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NUR 325 > E2 Obesity & Metabolic Syndrome > Flashcards

E2 Obesity & Metabolic Syndrome Flashcards

1
Q

Obesity is most prevalent in

A

non-hispanic black population followed by hispanics and non-hispanic whites

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2
Q

Obesity has the lowest prevalence in

A

Asians

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3
Q

What age range is obesity highest in?

A

Age 40-60

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4
Q

Adipose tissue

A

-Provides insulation and mechanical support for the body
-Secretes hormone-like molecules: Adipokines

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5
Q

Adipokines

A

immune cell function & bodys main energy reserve

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6
Q

Adipocytes

A

Fat-storing cells
-store fat as triglycerides
-can increase in number and hypertrophy to increase fat mass

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7
Q

Major areas for fat storage:

A
  1. Subcutaneous or peripheral adipose tissue (subdermal tissue)
  2. Visceral adipose tissue (Gets btwn organs)
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8
Q

What is a healthier type of fat storage that causes less inflammation?

A

Peripheral fat

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9
Q

Android vs gynoid obesity

A

Android: Apple, Men, greater risk of heart disease, hypertension, diabetes, and stroke

Gynoid: Pear, Women

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10
Q

What waist circumference causes greater risk of coronary artery disease

A

Women > 35in
Men >40 in

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11
Q

Adipose tissue is an ___ organ

A

Endocrine

Secrete Adipokines

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12
Q

What are the 5 adipokines?

A
  1. Leptin
  2. Angiopoietin-related protein
  3. Angiotensinogen
  4. Retinol-binding protein
  5. IL-6, TNF-alpha
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13
Q

Angiopoietin-related protein

A

Insulin resistance & inflammation

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14
Q

Angiotensinogen

A

-Precursor to A2
-Secreted from fat cells to help regulate BP
-Inflammation
-Insulin resistance in lipogenesis

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15
Q

Retinol-binding protein

A

insulin resistance in muscle

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16
Q

IL-6, TNF-alpha

A

Biomarkers related to inflammation
-CRP & inflammatory markers

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17
Q

Adipokines are cell signaling proteins that are necessary for life and good i general but too many or too much we associate with

A

obesity and causes problems

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18
Q

Adiponectin

A

“Good” Adipokines
-Inverse relationship with the fat content in the body

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19
Q

Increased fat content in body = _____ adiponectin produced

A

decreased

20
Q

What does adiponectin do?

A
  1. Enhances cell sensitivity to insulin
  2. Anti-inflammatory effects
  3. Protects against arteriosclerosis
21
Q

Leptin

A

“Good” adipokine
-Tells body it is fulls (Satiety)
-Works with adiponectin to increase sensitivity to insulin, reduce triglycerides, and inhibit fat accumulation

22
Q

Increased fat = _____ leptin

A

increased

23
Q

Obese individuals becomes

A

Leptin resistant

-Overeat
-Excessive weight gain
-Hyperglycemia
-Hyperinsulinemia

24
Q

A person is considered Obese if there BMI is

A

> 30kg/m2

25
Q

Obesity is the _____ leading cause of death

A

5th

26
Q

Genetics and obesity

A

-Polygenic condition
-Several genetic mutations associated (leptin gene)
-Obesogens

27
Q

What is obesogens?

A

Chemicals that can contribute to the development of obesity (must have a combination of lifestyle and environment factors involved)

28
Q

Risk factors for obesity

A

-Excess caloric intake
-Sedentary lifestyle
-Low socioeconomic status (poverty)
-Cultural aspects of eating
-Age (40-60)
-Smoking cessation
-Genetics
-Secondary disorders (Cushings, genetic disorders)

29
Q

BMI =

A

Weight (kgs) / height (m)^2

[Weight (pounds)/ height (inches) ^2 ] x 703

30
Q

What BMI is considered severe (morbidly) obese

A

> 40

31
Q

Ghrelin Action

A

-Stimulates hunger
-Controls gastric motility & acid secretion
-Stimulates growth hormone

32
Q

Ghrelin is ____ when obese

A

decreased

33
Q

Glucagon-like peptide (GLP-1)

A

-Stimulates insulin secretion
-Inhibits glucagon release
-Slows gastric emptying
-Increase satiety

34
Q

Glucagon-like peptide is _____ when obese

A

decreased

35
Q

Peptide YY Action

A

-reduce appetite
-inhibit gastric motility
-Increase energy expenditure

36
Q

Peptide YY is _____ when obese

A

decreased

37
Q

Cholecystokinin (CCK) Action

A

-Increase satiety
-Decrease food intake
-Stimulate gallbladder contraction
-Pancreatic enzyme release
-Slow gastric emtying

38
Q

Cholecystokinin (CCK) is ____ when obese

A

decreased (some say increased)

39
Q

Obese patients are often in chronic, _______

A

low-grade inflammatory state

40
Q

Macrophages, lymphocytes, neutrophils, and mast cells infiltrate adipocytes which cause release of ______. The systemic effects of these, coupled with other endocrine responses in obesity, results in _______

A

Cytokines

insulin resistance, metabolic syndrome, and health issues associated with obesity

41
Q

MOA of orlistat

A

binds to gastric and pancreatic enzymes and blocks these enzymes, reduces fat absorption by 30%

42
Q

Side effects of Orlistat

A

-Black box: Liver injury
-GI symptoms: oily spotting, flatulence, fecal incontinence (reduce by reducing fat intake to less than 30%)
-Decrease vitamin conentrations (MUST take multi-vitamin)

43
Q

Teaching point for orlistat

A

Must take for 3 months to start seeing effects

OTC

44
Q

Obesity drug therapy considerations for all

A
  1. Must use with diet & exercise
  2. Beset for people with a high health risk (BMI >30 04 BMI >27 w/ other risk factors)
  3. Most doctors will not prescribe unless patients have tried diet and exercise alone for 6 months
  4. Limited effectiveness
  5. Long-term treatment
  6. Rebound effect
45
Q

What are the 3 types of bariatric surgeries?

A

Liposuction
Gastric Bypass
Gastric Banding

46
Q

Metabolic syndrome is characterized by

A

atleast 3 risk factors

  1. Waist circumference (>40 men or >35 female)
  2. Triglycerides (>150)
  3. HDL cholesterol (<40 men or >50 female)
  4. BP (>120 Systolic or >85 diastolic)
  5. Fasting blood sugar (>110)
47
Q

What do we do for metabolic syndrome?

A

Treat the conditions individually
-High BP -> BP meds
-High triglycerides (anti-lipemic agents)
-High Blood glucose (diabetes management)

Most important:
-Weight loss
-Exercise
-Healthy diet
-Smoking cessation

NUR 325 (21 decks)

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