Obesity Flashcards

1
Q

Adipocytes

A
Store TGs
Synthesize fatty acids/TGs from carbohydrates
Break down stored fats
Release fatty acids for energy
Produce hormones – leptin
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2
Q

Regulation of hunger

A

Lateral hypothalamus: stimulation -> hunger, inhibition -> anorexia
-inhibited by leptin

Ventromedial nuclei: stimulated by leptin
Stimulation -> satiety
Lesion -> hyperphagia

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3
Q

BMI

A

Wt kg/(height m2)

Underweight less than 18.5
Normal 18.5-24.9
Overweight 25 – 29.9
Obese over 30

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4
Q

Hormonal regulation of fat utilization

A

Heavy exercise and stress -> mobilization and utilization of fat

Increased sympathetic stimulation -> epi and NE release from adrenal medulla

Epi activates hormone-sensitive TG lipase in fat cells -> rapid breakdown of TG, FAs to muscles as energy

Stress triggers release of ACTH -> glucocorticoids

Cortisol stimulates triglyceride lipases -> more free fatty acids to be used by muscles

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5
Q

Lipodystrophy

A

Abdominal obesity w/ no fat on extremities
Buffalo hump

Cause: leptin deficiency
Protease inhibitors – HIV meds

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6
Q

Obesity meds

A

Atypical antipsychotics
Mirtazapine
Insulin, TZDs, sulfonylureas
Progestins

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7
Q

Medical complications of obesity

A
Metabolic syndrome
T2DM
HTN
Atherosclerotic diseae: CAD, MI, PAD, stroke
OSA
Gout
Gallstones
PCOS
Fatty liver
OA
Candida infections of skin folds

Cancer: esophageal, colon, liver, gallbladder, pancreatic, breast, ovarian, uterine, prostate, NHL, multiple myeloma

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8
Q

Nonalcoholic steatohepatitis (NASH)

A

MC causes: obesity, T2DM, hyperlipidemia, insulin resistance

d/t insulin resistance at liver -> excess lipid accumulation in liver

-> cirrhosis, hepatocellular carcinoma, worsen Hep C progression

suspect if chronically elevated LFTs

Dx:
Liver US, CT scan, MRI
Magnetic resonance spectroscopy (gold standard)
Liver bx

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