Lecture 4 Flashcards
(22 cards)
What about the definition of obesity has changed?
Instead of just measuring Fat mass, we also want to measure health status
When looking at Obesity, Chronic Disease and Physical Activity how do they influence one another?
It is unclear which triggers the other but what is clear is that they all influence one another (would draw them as a triangle)
What is the difference between T1DM and T2DM?
Type 1 is an autoimmune disease where the beta-cells which produce insulin are destroyed causing a lack of insulin.
Type 2 is insulin resistance where the tissues can no longer take up glycogen so they become resistant to insulin
What is more common T2DM or T1DM?
T2DM is more common, 90% of diabetes is type 2
What percentage of the population has diabetes and what percentage of obese/overweight have type 2?
Total Population: 5-10% have T2DM
Obese/overweight: 10-20% have T2DM
What is Normal Fasting Glucose level and what level of Normal fasting glucose indicates that you have Diabetes
Normal: 5 mmol/L
Diabetic: 7 mmol/L
What number for the oral glucose tolerance test (OGTT) is associated with diabetes?
11.1 mmol/L
What is a proposed explanation for T2DM?
- Too many FFA’s floating around!
- the muscle becomes insulin resistant it will not take up anymore blood glucose
- the liver continues to process more blood glucose since insulin is heightened.
- pancreas initially increases insulin production but eventually fails (can’t keep up with muscle resistance and liver secretion) and begins to decrease insulin secretion
- Leads to hyperglycemia
How much of the total population has hypertension? Obese population?
Total:20-25%
Ob: 40%
What is adiponectin?
- secreted by adipocytes
- increases insulin sensitivity
- Decrease BW = Increase Adiponectin = increase insulin sensitivity
- Adiponectin is good and helps to decrease hypertension
What is Dyslipidemia?
- Obesity related phenotype, occurs in the LIVER
- Increase triglycerides
- Decrease HDL-C (good cholesterol)
- ALTERED LDL’s (not heightened) to be dense
With Dyslipidemia what occurs with LDL’s as insulin resistance increases? HDL-C? Tryglycerides?
The LDL’s alter, the total number does not change but the particles become smaller and more dense.
- HDL decrease
- Triglycerides increase
What is metabolic syndrome?
Combination of any 3 of the following symptoms:
- Elevated waist circumference
- Elevated Triglycerides
- Reduced HDLC
- Elevated BP
- Elevated Fasting plasma glucose (diabetes?)
If you had metabolic syndrome where would you be placed on the EOSS?
Stage 1 obesity, symptoms are still subclinical
What are the Pro’s and Con’s of metabolic syndrome?
Pro: Definition helps determine values, levels stated are not so advanced that treatment is complicated, risk factors are not clinical yet (thats good) but meaningful enough to help
Con: Definition is confusing, should exercise and eat well regardless, definition suits pharmaceutical advantage
Where do FFA come from?
FFA are secreted after eating
When do you want FFA’s to be secreted?
During exercise or fasting so that they can be utilized, but when in fed state the liver is overloaded which leads to too much glucose/glucagon production
What is ectopic?
Congenital displacement or abnormal positioning of an organ or part (storing fat in the wrong places ex visceral fat)
What is insulin resistance?
Condition where the natural hormone insulin is less effective at lowing glucose
What are the mechanisms of Insulin resistance?
- FFA and Ectopic fat (overload liver)
- Inflammation (of adipocytes)
- adipokinescytokines produced by adipose tissue
- Adiponetic (junk from fat cells)
What happens to leptin with short sleep? what happens to Ghrelin with short sleep?
Leptin: Decreases
Ghrelin: Increases
What is cortisol and what does it effect?
Cortisol is the stress hormone and is the most potent glucocorticoid because it effects glucose
