Metabolic Syndrome Flashcards Preview

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Flashcards in Metabolic Syndrome Deck (21)
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1
Q

inability of insulin to suppress ___ in adipose tissue and ___ by alpha cells in silets results in increased gluconeogenesis

A

failure of insulin to suppress lipolysis in adipose and glucagon secretion by alpha cells

2
Q

NCEP Adult Treaatment Panel III criteria for metabolic syndrome

A

Waist circumference Men >40in women >35in

Low HDL Men <40 women <50

HyperTG >150

HTN 130/85 or on Rx

Impaired fasting glucose or diabetes (100mg or taking Rx)

(3 or more criteria)

2
Q

adiopnectin and leptin ___ with insulin resistance

TNFa and resistin ___ with insulin resistance

A

adiopnectin and leptin decrease with insulin resistance

TNFa and resistin decrease with insulin resistance

3
Q

in MS, ___ from adipose cells that normally controls appetite center of brain is ineffective (resistance)

A

leptin

4
Q

Inflammation hypothesis of insulin resistance

A

enlarged fat cells attract macrophages and secrete inflammatory signals

signals work in muscle cell via JNK kinase

block insulin receptor IRS-1

4
Q

TGs are transfered to LDL and HDL, and VLDL particles gain cholesterol esters by action of ___

this reuslts in increased catabolism of HDL by liver and loss of ___ resulting in low HDL concentration

A

CETP

loss of Apo(A)

5
Q

lipid overload hypothesis

A

enlarged fat cells leak fatty acids >

> DAGS accumalate in muscle cells >

>inhibit insulin signaling thorugh novel PKCs (nPKCs) >

then block IRS-1

6
Q

the enhanced secretion of ____ and ___ produced by adipocytes and monocyte derived macrophages results in mor insulin reisstance and lipolyisis of adipose tissue TG stores to circulating FFAs

A

Il-6 and TNFa

7
Q

____ and ___increase hepatic production of fibrinogen and adipocyte production of Plasminogen activator inhibitor (PAI-1) resulting in a prothrombotic state

A

Cytokines and FFAs

8
Q

Treatment of dyslipidemia in MS

A

LDL: HMG-CoA reductase inhibitors (statins)

Ezetimibe

Hyper TG Fibric acid derivatives

Niacin

**Low HDL: **Fibrates or Niacin

10
Q

insulin resistance in MS tends to involve primarily ___ and ___ tissue

A

fat and muscle

11
Q

IL-6 and other cytokines increase hepatic ___ production

A

glucose

12
Q

Hyperinsulinemia may result in ____ and ____, contributing to HTN

A

enhanced sodium abs

increased sympathetic activity

12
Q

Orlistat mechanism

A

inhibitor of gastric and pancreatic lipases

decrease abs of dietary fat by 30%

13
Q

Fasting plasma glucose levels
DM
Impaired
Normal

2 hourOGTT
DM
Impaired
Normal

A

Fasting plasma glucose levels
DM >126
Impaired 100-125
Normal

2 hourOGTT
DM >200
Impaired 140-199
Normal

14
Q

suppression of _____ production by insulin is defective in insulin resistance, leading increased flux of FFA to liver, resulting in increased TGs

A

VLDLproduction

16
Q

lipotoxicity theory (most accepted)

A

increased fatty acids from adipocytes lead to changes in post-insulin receptor function in muscle cells

decreases IRS-1 function > decrease in insulin mediated glucose uptake

(also involved in beta cell failure, indirectly)

17
Q

in the liver increased FFAs result in an increased production of ____ and ____, as well as secretion of ____

A

production of glucose and TGs

secretion of VLDLs

18
Q

lipid profile in metabolic syndrome

A

low HDL

elevated TGs

moderate increase in LDL (which are more atherogenic and smaller)

20
Q

treatment of HTN in metabolic syndrome

A

ACEi

ARBS

21
Q

protrombotic state due to

A

Fibrinogen and PAI-1