Metabolic Syndrome Flashcards Preview

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Flashcards in Metabolic Syndrome Deck (21):
1

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

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

2

NCEP Adult Treaatment Panel III criteria for metabolic syndrome

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

adiopnectin and leptin ___ with insulin resistance

TNFa and resistin ___ with insulin resistance

adiopnectin and leptin decrease with insulin resistance

TNFa and resistin decrease with insulin resistance

3

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

leptin

4

Inflammation hypothesis of insulin resistance

enlarged fat cells attract macrophages and secrete inflammatory signals 

signals work in muscle cell via JNK kinase

block insulin receptor IRS-1

4

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

CETP

 

loss of Apo(A)

5

lipid overload hypothesis

enlarged fat cells leak fatty acids >

> DAGS accumalate in muscle cells >

>inhibit insulin signaling thorugh novel PKCs (nPKCs) >

then block IRS-1

6

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

Il-6 and TNFa

7

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

Cytokines and FFAs

8

Treatment of dyslipidemia in MS

LDL: HMG-CoA reductase inhibitors (statins)

Ezetimibe

 

Hyper TG Fibric acid derivatives

Niacin

 

Low HDL: Fibrates or Niacin

10

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

fat and muscle

11

IL-6 and other cytokines increase hepatic ___ production

glucose

12

Hyperinsulinemia may result in ____ and ____, contributing to HTN

enhanced sodium abs

increased sympathetic activity

12

Orlistat mechanism

inhibitor of gastric and pancreatic lipases 

 

decrease abs of dietary fat by 30%

13

Fasting plasma glucose levels
DM
Impaired
Normal

2 hourOGTT
DM
Impaired
Normal

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

2 hourOGTT
DM >200
Impaired 140-199
Normal

14

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

VLDLproduction

 

16

lipotoxicity theory (most accepted)

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

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

production of glucose and TGs

secretion of VLDLs

18

lipid profile in metabolic syndrome

low HDL

elevated TGs

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

20

treatment of HTN in metabolic syndrome

ACEi

ARBS

21

protrombotic state due to 

Fibrinogen and PAI-1