Metabolic Syndrome

Question 1

What is metabolic syndrome?

Answer 1

Cluster of risk factors for CVD and type 2 diabetes related to obesity

Question 2

What are the risk factors metabolic syndrome encompasses? (7)

Answer 2

• hyperglycaemia
• hypertension
• hypertriglycerdaemia
• low HDL cholesterol
• pro inflammatory state
• pro thrombotic state
• elevated FA in blood plasma (even in fed state)

Question 3

What is the prevalence of metabolic syndrome?

Answer 3

20-30% of adult population in most countries

Question 4

What are the racial discrepancies in MS in the UK?

Answer 4

• MS more common in BME communities.
• SA and white women less likely to have MB in comparison to their men
• no gender disparity in the black community

Question 5

How does MS affect adipose tissue?

Answer 5

In metabolic syndrome, adipose tissue is resistant to the action of insulin, so hormone sensitive lipase is always turned on (even in fed state) and adipose tissue is constantly releasing fatty acids

Question 6

What do pro inflammatory proteins in adipose tissue lead to?

Answer 6

• fatty liver
• insulin resistance
• inflammatory state

Question 7

What are adipocytokines?

Answer 7

cell to cell signalling proteins released by adipose tissue

Question 8

Name some adipocytokines and their function.

Answer 8

interleukin 6 –> pro inflammatory
decrease in adiponectin –> anti inflammatory
increase in plasminogen activator inhibitor –> prothrombotic

Question 9

Name the two ways in which the liver accumulates fat.

Answer 9

excess FAs taken up by liver –> TAG produced –> VLDL secreted and fat accumulation in liver

High glucose –> increased glucose uptake in liver –> liver makes FAs to use up glucose

Question 10

What is non alcoholic fatty liver disease (NAFLD) and non alcoholic steatohepatitis (NASH)?

Answer 10

NAFLD - fatty inflammation of liver

NASH - most extreme version of NAFLD. Cause of cirrhosis.

Question 11

What’s the difference between NAFLD and AFLD?

Answer 11

NAFLD - <14 units/week, 20-50% of pop

AFLD - > 14 units/week, 10% of pop

Question 12

How much alcohol load is cleared by the liver?

Answer 12

90%

Question 13

What is ethanol first converted to?

Answer 13

Acetaldehyde

Question 14

What is acetaldehyde converted to?

Answer 14

Acetate

Question 15

What enzyme catalyses the conversion of acetaldehyde to acetate?

Answer 15

acetaldehyde dehydrogenase

Question 16

How does ethanol metabolism lead to fatty liver?

Answer 16

acetate –> acetyl CoA –> produces TAG

Question 17

What are the primary interventions are used for MS?

Answer 17

• moderate weight loss
• moderate exercise
• diet composition

Question 18

What are the secondary pharmacological interventions?

Answer 18

• treat hypertension
• treat raised LDL levels
• antiplatelet therapy
• no recommendations for treating insulin resistance