apetite Flashcards

1
Q

what is osmolality and why we use it over osmolarity

A

Body fluid osmolality : solute concentration in 1kg vs osmolarity in one mol so osmolality more clinically relevant

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2
Q

what are the stimuli that tell the body we are thirsty and which is the most potent

A

body fluid osmolality
decreased blood volume
reduced bp

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3
Q

what hormone regulates osmolality? organ and specific site of action

A

ADH- Acts on the kidneys to regulate the volume & osmolality of urine
Collecting duct - Aquaporin 2 channel

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4
Q

action of ADH- SO EXPLAIn when high vs when low

A

When plasma ADH is low a large volume of urine is excreted (water diuresis)

When plasma ADH is high a small volume of urine is excreted (anti diuresis)

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5
Q

where is ADH STORED

A

posterior pituitary

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6
Q

how does our body measure osmolality and what does it do about it

A

Sensory receptors
Osmoregulation
Found in the hypothalamus

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7
Q

how do osmoreceptors stimulate ADH release and thirst

A

1) cells shrinK when plasma more concentrated BC fluid moves out

2) more cation channels open (as a direct result of shrink- mechanically they are pushed to open see slide 9)

3) membrane depolarizes

4) sends signal to ADH producing cells to incr ADH

5) fluid retention invokes drinking

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8
Q

what happens to our sensation of thirst when we first drink water and how?

A

Thirst is initially decreased temporarily due to
Receptors in mouth, pharynx, oesophagus are involved

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9
Q

when is thirst completely satisfied?

A

once plasma osmolality has decreased or blood volume or arterial pressure corrected.

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10
Q

how is the renin angiotensin aldosterone system involved in blood pressure/ volume changes

A

juxtaglomerular cells sense drop in BP and convert pre-renin to renin in kidney

then renin converts angiotensinogen to angiotensin I in the liver

then ACE converts angiotensin I to angiotensin II in the lungs

ANGIOTENSIN II does all the things to fix the issue of low water in body…

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11
Q

Angiotensin II actions to ensure high osmolality drops

A

1) increase thirst

2) aldosterone release from adrenal cortex which increases h2o retention via nacl absorption and K excretion in kidneys

3) vasoconstriction by increasing sympathetic activity

4) ADH secretion

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12
Q

are adults more likely to fluctuate weight a lot if they dont put consious effort to balance their intake and expenditure?

A

no. in general most adults maintain stable weight over long periods

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12
Q

based on body weight homeostasis principles what are the homeostatic processes that occur when fat mass incr and decr

A

when fat incr food expenditure decr and energy expend incr and sympathetic nervous system activity incr!!!
aiming to loose weight

and opposite for fat decr
aim to regain weight

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13
Q

What system(s) defend against rapid expansion of body weight?

A

Yet to be discovered

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14
Q

what is the main brain area involved in appetite regulation

A

hypothalamus controls food intake and energy expenditure

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15
Q

what are the stimuli that the hypothalamus reacts to to regulate apetite?

A

1) circulating factors: GHRELIN, PYY AND other gut hormones

leptin

2) neural input from periphery and other brain regions

16
Q

what are the relevant areas of the hypothalamus involves in appetite regulation and what brain structure to they surround anatomcally?

A

arcuate nucleus,
paraventricular nucleus, ventromedial hypothalamus
lateral hypothalamus

all sit around third ventricle

17
Q

which part of these hypothalamus integrates peripheral and central feeding signals and why?

A

arcuate nucleus bc it has Incomplete blood brain barrier, allows access to peripheral hormones.

18
Q

what are two neuronal populations of arcuate nucleus that are relevant?

A

Stimulatory (NPY/AGRP neuron)
Inhibitory (POMC neuron)

19
Q

where do these AGRP and POMC neurons of the arcuate nucleus act on?

A

the paraventricular nucleus and specifically MC4R neurons

19
Q

what is the effect of AGRP and POMC on MC4R and subsequently on satiety/ food intake?

A

MC4R are inhibitory neurons, they decrease food intake.

AGRP stimulates them so agrp neurons decr food intake.

POMC inhibit the inhibitory MC4R so they effectively incr food intake.

20
Q

evidence of the action of POMC and MC4-R and NPY/ AGRP

A

No NPY or Agrp mutations associated with appetite in humans.

POMC deficiency and MC4-R mutations cause morbid obesity.

21
Q

WHAT ARE SOme other brian regions that are involved in appetite control?

A

Higher centres
- Amygdala - emotion, memory.

Other parts of the hypothalamus, e.g. lateral hypothalamus

Vagus to brain stem to hypothalamus.

22
Q

explain the adipostat mechanism and proof

A

Circulating hormone produced by fat - adipocytes and enterocytes (leptin)

Hypothalamus senses the concentration of hormone.

Hypothalamus then alters neuropeptides to increase or decrease food intake and thermogenesis (expenditure)

  • ob/ob mice- mutation: dont make leptin are obese (ob/ob means genetic mutation that leads to obese phenotype_)
23
Q

why is leptin ineffective as a weight control drug in obese people?

A

Leptin circulates in plasma in concentrations proportional to fat mass

Overweight humans have ↑leptin

Obesity due to leptin resistance - hormone is present but doesn’t signal effectively

24
Q

what is the main reason we feel less hungry after a meal? (bulk in stomach? nutrients in circulation? hormonal signals from gut?)

A

hormonal signals from gut most less the others

25
Q

what are the types of cells are gi hormones secreted by

A

enteroendocrine cells along the gi tract

26
Q

what are two enteroendocrine hormones involved in appetite regulation?where is each secreted? (one stimulating one inhibiting)

A

Ghrelin secreted in stomach- stimulates appetite by increasing gastric emptying and acid secretion

peptide tyrosine tyrosine =peptide YY (PYY) secreted in large intestine
inhibits food intake

27
Q

when are Ghrelin levels highest?

A

before meals

28
Q

what is the mechanism of action of Ghrelin?

A

Directly modulates neurons in the arcuate nucleus
Stimulates NPY/Agrp neurons.
Inhibits POMC neurons.

29
Q

other than inreasing appetite what other functions does ghrelin perform?

A

regulation of reward, taste sensation, memory & circadian rhythm

30
Q

what is the effect of giving ghrelin in humans and rats?

A

increases appetite

31
Q

when and where very specifically is PYY released?

A

when food arrives to the terminal ileum and colon
PYY is released from TI (terminal ileum) and colon

32
Q

what is the mechanism of atin of PYY

A

stimulates POMC neurons and inhibits NPY release

33
Q

can we give PYY to people and by what mean?

A

digested or iV

34
Q

EFFECT OF pyy ON FOOD INTAKE IN HUMANS AND MICE

A

food intake drops from baseline

35
Q

comorbidities associated with obesity

A

stroke, diabetes, PERIPHERAL vascular disease- feet, gout, OA (osteoarthritis), bowel cancer, sleep apnoea, depression. MI hypertension

36
Q

what is a factor that plays a hige role in obesity

A

genetics, graph on slide 45 showing that in a toxic environment genetically prone