Block 3 - Lecture 1 Notes

Question 1

Traditional risk factors for cardiovascular disease

Answer 1

• dyslipidemia
• obesity
• hypertension
• smoking
• diabetes

Question 2

Clinical conditions that are additional risks for cardiovascular disease

Answer 2

• Insulin resistance
• Hyperinsulinemia
• Glucose intolerance

Question 3

Clustering conditions or risk factors that put individuals at risk for CVD and Type II

Answer 3

Raised blood pressure
Dyslipidemia
Raised fasting glucose
Central obesity

Question 4

Metabolic syndrome

Answer 4

Condition in humans where there is clustering of specific pathologies that represent increased CVD.

Question 5

Other names for metabolic syndrome

Answer 5

Syndrome X
Insulin resistance syndrome
Cardio Metabolic syndrome (CMS)

Question 6

Prevalence of metabolic syndrome

Answer 6

Over 40% over adults over 50

Question 7

Adipocyte dysfunction

Answer 7

Dysregulation of adipokine secretion

Question 8

Accelerate atherosclerosis

Answer 8

Increased cardiovascular morbidity and mortality

Question 9

Endothelial dysfunction

Answer 9

Dysregulation of microcirculatory responses

Question 10

Renal dysfunction

Answer 10

Micro or macro albuminuria

Question 11

Hepatic steatosis

Answer 11

Elevated lipid storage

Question 12

Inflammation

Answer 12

Increased inflammatory markers such as C-reactive Proteins (CRP)

Question 13

Hypercoagulability

Answer 13

Increased fibrinogen and plasminogen activator inhibitor-1

Question 14

Visceral obesity

Answer 14

Increase in visceral or abdominal adipose tissue

Question 15

Assessment of overall weight or obesity

Answer 15

Body-mass index (BMI)

Question 16

BMI equation

Answer 16

Kg/M^2

Question 17

Normal BMI

Answer 17

18.5-24.9

Question 18

Overweight BMI

Answer 18

25.0-29.9

Question 19

Obese BMI

Answer 19

30.0 - 39.99

Question 20

Extreme Obesity BMI

Answer 20

Greater than 40.0

Question 21

Ways to assess visceral obesity

Answer 21

Waist circumference and MRI

Question 22

M Value

Answer 22

Measurement of insulin sensitivity

Question 23

Insulin resistance

Answer 23

The state in which normal or elevated circulating insulin levels don’t elicit the expected biological response in organism or tissue

Question 24

Primary organ of insulin resistance

Answer 24

Skeletal muscle

Question 25

Other major organs of insulin resistance

Answer 25

Liver and adipose tissue

Question 26

What is an early defect in the development of metabolic syndrome

Answer 26

Insulin resistance

Question 27

When do we refer to someone as pre-diabetic?

Answer 27

When individuals who are insulin resistant but do not yet show symptoms of hyperglycemia

Question 28

Hyperinsulinemia

Answer 28

Condition in which an increase in insulin secretion is brought about in order to compensate for established insulin-resistant state and keep blood glucose close to normal

Question 29

Abnormal response to oral glucose tolerance test

Answer 29

Glucose intolerance

Question 30

Oral glucose tolerance test

Answer 30

Ingestion of 75 g of glucose and assessment of the blood glucose levels over the next 2-3 hours.

Question 31

Glucose intolerance

Answer 31

Glucose levels increase to high levels and remain high for longer than normal

Question 32

The development of glucose intolerance is closely associate with...

Answer 32

the development of insulin resistance

Question 33

Dyslipidemia is traditionally composed of...

Answer 33

- Excess plasma triglycerides and FFA (fasting and PP) - Decreased HDL and PHLA - Increased LDL

Question 34

Post-prandial

Answer 34

After a meal

Question 35

PHLA

Answer 35

Post-heparin lipolytic activity --> decreased ability to catabolize lipids in response to heparin

Question 36

Essential hypertension

Answer 36

Elevation in both systolic BP and diastolic BP (> 135 mm Hg / > 90 mm Hg)

Question 37

Insulin resistance and compensatory hyperinsulinemia of metabolic syndrome may cause...

Answer 37

- Increased central sympathetic outflow - Peripheral vasoconstriction - Renal retention of Na and water - Increased blood volume and total peripheral resistance (hypertension)

Question 38

How does hyperinsulinemia result in hypertension.

Answer 38

Insulin resistance --> hyperinsulinemia --> increased SNS activity / increased Na and water retention --> hypertension