Seoul, Korea
September 20, 2008 June 6-8, 2008
February 14-16, 2008 September 5-7, 2008
Zurich, Switzerland Munich, Germany
Moscow,Russia Seoul, Korea
April 18-20, 2008
August 16-19, 2007
Moscow,Russia
Beijing, China
June 15-17, 2007
October 17-19, 2007
August 14-17, 2008 Tokyo, Japan*,†
Vienna, Austria
Beijing, China
June 20-22, 2008
October 15-17, 2008
Vienna, Austria Tokyo, Japan*,†
May 4-6, 2007
Bucharest, Romania
November 1-4, 2007
May 2-4, 2008 Shanghai, China
Bucharest, Romania
November 6-9, 2008
February 16-17, 2007
Shanghai, China
Bangkok, Thailand
May 18-20, 2007
June 8-10, 2007
Guangzhou, China
Bangkok, Thailand
April 20-22, 2007 May 16-18, 2008
November 9-11, 2007
Catania, Italy Istanbul, Turkey Guangzhou, China February 15-16, 2008
Bangkok, Thailand
April 18-20, 2008
November 7-9, 2008 November 17-19, 2007
Catania, Italy June 13-15, 2008
Istanbul, Turkey Bombay, India* Bangkok, Thailand
November 15-17, 2008
*
Bombay, India
April 29-May 1, 2007 September 6-9, 2007
October 19-21, 2007 Kuala Lumpur, Malaysia*,† Bali, Indonesia*,†
Dubai, UAE
April 27-29, 2008 September 4-7, 2008
October 17-19, 2008 Kuala Lumpur, Malaysia*,† Bali, Indonesia*,†
Dubai, UAE
May 11-13, 2007
Melbourne, Australia*,†
January 26-28, 2007
Cape Town, SouthAfrica* May 9-11, 2008
Melbourne, Australia*,†
January 25-27, 2008
Cape Town, SouthAfrica* * Written examination of the American Board of Anti-Aging / Regenerative Medicine (ABAARM)and the
American Board of Anti-Aging Health Practitioners (ABAAHP)to be administered at this venue.
**
Oral examination of the American Board of Anti-Aging / Regenerative Medicine (ABAARM) to be administered at this venue.
†Written examination of the American College of Anti-Aging Sports Medicine Professionals (ACASP)to be administered at this venue.
§ Pending.
ISSUE 1, 2007
M C A R E
A REPORT FROM THE EDICAL OMMITTEE FOR GING ESEARCH AND DUCATION
SCIENTIFIC EDITORIAL BOARD
Executive Editor
Ronald Klatz, M.D., D.O. (USA)
President-American Academy of Anti-Aging Medicine Lifespan Literature Scan
Managing Editor
Robert Goldman, M.D., Ph.D., D.O., FAASP (USA)
President-National Academy of Sports Medicine
Chairman- American Academy of Anti-Aging Medicine
Associate Editor
Catherine Cebula (USA)
Administrator, The London School of Postgraduate Medical Education
Scientific Editorial Advisory Board Over 5 Million Rising Cost of
Juan Marcos Becerro, M.D., Ph.D. (Spain)
Olympic Medical Committee Spain (Ret.) Americans Afflicted with Living Affects Seniors
Heather Bird-Tchenguiz, M.B.A. (U.K.)
Director, World Academy of Anti-Aging Medicine Alzheimer’s In the United Kingdom, the Consumer
Denise Bruner, M.D. (USA)
Former President, American Society of Bariatric Physicians Credit Counseling service (CCCS) has
Anongnuth Chiangpradit, M.D. (Thailand) The Alzheimer’s Association reports that
Bumrungrad Hospital more than 5 million Americans are living found that the number of people age 60-
Brian Corrigan, M.D., Ph.D. (Australia) plus experiencing money concerns is grow-
Australian Olympic Committee (Ret.) with Alzheimer’s Disease (AD), a 10% in-
Eduardo De Rose, M.D., Ph.D. (Brazil) ing faster than any other age group. Pen-
crease since the last estimates issued by the
President, International Federation of Sports Medicine
sioners are being forced into debt because
Rafael Santonja Gomez, PharmD (Spain) organization five years ago. The Associa-
Olympic Committee, Spain of the rising cost of living. Recent reports
Dato Harnam, M.D., Ph.D. (Malaysia) tion projects that, unless scientists discover
President, Society for Anti-Aging & Aesthetic Medicine Malaysia a way to delay AD, the condition could af- have shown that the personal inflation rate
Thierry Hertoghe, M.D. (Belgium) for those age 60-plus is near 10%. Accord-
European Academy of Longevity Medicine flict 7.7 million Americans by 2030, and 16
Vernon Howard, Ph.D. (USA) ing to the Office for National Statistics,
million by 2050. Alzheimer’s Association
Harvard University (Ret.)
food prices were up 4.9%, electricity 27%,
Michael Klentze, M.D., Ph.D. (Germany) vice-president Steve McConnell observed
President, European Center for Aging Research & Education and gas 39.9%.
Stanley Kornhauser, Ph.D. (USA) that: “[in fighting heart disease, cancer, and
Director, National Institute for Electromedical Information other diseases, ironically] we’re keeping The Telegraph UK, 20 March 2007.
Seung-Yup Ku, M.D., Ph.D. (Korea)
Seoul National University people alive so they can live long enough
Edward Lichten, M.D. (USA)
to get Alzheimer’s disease.” US government
Wayne State College of Medicine
Jun Matusama, M.D. (Japan) figures released in 2006 show small declines
Japanese Society of Clinical Anti-Aging Medicine (JSCAM)
João Francisco Marques Neto, M.D., Ph.D. (Brazil) from most of the nation’s leading killers be-
President, SOBRAO tween 2000 and 2004, but deaths attributed
Wimpie Pangkahila, M.D. (Indonesia)
Udayana Medical University to AD rose by 33%.
Steve Sinatra, M.D. (USA)
University of Connecticut School of Medicine Associated Press, 20 March 2007.
Robert Tan, M.D. (USA)
University of Texas/Houston
Robert Tien, M.D., M.P.H. (Taiwan)
Duke University School of Medicine (Tenured)
Fredrick Vagnini, M.D. (USA) continued on page 5
Cornell University School of Medicine
ISSUE 1 2007
4(cid:3)•(cid:3)Anti-Aging(cid:3)Medical(cid:3)News(cid:3) Spring(cid:3)2007
M C A R E
A REPORT FROM THE EDICAL OMMITTEE FOR GING ESEARCH AND DUCATION
continued from page 4
Consequences of An Aging Spending Habits of
Population Singapore’s Seniors
The proportion of elderly people is growing faster in Singapore seeks to establish itself as a center of excel-
China than in any major country, with the number of lence for the elderly, where Asians fl ock to for goods
retirees set to double between 2005 and 2015, when and services to enhance their golden years. The na-
it will reach 200 million. By midcentury, 430 million tion’s Social Enterprise Committee aims to grow a vi-
Chinese – about a third of the nation’s population – will brant social entrepreneurship culture by 2010, which
be retirees. The nations’ one-child policy, along with a ultimately is hoped to spinoff economic independence
decline in the numbers of younger workers, will cause to Singapore’s elderly citizens. It is estimated that in
the ratio of workers to retired people to decline, from 2007, senior Singaporeans spent US$ 1.2 billion on
6 to 1 now to 2 to 1 by 2040. All of these demographic dining, entertaining, and shopping, as well as US$ 300
shifts are expected to place enormous demands on the million on travel and leisure. Experts predict that in
country’s finances. As a result, China is considering the next decade, elderly Singaporeans will outspend
raising the retirement age, from the current 50 to 55 their younger counterparts by three-fold.
for women and 55 to 60 for men. While raising the
Channel NewsAsia, 16 March 2007.
retirement age may alleviate pressures on the pension
system, some experts are fearful that it would spur
prolonged unemployment among younger workers.
In 2006, 4.13 million young Chinese graduated from
universities, yet 30% of them are still unemployed.
Prolonged employment of older workers is feared to
worsen the unemployment of the nation’s youth.
International Herald Tribune, 20 March 2007.
India Raises Retirement
Age for Teachers
Americans Easing into
India’s Central government has increased the retire-
Retirement ment age for teachers in centrally-aided educational
institutions from 62 to 65 years. In addition, they can
A study by The Vanguard Group, a mutual funds
be re-employed beyond 65 years and up to 70 years
company, found that many Americans are easing into
against sanctioned vacancies if they are not fi lled by
retirement via a gradual transition phase. The study
regular candidates. The increase in retirement age has
of 2,500 adults age 40 to 60 found that “a common
been necessitated to meet the growing demand for ex-
strategy for making the transition from work to re-
perienced teachers both in technical and non-technical
tirement is downshifting,” where workers shift to less
fi elds, explained Union Information and Broadcasting
stressful or simpler jobs before stopping work entirely.
Minister Priya Ranjan Dasmunsi.
Nearly 25% of those age 55-plus who were surveyed
have downshifted at least once, and 40% expected to IndiaEduNews.net, 16 March 2007.
do so in the future. As a result, about 6 in 10 Ameri-
cans will include part- or full-time work in their re-
tirement plans.
Associated Press, 18 March 2007.
continued on page 72
ISSUE 1 2007
Spring(cid:3)2007(cid:3) Anti-Aging(cid:3)Medical(cid:3)News(cid:3)•(cid:3)5
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Introduction countered in Syndrome X have been cise and controlled calorie diets. The
associated with many other diseases many causes of weight gain require a
The global epidemic of obesity
(Syndrome X, Y, Z…) 3 multi-pronged clinical approach. Bar-
threatens longevity. Considerable evi-
iatric medicine has not addressed con-
dence supports the notion that a phys- Obesity is caused by an interaction
sistently the management of obesity
ically active person of normal body of complex factors, including: genetic
related disease or Metabolic Syndrome
weight lives longer than the over- predispositions, poor lifestyle, normal
X in weight control tactics.
weight, inactive individual.1, 2 Obesity reductions in lean body mass with age
causes premature morbidity and mor- and diet. Pivotal observations of the Obesity has a series of “ugly disease
tality as a consequence of obesity re- effect of diet on aging are provided by companions” and it has emerged as
lated diseases are often associated met- many animal studies which show a re- the nation’s number one cause of pre-
abolic problems, such as the Metabolic lationship between retention of body mature death, at least indirectly. This
Syndrome X. Among the commonest functions or survival and partial food means that weight control initiatives
causes of premature death and disabil- restriction.1, 4 must address the primary objective of
ity are heart disease, cancer, stroke, This article is designed to reinforce overall health and well being.3 Excess
lung disease, diabetes mellitus, organic the importance of the management of dietary intake of simple sugars, com-
brain disease, accidents, infections and an overweight status with appropriate pounded by other factors, drives the
side effects of drugs. These diseases consideration of obesity related dis- disordered regulation of the functions
or disorders are often associated with ease, most notably Syndrome X. The of insulin (metabolic dysglycemia). In-
obesity or the Metabolic Syndrome X. approach described is a strategy for sulin resistance leads to excess insulin
The many obesity related diseases and “anti-aging” given the characterization secretion which has many negative ef-
diseases associated with Syndrome X of obesity and Metabolic Syndrome X fects on the body. In addition to the in-
mirror common causes of premature as disorders of premature aging. effi cient “handling” of blood glucose,
morbidity and mortality.2, 3 insulin excess in the presence of insu-
Weight Management Principles
lin resistance can promote cholesterol
The association between being
synthesis in liver, raise blood pressure,
overweight and the occurrence of the Simple or single interventions for
cause other hormonal aberrations and
Metabolic Syndrome X presents a weight control are universally unsuc-
result in cell proliferation.3
unifying concept of premature aging, cessful. There is not a documented,
with its attendant morbidity and mor- “stand-alone” use of a diet, drug or The legacy of Metabolic Syndrome
tality.3 Metabolic Syndrome X is char- dietary supplement that has resulted X has not been fully experienced.
acterized by the variable continuation consistently in sustained weight loss Some credible opinions imply that
of obesity, hypertension and hyper- or weight control. A combat against we may have a current generation of
cholesterolemia, linked by resistance obesity must involve a multi-factorial adults who may variably outlive their
to the hormone insulin. This variable approach including: positive lifestyle children. Syndrome X may be pre-
constellation of problems that are en- change, behavior modifi cation, exer- cipitating a “human dinosaur” phe-
Stephen Holt, MD is a pioneer of integrative medicine, best-selling author and he holds the academic rank of distinguished
professor of medicine. Dr. Holt is a frequent guest lecturer at scientifi c meetings and he is a Knight of the Order of St. John.
6(cid:3)•(cid:3)Anti-Aging(cid:3)Medical(cid:3)News(cid:3) Spring(cid:3)2007
Obesity and Longevity
nomenon as the metabolic evolution disease, gestational diabetes, changes a “back up plan” for management.3, 11,
of humankind cannot keep pace with in eicosanoid status and cancer. The 12 In contrast, natural approaches with
“advancing lifestyles”. Such lifestyles pathophysiology of Metabolic Syn- lifestyle modifi cation and nutritional
are characterized often by excess calo- drome X creates a platform for the de- and/or nutraceutical interventions
rie intake combined with inactivity. velopment of many disease.3, 5, 6 This may provide versatile and powerful,
is why I coined the terms Syndrome fi rst-line management options.3
Metabolic Syndrome X,
X, Y, and Z…3 Syndrome X is caused
The use of dietary supplements in
Syndrome X, Y, and Z..,
by a combination of adverse lifestyle
the adjunctive management of the
Insulin Resistance Syndrome and genetic predispositions; and it has
metabolic syndrome in the overweight
variable manifestations are apparent in
The phrase “Syndrome X” had been individual has led to the suggestion
proposed diagnostic criteria for meta-
used to describe the combination of that there is an array of nutraceuti-
bolic syndrome or the newly proposed
obesity, hypertension and hypercho- cals that can be defi ned as syndrome
“Syndrome X Clinical Index”.3
lesterolemia, linked by underlying in- X nutritional factors. (Table 1.) These
sulin resistance.3, 5 Approximately 70 Effective prevention and treatment nutritional factors include a variety of
million Americans have Syndrome X of Syndrome X involves a multifac- nutrients or botanicals or herbs that
which is causally linked with the de- eted approach to impact all cardinal may be used variably in a synergistic
velopment of cardiovascular disease components of the disorder. Current manner to correct underlying meta-
(Metabolic Syndrome X), female en- allopathic treatments may have been bolic problems in Syndrome X. (Table
docrine disorders, polycystic ovaries too focused on individual components 1.)
(PCOS), non-alcoholic fatty liver of Syndrome X and they tend to form
continued on page 8
TABLE 1. Syndrome X Nutritional Factors
Syndrome X nutritional factors are composed of nutrients, botanicals, herbs and extracts that are of potential value in the nutritional management of Metabolic
Syndrome X, associated with obesity. Some listed substances may provide nutritional support for diets used in the management of diabetes mellitus.
FACTOR THERAPEUTIC EFFECTS
Soluble fi ber e.g. oat beta glucan Soluble fi ber reduces post-prandial blood glucose, reduces blood cholesterol, improves glucose tolerance, regulates
bowel function, primes the immune system, probably by a prebiotic effect. In addition, soluble fi ber promotes satiety
and it has other intrinsic metabolic effects. Plays a pivotal role in nutritional management of syndrome X and weight
control, especially in children.
Soy Protein Soy protein reduces blood cholesterol and its isofl avone content may reduce platelet “stickiness” and exert valuable
(25 g/day) antioxidant functions. Value of vegetable protein rotation in diets. Soy has many other health benefi ts and it is an ideal
dietary substrate for use in diabetes mellitus and syndrome X. Soy is not toxic.
Omega 3 fatty acids (EPA) Omega 3 fatty acids are best taken in fi sh oil concentrates, high in EPA, presented in enteric coated capsules for greater
compliance and bioavailability. Plant precursors of omega 3 fatty acids (e.g. fl axseed oils, walnut oils, macadamia etc.
are not reliable sources of active fatty acids). Fish oil sensitizes insulin by acting on PPAR receptors and it has multiple
health benefi ts including: cardiovascular benefi ts, anti-infl ammatory actions etc.
Chromium Several studies imply that chromium in various forms may assist in blood cholesterol reduction, weight control and
they may sensitize the actions of insulin.
Alpha lipoic acid A powerful anti-oxidant which plays a specifi c role in combat against advanced glycation end-products (AGES), with
possible reduction in tissue complications in states of dysglycemia. Has a specifi c insulin sensitizing role, but should
not be given by parenteral administration.
Vanadium An insulin sensitizer of variable value.
Antioxidants Including but not limited to anthocyanadins, ellagic acid, turmeric, biofl avonoids, direct or indirect anti-oxidant vitamins
or minerals e.g. Vitamin E, C, A, selenium, zinc etc. Anti-oxidants are often misused and mis-formulated. Anti-oxidants
should be given with REDOX balance to access all body tissues, hydrophilic and lipophillic properties. Single high
dose antioxidants are best avoided, especially by unopposed intravenous administration.
Starch blockers and fat blockers White kidney bean extract, soluble fi ber, chitin of variable value.
Cinnamon An insulin mimetic.
Maitake Weak insulin sensitizing effect with both whole mushroom powder and fractions. Not a stand-alone weight control or
syndrome X nutritional factor.
Green coffee bean extract Polyphenols e.g. chlorogenic acid assists in correction of dysglycemia, with specifi c effects on hepatic glucose
synthesis.
Green tea Very potent antioxidant with widespread health benefi ts, including effects on glucose metabolism. Distinguished
content of catechins, especially EGCG.
Hoodia gordonii Proposed as a non-stimulant appetite suppressant due to its content of steroidal glycosides.
Spring(cid:3)2007(cid:3) Anti-Aging(cid:3)Medical(cid:3)News(cid:3)•(cid:3)7
Obesity and Longevity continued from page 7
These natural substances may help While the underlying biochemi- the complications of obesity and dia-
reverse pathophysiology encountered cal basis of the relationships between betes mellitus is related to oxidated
in the overweight person by address- obesity or Metabolic Syndrome X and tissue stress with the development
ing: abnormal glucose metabolism, in- infl ammatory disease remains under- of advanced glycation end products
sulin resistance, body status of infl am- explored, these circumstances permit (AGES).3 Therefore, the treatment of
mation, diminished immune function, me to coin the term “obesitis” and obesity related disease seems quite in-
blood lipid abnormalities, hyperten- propose that “anti-infl ammatory” ap- complete without supporting antioxi-
sion and other issues that precipitate proaches shouldn’t be overlooked as dant activity in the obese clinical man-
or contribute to obesity related dis- an important part of obesity manage- agement of the obese or overweight
ease. (Table 1.) However, one has to ment. person. (Tables 1 and 2.)
be reminded that dietary supplements
Up to one third of blood levels of Circadian Biorhythms, Sleep,
are not to used prevent or treat dis-
the infl ammatory cytokine, IL-6,
Obesity and Metabolic
ease: an enigma created by the law in
may emanate from adipose tissue and
many countries. Syndrome X
weight loss is often associated with
Obesitis: A Concept that reduction in blood markers of infl am- Sleep deprivation, overweight status
Further Unifi es Modern mation e.g. C-reactive protein (CRP), and Metabolic Syndrome X appear to
IL-18.17 Popular healthcare authors be inextricably linked in many people.
Disease Theories?
have attempted to link infl ammation The mechanisms of this association
Obesity and excess body fat can be with many common diseases, but their are not fully understood. Reduction in
classifi ed as infl ammatory conditions interpretation of this important as- sleep duration in healthy young men is
and infl ammation is a key factor in the sociation is limited or naive because associated with major changes in hor-
pathophysiology of Metabolic Syn- only changes in eicosanoid status are monal levels of substances (ghrelin and
drome X. 6, 7, 13, 14 Not only does obesi- emphasized (e.g. The Zone).18 While leptin) that increase hunger and appe-
ty raise the level of pro-infl ammatory correcting eicosanoid precursor path- tite, thereby promoting weight gain.27
messenger molecules in the body, it ways with Omega 3 fatty acids is an An established association between
precipitates or contributes to several important anti-infl ammatory and in- short sleep duration and obesity has
disorders of infl ammation, including sulin sensitizing maneuver, it is not the led to the proposition that more sleep
cardiovascular disease, cancer, arthri- whole story.3, 6-12 is necessary to prevent obesity.27-29
tis, liver disease and asthma.6 This in-
Recent studies have confi rmed the Chronic lack of sleep may increase
fl ammatory disease “link” compounds
anti-infl ammatory actions of certain susceptibility to the Metabolic Syn-
the undesirable effects of insulin resis-
substances that are found in fat tis- drome X and it is known that forced
tance.
sue.16 These substances have been sleep deprivation in healthy young
The hallmarks of Metabolic Syn- referred to as adipocytokines which adults appears to be “diabetogenic”,
drome X and many cases of pre-Type include leptin, adiponectin, and visfa- as evidenced by detectible alterations
II, or early Type II diabetes mellitus tin.16 Adiponectin is manufactured by of glucose metabolism.27 The diabe-
involves the presence of insulin resis- fat cells and blood levels of this protein togenic effects of sleep deprivation
tance.7 Insulin acts by specifi c recep- are reduced in states of obesity, insulin may be hormonally mediated. Sleep-
tor binding which precipitates many resistance, type II diabetes mellitus lessness has been associated with de-
intra-cellular events.7 Current evi- and atheroma.8, 12 Adiponectin exhib- creases in the normal nocturnal surge
dence suggests that insulin resistance its potent anti-infl ammatory effects of thyrotropin or growth hormone
is determined partially by chemical by suppressing TNF-alpha synthesis and increases in corticosteroid secre-
mediators that are released from im- and promoting the availability of anti- tion. These hormonal changes are of-
mune competent cells or fat cells.7, 15 infl ammatory cytokines, e.g. inter- ten present in the elderly, reinforcing
For example, elevated levels of the in- leukin-10 or interleukin-1- receptor the notion of a potential causal rela-
fl ammatory cytokine, tumor necrosis antagonist.13, 19 The “plot” thickens in tionship between sleeplessness and/or
factor-alpha (TNF-alpha) are associ- “obesitis” where imbalances of pro- obesity and premature aging. 27-31
ated with overnutrition and reduction infl ammatory and anti-infl ammatory
The relationship between obesity
of TNF-alpha activity is associated cytokines exist.
and insomnia may be linked to the ex-
with weight loss improvements in in-
The fi nal common pathway of tis- citability of brain cells, most notably
sulin resistance.16 Many factors that
sue damage often involves oxidated the stress-responsive hypocretin/orex-
link infl ammation and tissue damage
damage due to the generation of free in cells in the hypothalamus.30 Daily
have come from recent studies of non-
radicals, perhaps exacerbated by a re- stresses may act on the hypothalamus,
alcoholic, fatty liver disease which is
duction in antioxidant defenses in the resulting in sustained stimulation of
a common component of Metabolic
body.13 Of course, the progression of hypocretin/orexin cells which could
Syndrome X.3, 9
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