Endocrine - Obesity and Metabolic Syndrome

Question 1

How do fat cells change in size and number as intake exceeds expenditure? Expenditure exceeds intake?

Answer 1

Grow in number and size with increased consumption

Decease in size only as expenditure exceeds intake

Question 2

What is the roleof LPL?

Answer 2

Lipoprotein lipase removes triglycerides from blood to adipose tissue and muscle

Question 3

How does LPL activity change in an obese person compared to a normal person?

Answer 3

Obese LPL activity is increased in adipose tissue

Question 4

What genetic disorder is characterized by excessive appetite, massive obesity, short stature, and mental retardation? What two hormones are increased?

Answer 4

Prader Willi

GH and ghrelin

Question 5

What gene is expressed in adipose tissue that codes for leptin? What does leptin do?

Answer 5

Ob gene

Leptin suppresses appetite

Question 6

What can be given as a injection to reduce weight in humans by increasing satiation?

Answer 6

Leptin injections

Question 7

Where is ghelin secreted from?

Answer 7

The stomach

Question 8

What can influence ghrelin’s response to a meal?

Answer 8

Mindset - if you think you are eating a low calorie meal, you may still be hungry, regardless if it was really low calorie or not

Question 9

How does lack of sleep change ghrelin levels?

Answer 9

Increases ghrelin

Decreases leptin

Question 10

How does white fat differ from brown fat?

Answer 10

White - stores fat to use for energy later, oxidation releases energy as ATP and heat
Brown - releases stored energy as heat to defend against cold and obesity. Oxidation uncoupled from ATP formation

Question 11

What is brite adipocytes? What can trigger their formation?

Answer 11

White cells that have undergone browning

Physical activity can trigger this

Question 12

What does $.67 meal upgrade really get you?

Answer 12

400 kcal
36 grams extra body fat
$6 increase in health-care cost

Question 13

What BMI and waist circumference indicate overweight/obesity in men and women?

Answer 13

Over weight - BMI 25-29.9
Obese - BMI 30+
Waist: M>40in, F>35in

Question 14

What are the 5 requirements for metabolic syndrome?

Answer 14

Central obesity
Insulin resistance: glucose fasting >100
High BP: >130/85
High triglycerides >150 mg/dL
Low HDL: <40 males, <50 females

Question 15

What are 4 comorbities of overweight/obesity?

Answer 15

Fatty liver
Gallstones
PCOS
Breathing problems during sleep

Question 16

What is adiponectin? What level is seen in metabolic syndrome?

Answer 16

Anti-inflammatory

Reduced in metabolic syndrome

Question 17

What is resistin? What does it do?

Answer 17

A protein adipokine

Promotes insulin resistance in the liver

Question 18

What is the MOA of Orlistat (Alli, Xenical)?

Answer 18

Inhibits pancreatic lipase in GI, blocking digestion and absorption of dietary fat

Question 19

What three things does metformin do?

Answer 19

Reduces gluconeogenesis
Decrease intestinal glucose absorption
Improves insulin sensitivity

Question 20

What is the MOA of thiazolidinediones?

Answer 20

Improves insulin sensitivity

Question 21

What do statins, bile acid sequestrants, ezetimibe all do?

Answer 21

Reduce LDL

Question 22

What drug class decreases plasma triglycerides? What natural product does this also?

Answer 22

Fibrates

Omega-3 fatty acids

Question 23

What drug decreases tryglycerides and LDL and increases HDL?

Answer 23

Niacin