E2 Obesity & Metabolic Syndrome

Question 1

Obesity is most prevalent in

Answer 1

non-hispanic black population followed by hispanics and non-hispanic whites

Question 2

Obesity has the lowest prevalence in

Answer 2

Asians

Question 3

What age range is obesity highest in?

Answer 3

Age 40-60

Question 4

Adipose tissue

Answer 4

-Provides insulation and mechanical support for the body
-Secretes hormone-like molecules: Adipokines

Question 5

Adipokines

Answer 5

immune cell function & bodys main energy reserve

Question 6

Adipocytes

Answer 6

Fat-storing cells
-store fat as triglycerides
-can increase in number and hypertrophy to increase fat mass

Question 7

Major areas for fat storage:

Answer 7

1. Subcutaneous or peripheral adipose tissue (subdermal tissue)
2. Visceral adipose tissue (Gets btwn organs)

Question 8

What is a healthier type of fat storage that causes less inflammation?

Answer 8

Peripheral fat

Question 9

Android vs gynoid obesity

Answer 9

Android: Apple, Men, greater risk of heart disease, hypertension, diabetes, and stroke

Gynoid: Pear, Women

Question 10

What waist circumference causes greater risk of coronary artery disease

Answer 10

Women > 35in
Men >40 in

Question 11

Adipose tissue is an ___ organ

Answer 11

Endocrine

Secrete Adipokines

Question 12

What are the 5 adipokines?

Answer 12

1. Leptin
2. Angiopoietin-related protein
3. Angiotensinogen
4. Retinol-binding protein
5. IL-6, TNF-alpha

Question 13

Angiopoietin-related protein

Answer 13

Insulin resistance & inflammation

Question 14

Angiotensinogen

Answer 14

-Precursor to A2
-Secreted from fat cells to help regulate BP
-Inflammation
-Insulin resistance in lipogenesis

Question 15

Retinol-binding protein

Answer 15

insulin resistance in muscle

Question 16

IL-6, TNF-alpha

Answer 16

Biomarkers related to inflammation
-CRP & inflammatory markers

Question 17

Adipokines are cell signaling proteins that are necessary for life and good i general but too many or too much we associate with

Answer 17

obesity and causes problems

Question 18

Adiponectin

Answer 18

“Good” Adipokines
-Inverse relationship with the fat content in the body

Question 19

Increased fat content in body = _____ adiponectin produced

Answer 19

decreased

Question 20

What does adiponectin do?

Answer 20

1. Enhances cell sensitivity to insulin
2. Anti-inflammatory effects
3. Protects against arteriosclerosis

Question 21

Leptin

Answer 21

“Good” adipokine
-Tells body it is fulls (Satiety)
-Works with adiponectin to increase sensitivity to insulin, reduce triglycerides, and inhibit fat accumulation

Question 22

Increased fat = _____ leptin

Answer 22

increased

Question 23

Obese individuals becomes

Answer 23

Leptin resistant

-Overeat
-Excessive weight gain
-Hyperglycemia
-Hyperinsulinemia

Question 24

A person is considered Obese if there BMI is

Answer 24

> 30kg/m2

Question 25

Obesity is the _____ leading cause of death

Answer 25

5th

Question 26

Genetics and obesity

Answer 26

-Polygenic condition -Several genetic mutations associated (leptin gene) -Obesogens

Question 27

What is obesogens?

Answer 27

Chemicals that can contribute to the development of obesity (must have a combination of lifestyle and environment factors involved)

Question 28

Risk factors for obesity

Answer 28

-Excess caloric intake -Sedentary lifestyle -Low socioeconomic status (poverty) -Cultural aspects of eating -Age (40-60) -Smoking cessation -Genetics -Secondary disorders (Cushings, genetic disorders)

Question 29

BMI =

Answer 29

Weight (kgs) / height (m)^2 [Weight (pounds)/ height (inches) ^2 ] x 703

Question 30

What BMI is considered severe (morbidly) obese

Answer 30

>40

Question 31

Ghrelin Action

Answer 31

-Stimulates hunger -Controls gastric motility & acid secretion -Stimulates growth hormone

Question 32

Ghrelin is ____ when obese

Answer 32

decreased

Question 33

Glucagon-like peptide (GLP-1)

Answer 33

-Stimulates insulin secretion -Inhibits glucagon release -Slows gastric emptying -Increase satiety

Question 34

Glucagon-like peptide is _____ when obese

Answer 34

decreased

Question 35

Peptide YY Action

Answer 35

-reduce appetite -inhibit gastric motility -Increase energy expenditure

Question 36

Peptide YY is _____ when obese

Answer 36

decreased

Question 37

Cholecystokinin (CCK) Action

Answer 37

-Increase satiety -Decrease food intake -Stimulate gallbladder contraction -Pancreatic enzyme release -Slow gastric emtying

Question 38

Cholecystokinin (CCK) is ____ when obese

Answer 38

decreased (some say increased)

Question 39

Obese patients are often in chronic, _______

Answer 39

low-grade inflammatory state

Question 40

Macrophages, lymphocytes, neutrophils, and mast cells infiltrate adipocytes which cause release of ______. The systemic effects of these, coupled with other endocrine responses in obesity, results in _______

Answer 40

Cytokines insulin resistance, metabolic syndrome, and health issues associated with obesity

Question 41

MOA of orlistat

Answer 41

binds to gastric and pancreatic enzymes and blocks these enzymes, reduces fat absorption by 30%

Question 42

Side effects of Orlistat

Answer 42

-Black box: Liver injury -GI symptoms: oily spotting, flatulence, fecal incontinence (reduce by reducing fat intake to less than 30%) -Decrease vitamin conentrations (MUST take multi-vitamin)

Question 43

Teaching point for orlistat

Answer 43

Must take for 3 months to start seeing effects OTC

Question 44

Obesity drug therapy considerations for all

Answer 44

1. Must use with diet & exercise 2. Beset for people with a high health risk (BMI >30 04 BMI >27 w/ other risk factors) 3. Most doctors will not prescribe unless patients have tried diet and exercise alone for 6 months 4. Limited effectiveness 5. Long-term treatment 6. Rebound effect

Question 45

What are the 3 types of bariatric surgeries?

Answer 45

Liposuction Gastric Bypass Gastric Banding

Question 46

Metabolic syndrome is characterized by

Answer 46

atleast 3 risk factors 1. Waist circumference (>40 men or >35 female) 2. Triglycerides (>150) 3. HDL cholesterol (<40 men or >50 female) 4. BP (>120 Systolic or >85 diastolic) 5. Fasting blood sugar (>110)

Question 47

What do we do for metabolic syndrome?

Answer 47

Treat the conditions individually -High BP -> BP meds -High triglycerides (anti-lipemic agents) -High Blood glucose (diabetes management) Most important: -Weight loss -Exercise -Healthy diet -Smoking cessation