Obesity

Question 1

What do adipocytes do?

Answer 1

Store fat, triglycerides
synthesize fatty acids from carbs
break down stored fats for energy
produce leptin

Question 2

What are the functions of leptin?

Answer 2

inhibit lateral hypothalamus to decrease hunger b/c it is naturally hungry
stimulates the ventromedial nucleus of the hypothalamus b/c it is naturally skinny

Question 3

What happens when you exercise or are stressed?

Answer 3

mobilize fat for energy!
increase in sympathetic stimulation increases NE & Epi
Increase in ACTH and therefore, Cortisol

increase in lipase in fat cells

Question 4

What is lipodystrophy?

Answer 4

atrophy or hyperplasia of fat cells so that you get distributions of fat
Ex: buffalo hump in cushing’s

Question 5

What are some causes of lipodystrophy?

Answer 5

leptin deficiency

HIV meds, like protease inhibitors

Question 6

what are some meds that can cause obesity?

Answer 6

atypical antipsychotics
mirtazapine
insulin, TZD, sulfonylureas
some progestins

Question 7

What is the diagnostic criteria for metabolic syndrome?

Answer 7

3/5

1. abdominal obesity: men>40, women>35”
2. high triglycerides: >150
3. Low HDL, Men130/85
4. fasting glucose>100

Question 8

Describe the progression of the liver problems caused by obesity.

Answer 8

Fatty Liver–>NASH–>Cirrhosis–>Hepatocellular Carcinoma

Question 9

Which signs would you see that would point to non-alcoholic steatohepatitis?

Answer 9

histo: fatty liver + inflammation w/ neutrophils and fibrosis
Labs: elevated ALT and AST, ALT>AST, elevated Alk phosph

Question 10

What are the imaging methods for diagnosis of NASH?

Answer 10

LIVER US, CT, MRI
magnetic resonance spectroscopy (gold standard)
liver biopsy