Adult Obesity and Metabolic Syndrome Flashcards Preview

Dems Unit 2 Part 2 YAAAY > Adult Obesity and Metabolic Syndrome > Flashcards

Flashcards in Adult Obesity and Metabolic Syndrome Deck (36):
1

how to calculate BMI

weight (kg) divided by height (square meters)

2

the same formula for BMI is used in

men and women
different ethnicities

3

3 groups of people that BMI may be inaccurate for

Overestimates risk:
-very muscular= athletes

Underestimates risk:
-sarcopenic obesity: lost large muscle mass but have clinically important obesity: elderly
-abdominal obesity without BMI criteria

4

BMI and
morbidity and mortality

-mortality increases with BMI >25
-significant rise BMI >30
-sharp rise at >35 and >40

5

BMI and age

lowest morbidity and mortality with BMI 25-29.9

6

BMI Ethnic Differences

-recommended lower waist circumference cutoff for east asian and south asian vs white
-weight related disease risk may be lower in AA compared to white
-currently use same standards for all ethnic groups

7

Waist circumference is a useful measurement in what patients?

-intermediate risk
-Overweight & Stage 1 obesity
-BMI 25-34.9
-if BMI is suspected to not be an accurate surrogate measurement of body fat

8

abdominal fat is associated with

-deposition internal organs

9

abdominal fat is an independent risk factor for what 5 outcomes even when BMI is not elevated?

CV disease
T2DM
HTN
Hypercholesterolemia
mortality

10

how to measure waist circumference

-horizontal plane around abdomen at level of superior border of iliac crest
-end of normal expiration

alternative: mark a point halfway between iliac crest and lower border of ribs

11

5 levels of BMI categories

Normal: 18.5-24.9
Over: 25-29.9
Stage 1: 30-34.9
Stage 2: 35-39.9
Stage 3: >40

12

severe obesity equivalent

Stage II 35-39 + major weight related condition (T2DM)

13

5 detailed examples of obesity related conditions

1. T2DM/ Impaired Glucose Tolerance
2. dislipidemia
3. CAD
4. Sleep Apnea
5. Non-Alcoholic Fatty Liver Disease

14

T2DM and obesity

-70% of adults with T2DM have BMI of at least 27

-RR of diabetes in women with BMI 23-23.9 is 3.6 times women with BMI less than 22

- risk of diabetes increase linearly with BMI

15

Dislipidemia and obesity

-elevated triglycerides, low HDL, high LDL
- Men: hypercholesterolemia increases progressively with BMI
-Women: increases until BMI 25-27

16

CAD and obesity

-increased risk with abdominal distribution
-begins to increase at Men 23, women 22
-remains independent risk factor even after correction for associated risk factors

17

sleep apnea info and consequences

-partial or complete airway obstruction during sleep: episodes of apnea

repeated episodes of hypoxemia -->
daytime somnolence, morning headache, HTN -->
pulmonary HTN, RHF

18

sleep apnea study

-40% obese men and 3% obese women had sleep apnea that warranted intervention vs 0 controls
-8% obese men and 5.5% obese women had sleep apnea that warranted sleep evaluation

19

Non-Alcoholic Fatty Liver Disease (NAFLD) and obesity

20% of obese patient may have

-hepatomegaly
-abnormal liver enzymes
-abnormal liver histology: macrovesicular steatosis, stetohepatitis, fibrosis, cirrhosis

20

moderate weight loss benefits

5-10% body weight
-glycemia
-blood pressure
-lipids
-fatty liver disease
-osteoarthritis symptoms
-severity of obstructive sleep apnea

21

larger weight loss benefit

reduced mortality from CV disease and cancer

22

Derm comorbidities and complications of obesity

acanthosis nigricans
cellulitis
striae
lymphedema

23

genitourinary comorbidities and complications of obesity

polycystic ovarian syndrome
erectile dysfunction
benign prostate hypertrophy
menstrual abnormalities
infertility
pregnancy complications
stress incontinence

24

metabolic comorbidities and complications of obesity

T2DM
gout
insulin resistance
metabolic syndrome
hyperuricemia
vitamin d deficiency
nephrolithiasis

25

cancer comorbidities and complications of obesity

postmenopausal breast
colon
prostate
endometrial
kidney
gallbladder

26

metabolic syndrome

-specific body phenotype of abdominal obesity associated with group of metabolic disorders that are risk factors for cv disease

27

5 characteristics of metabolic syndrome

1. abdominal obesity
2. elevated blood pressure
3. high triglycerides
4. low HDL
5. Impaired glucose tolerance/ T2DM

*metabolic syndrome with at least 3 criteria

28

metabolic syndrome criteria:
Abdominal obesity:
Men vs Women

waist circumference
men: >102 cm (> 40 inches)
women: >88cm (>35 in)

29

metabolic syndrome criteria:
triglycerides

>150mg/dL or
drug treatment for abnormal lipids

30

metabolic syndrome criteria:
HDL:
Men vs Women

men:

31

metabolic syndrome criteria:
blood pressure:

>130 systolic
>85 diastolic
or anti HTN drug

32

metabolic syndrome criteria:
fasting glucose

>110
or hypoglycemic drug

33

obesity focused history

-chronological body weight change
-previous weight loss attempts
-related medical complications
-medications causing gain
-smoking and social history
-family history
-dietary and physical patterns
-Goals
-Readiness and Motivation
-Screening for Depression

34

obesity focused physical exam

-height, weight, BMI
-waist circumference
-BP
-Pulse & O2 sat
-signs of pulm htn/ venous insufficiency (edema, hyper pigmentation)
-thyroid disease (goiter)
-signs of insulin resistance/ DM (acanthuses nigricans)

35

Labs in obesity focused exam

1. thyroid stimulating hormone
2. Diabetes screen: fasting blood glucose or Ha1c
3. lipid planel
4. liver associated enzymes
-other: sleep study

36

percentage of america adults >20 overweight and obese

obese: 35%
overweight: 33.5%