Lecture 4 - carbs Flashcards

1
Q

what are carbohydrates

A
  • source of energy
    o diet
    o endogenous
    ▪ stored form of energy
  • structural components
    o cell membrane
    o RNA and DNA
    o cell walls of bacteria and plants
  • Glucose
    o Major clinically significant carbohydrate
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2
Q

4 structural properties may be used to classify carbohydrates:

A
  1. The size of the base carbon chain (number of carbons in the molecule)
  2. Location of the CO group
  3. Number of sugar units
  4. The stereochemistry \
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3
Q

C L A S S I F I C A T I O N ( C A R B O N N U M B E R )

A

basic formula where n is the number of carbon

3-triose- glyceraldehyde
dihydroxyacetone
4- tetrose - erythrose
5-pentose - rib or deoxyribose
6-hexose- glucose galactose
7-heptose-sedoheptulose

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4
Q

A L D O - HEX - O S E F A M I L Y

A
  • ALDO
    – aldehyde group where the carbonyl group is found on the end C so C=O on terminal C
    -carbs from aldehydes are called aldoses
  • HEX
    – 6 carbons
  • OSE
    – carbohydrate
  • 3 naturally occurring forms
    – D-glucose
    – D-galactose
    – D-mannose
  • Chemical formula: C6H12O6
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5
Q

THE K E T O - HEX - O S E F A M I L Y

A
  • KETO
    – ketone group where the carbonyl group C=O is found on a C that is in the middle
    -carbs from ketones is called ketoses
  • HEX
    – 6 carbons
  • OSE
    – carbohydrate
  • 1 naturally occurring form
    – D-fructose
  • Chemical formula: C6H12O6
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6
Q

what are isomers

A
  • Isomers
    o compounds with the same molecular formula but different structures
    ▪ identical number of atoms and atomic elements
  • difference in configuration around one specific C atom
    o glucose, fructose, galactose, mannose C6H12O6 (epimer)
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7
Q

what is a Stereoisomers

A

o compounds identical in composition and differ only in spatial configuration
* D- and L- configuration
D- -OH on the right
L- -OH on the left
o most sugars in humans are of the D form with OH on the right

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8
Q

enantiomers

A

Non-superimposable mirror images are called enantiomers
(optical isomers)
– they have a “chiral” carbon

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9
Q

what is a M O N O S A C C H A R I D E S

A

simple sugar
* a single polyhydroxy aldehyde or ketone unit that cannot be
hydrolyzed to a simpler form
–c=o and -oh groups form a ring structure (with the chiral carbon) through intramolecular hemiacetal or hemiketal linkage

-when an aldehyde and alcohol come together a ring structure is formed through INTRAMOLECULAR HEMIACETAL OR HEMIKETAL LINKAGES

in a HEMIACETAL FORM (alde+alco) - THE HYDROXYL forms a bridge between c1 and c5 and the carbonyl forms alcohol

makes a carboxylic acid OH-C-OR
the anomeric carbon is the c attached to C=O

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10
Q

carbonyl

A

c=O

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11
Q

carboxyl

A

COOH

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12
Q

ketone and alcohol reaction - hemiketal

A

It is the =O (carbonyl group) that reacts with the –OH (alcohol or
“hydroxyl” group)

The H+ from the alcohol group moves positions to form a new OH and the remaining O (from the alcohol) forms the “bridge

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13
Q

fructose

A

❑ Carbonyl group (at C2 - anomeric carbon) and chiral carbon (at C5) form the hemiketal linkage to form the ring structure
❑ Hemiketal linkage: between the carbonyl group (-C=O) and the chiral carbon
❑ Chiral carbon is the highest numbered carbon with 4 different “groups

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14
Q

A and B isomers

A

Two chiral ring forms are possible
o MUTAROTATION alters the equilibrium between the three forms
* spontaneous opening and closing of the hemiacetal or hemiketal structure
* carbon about which this rotation occurs is the anomeric carbon
o  (-OH group down) and  (-OH group up) anomers

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15
Q

chemical properties of monosacc

A
  • some carbohydrates are reducing substances
    – free aldehyde or ketone group required
  • the anomeric carbon must remain unaltered
  • the ring must be able to open up!

– Cu2+ or Fe3+ ions can be reduced by reducing sugars
* the resulting oxide is red
* lab application:
o Urinalysis: clinitest tablets with Benedicts reagent /clinitest (Copper 2 Sulphate reduced to copper 1 oxide)
if testing water or egg white the result will be blue or negative but if testing glucose or other sugars the test will be red or post

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16
Q

what are disacc

A

-two monosaccharides joined covalently by a glycosidic bond,
with a formation of h2o
o aldehyde or ketone group of one monosaccharide joins to alcohol or aldehyde or ketone group of another
o Cx(H2O)y

  • physiologically important disaccharides
    maltose = glucose + glucose
    lactose = glucose + galactose
    sucrose = glucose + fructose
17
Q

how does disaccharide act as a reducing sugar

A

-can be a reducing sugar only if there is a free aldehyde or ketone group

  • When the anomeric carbon has a hydroxyl group available to participate, it is considered “reducing”
  • If the anomeric carbon is involved in the linkage, then it cannot be a reducing sugar

so if the anomeric carbon is axial or equatorial alone thats okay but if its joined like \o/ then no

18
Q

what happens when a sugar is reducing

A
  • it reduces another compound and is oxidized i.e the carbonyl group is oxidized to a carboxyl group
  • All monosacccharides are reducing sugars because they are capable of opening up the ring form
  • The reducing end of the disaccharide is the monosaccharide with a free anomeric carbon that is not involved in a glycosidic bond and is capable of converting to the open chain form.
19
Q

how are disaccharides hydrolyzed

A

intestinally by disaccharidases like maltASE, lactase, sucrase

o monosaccharides are absorbed and transported to liver

o the only CHO to be directly used for energy or stored as glycogen is glucose

  • fructose and galactose cannot be used until they are converted to glucose
20
Q

what is starch

A

polysaccharides
o Storage form of carbohydrate in plants

o Composed of two polymers:
* Amylose
▪ linear chain of alpha-1,4-linked glucose units more than a 1000 glucose will make an amylose

  • Amylopectin
    ▪ highly branched chain: with alpha 1-4 and alpha1-6 links
    ▪ up to 1 million glucose units
21
Q

what is Glycogen

A

polysaccharides
o animal storage form of carbohydrate
* liver (hepatocytes)
* muscle
o similar to amylopectin, more highly branched (every 8-12 units)
* enhanced solubility

22
Q

what is Cellulose

A

polysaccharides

structural polysaccharide in plants
o high tensile strength from beta-1,4 linkages look like ////

o humans do not have cellulases
-purest form of cellulose is in
cotton

23
Q

what are two major hormones that help maintain glucose levels between 4.1-5.6 mmol/l

A
  • Insulin:
    ▪ Increases glycogenesis and glycolysis
    ▪ Increases lipogenesis
    ▪ Decreases glycogenolysis
  • Glucagon:
    ▪ Increases glycogenolysis
    ▪ Increases gluconeogenesis

o Regulatory hormones:
* Insulin, Glucagon, Epinephrine, Cortisol, Growth hormone, ACTH
o Disorders of carbohydrate metabolism:
* Hyperglycemia (high blood glucose), Hypoglycemia (low blood glucose)

24
Q

Glycogenesis

A

pathway in glucose metabolism

  • converts glucose to glycogen for storage
  • occurs when blood glucose is high resulting in a lowered blood glucose
  • mainly in liver hepatocytes, influenced by insulin
25
Q

GlycogenoLYSIS

A

pathway in glucose metabolism

breakdown of glycogen to glucose
* occurs when blood glucose is LOW, results in a raised blood glucose

  • mainly in liver, some in muscles, influenced by glucagon and other hormones
26
Q

GlucoNEOgenesis

A

pathway in glucose metabolism
* formation of glucose from non-CHO sources (glycerol, amino acids, lactate)
* occurs when blood glucose is low, results in a raised blood glucose
-it is significant in hypoglycemic states

27
Q

o Glycolysis and Lipogenesis

A

pathways in glucose metabolism

o Glycolysis
* Metabolism of glucose into pyruvate or lactate (energy production)

o Lipogenesis
* Conversion of carbohydrates to fatty acids

28
Q

what monosaccharides are of clinical significance

A

Glucose and galactose

o Hyperglycemia (increased blood glucose) determines a diagnosis of diabetes mellitus (DM)

  • Diabetes mellitus
    ▪ Glucose is underutilized
    ▪ Insulin secretion is impaired or there is tissue insensitivity to its action (or both)
    ▪ Type 1
    ▪ Type 2
    ▪ Gestational diabetes mellitus
29
Q

what is type 1 diabetes

A

-diagnosed in childhood
* ABOSULTE insulin deficiency - autoimmune destruction of the insulin-secreting beta cells of the pancreas

30
Q

what is type 2 diabetes

A

appears in adulthood (most common)
* insulin deficiency (insulin is present, but the target tissues are not sensitive enough)

  • glucotoxicity - beta cells of the pancreas increasingly unresponsive to glucose
  • environmental factors
31
Q

what is gestational diabetes

A

insulin resistance during pregnancy
* maternal hyperglycemia associated with increased neonatal morbidity and mortality

32
Q

Consequences of untreated prolonged hyperglycemia or DIABETES

A

Retinopathy
o Renal dysfunction
oPeripheral circulatory problems
o Myocardial infarction
oStroke

Lab findings in hyperglycemia
o↑ glucose in (serum and urine)
o↑ osmolality in (serum and urine)
o ketonemia and ketonuria in (serum and urine)
o↓ pH (blood and urine)- acidosis
o↑ urine-specific gravity
o electrolyte imbalance
o↓ insulin

33
Q

what is HYPOglycemia and why is it clinically significant

A

from a monosaccharide - Glucose (decreased blood glucose)
* not as common
* defective glucose counter-regulation by glucagon, epinephrine

  • unawareness in half of long-standing
    Type 1 diabetics
    o no neurogenic warning symptoms
    o decreased epinephrine response
34
Q

consequences of untreated hypoglycemia

A

-severe CNS dysfunction : headache, confusion, dizziness, seizures, loss of
consciousness, death

  • Lab findings in hypoglycemia
    o ↓↓ blood glucose levels
    o ↑ insulin

glucose in infants is lower than in adults
hypogly in infants is transient - prematurity, maternal diabetes, GMD, maternal toxemia

less transient if there are inborn metabolism errors

35
Q

hypoglycemia in infants is called :

A

galactosemia
o congenital enzyme deficiency
o cannot convert galactose to glucose
o “failure to thrive”
o screen at birth
o easy to treat

o Lab findings
* hypoglycemia
* hyperbilirubinemia
* ↑ galactose

causes brain damage, cataracts, jaundice, enlarged liver, kidney damage,

if a galactosemic baby is given milk the unmetabolized milk sugars will build up and damage the liver, eyes, kidneys and brain

36
Q

hypoglycemia in adults causes

A

Decreased glucose production or increased glucose utilization

o drugs - most prevalent cause
o ethanol - inhibits gluconeogenesis
o hepatic disease
o pancreatic tumours
o septicemia
o defective glucose counter regulation

37
Q

what are some disaccharide deficiencies of clinical significance

A

-can lead to forms of glycogen storage disease ie Lactase deficiency
-deficiencies of individual disaccharidases

38
Q

what is Lactase deficiency:

A
  • inability to digest lactose (milk sugar)
  • occurs after weaning
  • unabsorbed lactose is fermented by intestinal bacteria leading to cramps, bloating, gas formation, diarrhea
  • premature infants are more prone to lactose intolerance: the enzyme levels do not increase significantly until the third trimester of pregnancy

o Diagnosis would be lactose intolerance
* lactose tolerance test
* breath hydrogen
* stool acidity
* reducing substances

o Treatment
* avoid lactose-containing foods
* lactase tablets

39
Q

Polysaccharides deficiency clinical significance

A

Glycogen storage disease -deficiency of an enzyme involved in glycogen metabolism - glycogenolysis
* inherited defects will present in childhood
* affects liver and skeletal muscle
o LIVER forms are marked by hepatomegaly and hypoglycemia
o MUSCLE forms have mild symptoms that manifest after strenuous exercise
* no specific treatment or cure
o liver transplant