Lecture 26/27: Obesity Flashcards by Katlyn Heneghan

How do you calculate BMI?

BMI = 703 * (weight) / (height)^2

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____ Syndrome precedes the development of T2DM in obese patients

Metabolic Syndrome

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True or False: MetS and T2DM are associated with obesity and sedentary lifestyle

True

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True or False: T2DM is associated with insulin resistance

True

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___, ____, and ____ are important for control of blood glucose

Insulin, glucagon, and epinephrine

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True or False: Exercise, diet, and behavioral changes can reverse MetS and T2DM

True

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What is the treatment for obesity of the cause is metabolic syndrome?

Weight loss

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____ _____ are metabolic abnormalities associated with obesity (hyperglycemia, CVD, hyperinsulinemia, insulin resistance)

Metabolic Syndrome

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Ectopic accumulation of TAG in liver can cause _____ disease

non-alcoholic liver disease
(higher risk of liver cancer/cirrhosis)

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What drug is an oral anti-diabetes medication that inhibits gluconeogenesis?

Metformin

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HBA1C that is greater than 6.5 means ___

diabetes

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What should one’s FBG/RBG be for a diagnosis of DM?

FBG: more than 125
RBG: more than 200

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Stress can trigger hyperglycemia in DM patients through ____

epinephrine

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Insulin decrease what four processes?

-Gluconeogenesis
-Ketogenesis
-Lipolysis
-Glyogenolysis

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Glucagon/Epi increase what four processes?

-Gluconeogenesis
-Ketogenesis
-Lipolysis
-Glyogenolysis

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Higher levels of ___ are required to control blood glucose in insulin-resistant, obese person

insulin

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Blood glucose is kept within the same narrow __ through the day in both normal weight and obese individuals

range

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When pancreas is unable to make more insulin, ____ will arise

T2DM

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___ is hormone made in alpha cells of the pancreas

Glucagon

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Secretion of glucagon is stimulated by low ___ levels and ___

glucose; epinephrine

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___ is a catabolic hormone made in alpha cells of the pancreas that signals the fast state

Glucagon

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Glucagon stimulates ___, ___, and ___ in the liver, as well as ___ in the adipose tissue

liver: glycogenolysis; gluconeogenesis; ketogenesis

adipose: lipolysis

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Epinephrine stimulates what three processes?

Gluconeogenesis
Glycogenolysis
Lipolysis

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What hormone is made in the beta cells of the pancreas and is secreted in response to ingestion of glucose?

Insulin

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What anabolic hormone signals the fed state?

Insulin

True or False: Glucagon stimulates TAG synthesis in adipose tissue

False - insulin stimulates TAG synthesis in adipose tissue

True or False: Insulin stimulates transport of glucose into muscles and stimulates adipose tissue (GLUT4)

True

Insulin *inhibits* _____ and _____ in the liver and ___ in adipose tissue

Liver: Gluconeogenesis/ketogenesis Adipose: Lipolysis

What three processes does insulin stimulate in the liver?

1) Glycogenesis 2) Lipogenesis 3) Protein synthesis

Insufficient insulin production or insulin resistance causes ____

hyperglycemia

True or False: Not all obese individuals develop T2DM and not all T2DM patients are obese

True

What two hormones control glucose homeostasis?

Insulin Glucagon

DM is a disease characterized by _____

hyperglycemia

What is the cure for Metabolic Syndrome?

Diet, exercise, behavior modification

What is the cause of MetS?

Insulin resistance induced by obesity and sedentary lifestyle (and genetics)

____ are metabolic abnormalities associated with obesity that predisposes individuals to CVS and T2Dm

Metabolic Syndrome

How is MetS diagnosed?

1) waist circumference - more than 40" for men and more than 35" for women 2) hyperglycemia 3) dyslipidemia (high TAG, low HDL) 4) HTN

____ is a pathological state characterized by the excessive accumulation of body fat in a person, which puts them at higher risk of developing chronic illnesses (T2DM or CVD)

Obesity

BMI greater than 25 signifies that one is ___ while BMI that is greater than 30 signifies ___

Overweight; obesity

The idea that body weight returns to its initial starting point after either experimental over/underfeeding describes what idea?

Set Point Hypothesis

___ , a DNA demethylase, was the first gene to be linked to high BMI

FTO gene

True or False: Mutations and polymorphisms are associated with obesity

False - polymorphisms are associated with obesity (but not mutations)

____is a hormones that signals satiety and suppresses appetite

Leptin

Mutations in what hormones or hormone receptor results in early onset childhood obesity?

Leptin or leptin hormones

~5% of early onset childhood obesity cases are ______

monogenic

Where is leptin made? Do obese people have it?

1) Made: adipose tissue 2) Obese people have it? Yes - in excess! Have leptin resistance

Why can leptin not be use to treat common obesity?

Leptin resistance is so strong that there is no effect

Causes of common obesity?

Multifactorial and polygenic (genetic, environment, and behavioral components)

Genetics plays an important in the development of obesity. It's likely that genetics ___ individuals to obesity and if behavior and environment are appropriate, then this genetically pre-disposed individual will develop obesity

pre-disposes

Two types of fat disposition?

Android and Gynoid

What type of fat deposition tissue is more metabolically active, has high lipolysis rates, promotes release of FFA/leptin/other cytokines into portal vein?

Android

What type of fat deposition tissue has larger adipocytes (store TAG better), lower rates of lipolysis, and FFA are release into general circulation/absorbed by muscle tissue?

Gynoid

Which type of fat deposition is associated with lower body obesity and lower risk for developing chronic conditions?

Gynoid

Adipose tissues behave like an organ by releasing ___

Adipokines

True or False: Adipokines affect appetite, satiety, energy expenditure, fat distribution, insulin sensitivity, and inflammation

True

Modest weight gain or loss in a non-obese person mainly affects the __, but not the number, of adipocytes

size (hypertrophy)

When adipocytes reach their max size, further weight gain is achieved by recruitment and proliferation of new ______

preadipocytes

Weight loss occurs mainly by a decrease in adipose ___

size (hypertrophy)

How does overnutrition affect number and size of adipocytes?

Overnutrition increase number and size of adipocytes

True or False: Obese individuals do not have insulin

False - they have insulin at higher levels and develop resistance

___ is a hormone that signals energy storage and suppresses appetite

Insulin

True or False: Insulin treatment can result in weight gain

True

___ is an appetite-stimulating hormone ("hunger hormone") that signals hunger. It comes from the stomach and GI and regulates energy expenditure and thermogenesis.

Ghrelin

Do obese individuals have ghrelin?

Yes - lower levels

____ is a adipokine with various benefits in terms of glucose metabolism, blood pressure, serum lipids, and body weight. It is located in adipocytes.

Adiponectin

Do obese people have adiponectin?

Yes - lower levels

Leptin is made by adipocytes and acts on ___, a brain structure

hypothalamus

How does leptin signal satiety?

Inhibits orexigenic signaling and stimulates anorexigenic signaling

___ and ____ inhibit orexigenic neurons

POMC; CART

Circulating leptin levels correlate with ____mass

fat mass

Obese people typically experience ____ resistance

leptin

True or False: Leptin decreases AMPK activity

True

Adiponectin is made almost exclusively by ___

adipocytes

True or False: Higher levels of adiponectin in lean people are correlated with better lipid profiles, lower blood pressure, and improved insulin sensitivity

True

Treatment of obesity with exogenous ___ has deleterious effects on bone density

adiponectin

Dietary restriction may cause decrease in metabolic rate, but must be implemented with ____ changes

behavioral

Glucagon-like peptide 1 (incretins) is a T2DM medication. It is secreted by the __ and slows ____ empty. It increase glucose control and suppresses hunger.

gut; stomach

True or False: Semaglutide is administered once a week, allows for better glucose control, lower blood pressure, and lower markers for inflammation

True

True or False: Gastric bypass surgery, sleeve gastrectomy, and adjustable gastric band may cause decrease in metabolic rate and must be implemented with behavioral changes

True