Flashcards in Lecture 10 - Managing, Preventing Metabolic Syndrome Deck (24):
What is Orlistat?
A liase inhibitor.
Causes steatorrhoea if lipids are eaten
Outcomes of experiment comparing gastric banding with current medical treatment for obesity
At outset of experiment, both medical and surgical groups had 38% metabolic syndrome prevalence.
After experiment, 24% of medical had MS, only 3% of surgical had MS
Therefore, it is possible to reverse metabolic syndrome with weight loss
Why can't the basis for metabolic syndrome be purely genetic?
Genes don't mutate fast enough to explain the rapid rise in obesity prevalence
Experiment testing ability to keep lost weight off
Mice divided into groups.
One group fed high energy diet (8% corn syrup).
Other group fed low energy Chow diet.
HE diet group split into two groups after a few weeks. One continued on HE diet, the other switched to calorie-controlled chow.
Chow group allowed to eat as much chow as they wanted. Returned to same weight as mice on HE diet.
What might be a causative agent for obesity?
Effect of starvation in first trimester
Child develops obesity, metabolic syndrome
Very-low energy diet
800 calories per day.
One meal per day, with oil and vitamin supplements.
Issue with very-low calorie diet
Weight gained back after 5 years
Neural weight regulation
In the hypothalamus, arcurate nucleus.
Within arcurate nucleus are two nerve types:
1) Neuropeptide Y nerves. Make glutein-related peptide, neuropeptide Y. These promote hunger.
2) POMC nerves. Release POMC, which is cleaved to MSH. MSH, CART inhibit hunger.
How is the arcurate nucleus of the hypothalamus regulated?
Hormones in the blood.
One promotes hunger (ghrelin, from empty stomach)
Small intestine releases cholecystokinin, glucagon-like peptide-1, PYY.
Adipose tissue releases leptin.
Pancreas releases amylin, pancreatic polypeptide, insulin.
These suppress hunger
Test on hormone levels in blood with dieting
Blood sample taken pre-prandially, then every four hours post-prandially.
After diet, ghrelin levels increased.
PYY, CCK, amylin, leptin levels decreased.
Levels only returned to baseline with weight gain back to obese level.
Drug combination that can reduce, and keep off weight
Duromine (15mg), topamax (25mg)
Issues with duromine/topamax therapy
Types of stomach banding
1) Gastric banding
2) Sleeve gastrectomy
How does gastric banding reduce hunger?
Bolus of food pushes against band around top of stomach, sends signal via vagus nerve that stomach is full
How does sleeve gastrectomy reduce hunger?
Removes part of stomach that produces ghrelin
Drug that can slow absorption of carbohydrates
Effect of glucagon-like peptide-1
Suppresses glucagon, hunger.
Increases insulin levels
Inhibitor of glucagon-like peptide-1
Drug that increases renal excretion of glucose
Increases renal excretion of glucose
Why are statins not often recommended for people with metabolic syndrome?
Typical dyslipidaemia for MS is high TAGs, low HDL.
Statins would reduce HDL levels
Drug that reduces uric acid levels in blood