Chapter 20- Perturbations of Energy Metabolism: Obesity and Diabetes Mellitus Flashcards
What is intermediary metabolism?
all changes that occur in a food substance beginning with absorption and ending with excretion
What are the energy content of carbohydrates, protein, fat, and alcohol?
Carbohydrate 4, protein 4, fat 9, alcohol 7kcal/g
BMR is increased in what diseases?
hyperthyroidism, fever, Cushing’s syndrome, tumors of adrenal gland, anemia, leukemia, polycythmia, cardiac insufficiency, & injury
BMR is decreased in what diseases?
hypothyroidism, starvation, malnutrition, hypopituitarism, hypoadrenalism (Addison’s disease), and anorexia nervosa
Integration of signals for energy storage and dissipation are mediated by what?
Hypothalamus
what is AMPK?
heterotrimeric protein complex and consists of a catalytic alpha-subunit and regulatory beta and gamma subunits
When AMP levels rise during anabolism what happens to AMPK?
AMPK is allosterically activated -> promotes ATP synthesis by activating key regulatory enzymes in the catabolic pathways
Negative allosteric regulators of AMPK are?
phosphocreatine and glycogen
MOA of metformin
activates AMPK -> inhibits the transcription of key regulatory hepatic enzymes required for gluconeogenesis
What is leptin?
Long-term regulator of energy store in adipocytes, functions in the afferent signal pathway of - feedback loop in regulating the size of adipose tissues & energy balance
Where is leptin synthesized?
adipocytes
how is leptin synthesis increased?
insulin, glucocorticoids, & estrogens
What happens when leptin levels are low
starvation, [low leptin] -> production of neuropeptide Y from hypothalamus, transported to paraventricular nucleus (PVN) of hypothalamus -> ↑appetite, & ↓ energy expenditure, Temp, reproductive function, and ↑ parasympathetic activity
What happens when leptin levels are high?
[↑leptin] -> opposite set of reactions ↓NPY -> activates POMC pathway-> mediated by MSH binding to MC4-R -> initiate reactions, ↓appetite, ↑energy expenditure, and sympathetic activity
Leptin levels in obese individuals are?
High leptin levels in obese individuals -> due to resistance or defect in leptin receptors
What transcription factor regulates conversion of preadipocytes to adipocytes?
peroxisome proliferator-activated receptor-γ (PPAR-γ2)
what are thiazolidinadiones?
hypoglycemic agent given to diabetics, synthetic ligands for PPAR-γ2-> activates PPAR-γ2 -> adipogenesis, increase insulin sensitivity
BMI overweight and obese
BMI- 25-29.9 = overweight
>30= obese
Short term regulators of hunger and satiety are
plasma levels of glu & a.a., cholecystokinin & other hormones
only known appetite stimulating peptide hormone secreted by the stomach
Ghrelin, also stimulates GH secretion
early onset obesity can be characterized by
Congenital human leptin deficiency, defective leptin receptor gene-> high plasma leptin d/t defective leptin metabolism or leptin resistance
Prader-Willi syndrome:
the most prevalent form of dysmorphic genetic obesity, PWS is caused by absence of the paternally derived PWS/AS region of chromosome 15
Angelman syndrome:
inherited chromosome 15 deletions from mother
Obesity treatments
behavioral modifications, dietary restrictions, exercise, pharmacotherapy (sibutramine, orlistat), & surgical intervention (bariatric surgery)