KIN 404 1 Flashcards
(137 cards)
What is diabetes mellitus?
A metabolic disorder characterized by the presence of hyperglycemia due to defective insulin secretion, insulin action or both. The chronic hyperglycemia of diabetes is associated with significant long-term damage, dysfunction and failure of various organs – especially the kidneys, eyes, nerves, heart and blood vessels
Characeristics of type I diabetes
Absolute deficiency of insulin secretion due to autoimmuno destruction of beta-cells of the pancreas. Also called insulin-dependent diabetes/juvenile onset diabets. Account for only 5-10% of those with diabetes/
Characteristics of Type II diabetes
A combination of insulin resistance and relative insulin deficiency. Also called non-insulin-dependent diabetes/adult onset diabetes. No auto-immune destruction of beta-cells. Patients usually obese and particularly in the abdominal region
What is metabolic syndrome?
A clustering of chronic disease risk factors, including abdominal obesity, dyslipidemia (elevated TGs and/or low levels of HDL-C), elevated blood pressure and elevated fasting glucose
MetS is associated with substantially elevated risk of…
type 2 diabetes (5-fold) and of atherosclerotic cardiovascular disease (2-3 fold)
Neuronal population within the arcuate nucleus (ARC) of the hypothalamus that stimulate food intake?
Neurons that co-express neuropeptide Y (NPY) and agouti related peptide (AgRP) stimulate appetite
Neuronal population within the acruate nucleus (ARC) of the hypothalamus that suppress feeding?
Neurons co-expressing pro-opiomelanocortin (POMC) and cocaine-amphetamine-regulated transcript (CART) supress feeding
How do POMC neurons stimulate appetite?
alpha-melanocyte-stimulating hormone is produced and this binds to melanocortin-4 receptors in the paraventricular nucleus to suppress food intake
What is the orexigenic effect of NPY mediated by?
Stimulation of hypothalamic Y1R and Y5R in addition to local inhibition of POMC neurons in the ARC
In relation to food intake, what does BDNF do?
suppresses food intake
What is PYY, and what does it do?
Peptide tyrosine tyrosine (PYY)…acts in hypothalamus to decrease food intake. It also increases energy expenditure and delays gastric emptying in mice
What is PP, and what does it do?
Pancreatic Polypeptide…thought to reduce food intake directly through Y4R in the brainstem and hypothalamus
What is GLP-1, and what does it do?
Glucagon-like-peptide-1. …has a potent incretin effect, reduces food intake, supresses glucagon secretion and delays gastric emptying
What is GLP-2, and what does it do?
Glucagon-like-peptide-2…no effect on food intake, but stimulates crypt cell proliferation
What is oxyntomoduline, and what does it do?
Reduces food intake and increases energy expenditure
What is glucagon, and what does it do?
Produced by the alpha-cells of the pancreatic islets…reduces food intake and meal size in addition to reducing body weight gain
What is ghrelin, and what does it do?
It’s the only known orexigenic gut hormone…increases food intake and body weight with a reduction in fat utilization in rodents
What is CCK, and what does it do?
Cholecystokinin, first gut hormone shown to modualte food intake. May act to reduce food intake.
What is amylin, and what does it do?
Stored and released along with insulin in response to food intake. Reduces food intake and body weight and improves glycemic control and causes weight loss in patients with T2DM
What is leptin, and what does it do?
Adipokine that exerts its anorectic effect via the ARC. It inhibits NPY/AgRP neurons and activates POMC/CART neurons, resulting in reduced food intake and increased energy expenditure.
How does gastric bypass surgery affect ghrelin levels differently than diet induced weight loss?
Gastric bypass actually lowers ghrelin levels, whereas 24-hour diet induced weight loss actually increases ghrelin levels (making weight gain easier)
How does hypothalamic ciliary neurotrophic factor effect food intake?
Reduces AMPK signaling, and its effects are maintained in diet-induced obesity
A woman with a BMI of 24 would be classidied _______ and a man with a BMI of 29 would be ________
normal, overweight
An unnamed kin prof has undergone a # of tests in your clinic which have produced the following results: a fasting hyperinsulinemia in the highest quartile, normal blood glucose following an OGTT, BMI of 33, low fasting blood glucose, and high plasma TGs. What is your diagnosis?
Insulin resistance and obesity (not metabolic syndrome because he only has 1/4 risk factors, with elevated TGs to be the only risk factor)