Module 7 ChatGPT Flashcards
(128 cards)
1
Q
What is the primary fuel used during overnight fasting
A
Fatty acids for cardiac muscle, skeletal muscle, and liver
2
Q
What is the role of bile salts in lipid digestion
A
Bile salts emulsify fats in the intestine, increasing their surface area for digestion by pancreatic enzymes
3
Q
What are chylomicrons, and what is their function
A
Chylomicrons are lipoprotein particles that transport dietary lipids from the intestines to other tissues in the body
4
Q
What enzyme activates fatty acids for metabolism and what is the product
A
Acetyl-CoA synthetase conversts FA to fatty acyl-CoA derivatives
5
Q
What is the significance of carnitine in fatty acid metabolism
A
Carnitine transports long-chain fatty acids into the mitochondria for beta-oxidation
6
Q
What is the role of Carnitine Palmitoyltransferase I (CPT I)
A
CPT I transfers fatty acyl groups from CoA to carnitine, enabling their transport into the mitochondria for oxidation
7
Q
How is beta-oxidation regulated (4)
A
Fatty acids, ATP, NADH, and CPT I - (CPT 1 inhibited by malonyl-CoA)
8
Q
What are ketone bodies, and when are they produced
A
Ketone bodies are produced during fasting when fatty acids are oxidized, and the acetyl-CoA generated exceeds the TCA cycle capacity
9
Q
What is the role of Acetyl-CoA Carboxylase in fatty acid metabolism
A
Acetyl-CoA Carboxylase converts acetyl-CoA to malonyl-CoA, the first step in fatty acid synthesis, and inhibits CPT I during fed states
10
Q
How does the insulin/glucagon ratio affect ketogenesis
A
A decreased insulin/glucagon ratio during fasting inhibits acetyl-CoA carboxylase, lowering malonyl-CoA levels, which activates CPT I and promotes ketogenesis
11
Q
What is the role of omega-oxidation in fatty acid metabolism
A
Omega-oxidation is a minor pathway that becomes more active when beta-oxidation is compromised, providing succinyl-CoA for the TCA cycle
12
Q
What are the key features of Refsum disease
A
Refsum disease is a peroxisomal disorder caused by impaired alpha-oxidation of branched-chain fatty acids, leading to the accumulation of phytanic acid
13
Q
What are the clinical symptoms of Refsum disease (6)
A
Vision loss
Anosmia
Bone abnormalities
Progressive muscle weakness
Ataxia
Dry, scaly skin (ichthyosis)
14
Q
What is the primary difference between long-chain and very-long-chain fatty acid oxidation
A
Long-chain fatty acids are oxidized in mitochondria, while very-long-chain fatty acids are oxidized in peroxisomes
15
Q
What is the role of the electron transport chain in fatty acid oxidation
A
The electron transport chain reoxidizes NADH and FADH2 produced during beta-oxidation, driving ATP synthesis
16
Q
What are the two most common unsaturated fatty acids in the human diet
A
Oleate (C18:1) and linoleate (C18:2) are the most common unsaturated fatty acids in the diet
17
Q
What is the function of the enzyme lipoprotein lipase (LPL)
A
LPL hydrolyzes triglycerides in chylomicrons and VLDL, releasing free fatty acids for uptake by tissues
18
Q
What triggers the release of fatty acids from adipose tissue
A
Fatty acids are released from adipose tissue in response to hormones like glucagon and epinephrine during fasting
19
Q
What is the role of medium-chain acyl-CoA dehydrogenase (MCAD)
A
MCAD catalyzes the first step in the beta-oxidation of medium-chain fatty acids, converting them to acetyl-CoA
20
Q
What are the consequences of MCAD deficiency
A
MCAD deficiency leads to hypoglycemia and the accumulation of medium-chain fatty acids, which can cause metabolic crises during fasting
21
Q
What are the steps involved in the activation of long-chain fatty acids
A
Long-chain fatty acids are activated by acyl-CoA synthetase, forming fatty acyl-CoA, which is then transported into mitochondria for oxidation
22
Q
What is the significance of propionyl-CoA in odd-chain fatty acid oxidation
A
Propionyl-CoA, generated from odd-chain fatty acids, is converted to succinyl-CoA, which enters the TCA cycle and contributes to gluconeogenesis
23
Q
What happens to fatty acids in the absence of oxygen
A
Without oxygen, fatty acids cannot undergo beta-oxidation, as it is an aerobic process, leading to a reliance on glucose for energy
24
Q
What is the function of acyl-CoA dehydrogenase in beta-oxidation
A
Acyl-CoA dehydrogenase catalyzes the first step in beta-oxidation, forming a trans-double bond between the alpha and beta carbons of the fatty acyl-CoA
25
What is the impact of a deficiency in CPT II (3)
CPT II deficiency impairs the transfer of fatty acyl-CoA into the mitochondrial matrix, leading to muscle weakness, pain, and myoglobinuria during exercise
26
What are the clinical features of carnitine deficiency (3)
Carnitine deficiency leads to muscle weakness, hypoglycemia, and cardiomyopathy due to impaired fatty acid transport into mitochondria
27
What is the role of peroxisomes in fatty acid metabolism
Peroxisomes are responsible for the beta-oxidation of very-long-chain fatty acids and branched-chain fatty acids, which are then shortened for further metabolism in mitochondria
28
What is the significance of malonyl-CoA in the regulation of fatty acid metabolism
Malonyl-CoA inhibits CPT I, preventing the transport of fatty acids into mitochondria for beta-oxidation during the fed state
29
What is the function of thiolase in beta-oxidation
Thiolase catalyzes the final step in beta-oxidation, cleaving the fatty acyl-CoA to produce acetyl-CoA and a shortened fatty acyl-CoA
30
What is the role of albumin in fatty acid transport
Albumin binds and transports free fatty acids in the blood from adipose tissue to other tissues for oxidation
31
What are the consequences of a deficiency in very-long-chain acyl-CoA dehydrogenase (VLCAD) (3)
VLCAD deficiency impairs the oxidation of very-long-chain fatty acids, leading to hypoglycemia, muscle weakness, and cardiomyopathy
32
What are ketone bodies, and why are they important during fasting
Ketone bodies are produced from acetyl-CoA during fasting and serve as an alternative energy source for the brain and other tissues when glucose is scarce
33
What is the difference between alpha-oxidation and beta-oxidation of fatty acids
Alpha-oxidation occurs in peroxisomes and is involved in the metabolism of branched-chain fatty acids, while beta-oxidation occurs in mitochondria and breaks down straight-chain fatty acids
34
What is the role of omega-oxidation in fatty acid metabolism
Omega-oxidation provides an alternative pathway for the oxidation of fatty acids, particularly when beta-oxidation is impaired
35
What are the major products of beta-oxidation
The major products of beta-oxidation are acetyl-CoA, NADH, and FADH2, which enter the TCA cycle and electron transport chain to generate ATP
36
What is the role of Coenzyme A in fatty acid metabolism
Coenzyme A activates fatty acids to form acyl-CoA, which is required for their subsequent metabolism in beta-oxidation and other pathways
37
What happens to fatty acids that cannot be immediately oxidized
Fatty acids that cannot be oxidized are re-esterified into triglycerides for storage in adipose tissue
38
What is the clinical significance of fatty acid oxidation disorders
Fatty acid oxidation disorders can lead to severe metabolic crises, including hypoglycemia, muscle weakness, and cardiomyopathy, particularly during fasting or illness
39
What are the primary sources of fatty acids for oxidation
Fatty acids for oxidation primarily come from dietary fats and triglycerides stored in adipose tissue
40
What is the role of mitochondrial trifunctional protein in fatty acid oxidation
Mitochondrial trifunctional protein catalyzes the last three steps of beta-oxidation for long-chain fatty acids
41
What is the role of the liver in ketone body synthesis
The liver produces ketone bodies from acetyl-CoA during periods of fasting or low carbohydrate intake, providing an alternative energy source for other tissues
42
What triggers the onset of beta-oxidation in tissues
Beta-oxidation is triggered by hormonal signals such as glucagon and epinephrine, which promote the release of fatty acids from adipose tissue
43
What are the main regulatory factors of beta-oxidation
Beta-oxidation is regulated by the availability of fatty acids, the NADH/NAD+ ratio, and the activity of key enzymes such as CPT I
44
What is the role of NADH and FADH2 in fatty acid metabolism
NADH and FADH2 generated during beta-oxidation are used in the electron transport chain to produce ATP
45
What happens to acetyl-CoA produced during beta-oxidation
Acetyl-CoA produced during beta-oxidation can enter the TCA cycle for ATP production or be converted to ketone bodies in the liver
46
What is the role of AMP-activated protein kinase (AMPK) in fatty acid metabolism
AMPK activates beta-oxidation by inhibiting acetyl-CoA
47
What are the main functions of lipids in the body
Lipids provide energy storage, insulation, cellular structure, and signaling."
48
What is the role of fatty acids in metabolism
Fatty acids are oxidized to produce ATP or stored as triglycerides for energy."
49
What are triglycerides composed of
Triglycerides are composed of three fatty acids esterified to a glycerol backbone."
50
How are triglycerides transported in the blood
Triglycerides are transported in the blood within lipoproteins like chylomicrons and VLDL."
51
What enzyme is responsible for the breakdown of triglycerides
Lipoprotein lipase breaks down triglycerides into free fatty acids and glycerol."
52
What is the function of chylomicrons
Chylomicrons transport dietary triglycerides and cholesterol from the intestines to tissues."
53
What is the role of VLDL in lipid transport
VLDL transports triglycerides from the liver to peripheral tissues."
54
How is LDL formed
LDL is formed from the conversion of VLDL after triglycerides are removed by lipoprotein lipase."
55
What is the primary function of LDL
LDL delivers cholesterol to peripheral tissues and plays a role in cholesterol homeostasis."
56
What are HDL particles, and what is their function
HDL particles collect excess cholesterol from tissues and return it to the liver for excretion."
57
What is the process of lipogenesis
Lipogenesis is the metabolic process of synthesizing fatty acids from acetyl-CoA in the liver and adipose tissue."
58
What hormone stimulates lipogenesis
Insulin stimulates lipogenesis by promoting the uptake and storage of glucose and fatty acids."
59
What is the function of acetyl-CoA carboxylase in fatty acid synthesis
Acetyl-CoA carboxylase converts acetyl-CoA to malonyl-CoA, the first step in fatty acid synthesis."
60
How does malonyl-CoA regulate fatty acid metabolism
Malonyl-CoA inhibits carnitine palmitoyltransferase I (CPT1), preventing fatty acid oxidation in the mitochondria."
61
What is the role of the enzyme HMG-CoA reductase
HMG-CoA reductase is the rate-limiting enzyme in cholesterol synthesis."
62
What is the impact of statins on cholesterol metabolism
Statins inhibit HMG-CoA reductase, reducing cholesterol synthesis in the liver."
63
What are the main sources of cholesterol in the body
Cholesterol comes from dietary intake and de novo synthesis in the liver."
64
What is the function of cholesterol in cell membranes
Cholesterol helps maintain membrane fluidity and stability in cell membranes."
65
How is cholesterol excreted from the body
Cholesterol is excreted as bile acids in the feces."
66
What is the role of bile acids in digestion
Bile acids emulsify dietary fats, aiding in their digestion and absorption in the intestines."
67
What is the significance of the LDL receptor
The LDL receptor mediates the uptake of LDL cholesterol into cells, regulating blood cholesterol levels."
68
How does HDL contribute to reverse cholesterol transport
HDL removes excess cholesterol from tissues and transports it to the liver for excretion."
69
What is the role of apolipoproteins in lipid metabolism
Apolipoproteins serve as structural components of lipoproteins and act as cofactors for enzymes involved in lipid metabolism."
70
What is the impact of high LDL levels on cardiovascular health
High LDL levels are associated with an increased risk of atherosclerosis and cardiovascular disease."
71
What is atherosclerosis
Atherosclerosis is the buildup of cholesterol and other substances in the arterial walls, leading to plaque formation and reduced blood flow."
72
How does dietary fiber affect cholesterol levels
Dietary fiber can reduce cholesterol levels by binding bile acids and promoting their excretion."
73
What is the relationship between saturated fats and cholesterol levels
Saturated fats can increase LDL cholesterol levels, contributing to a higher risk of cardiovascular disease."
74
What are the effects of trans fats on lipid profiles
Trans fats increase LDL cholesterol and decrease HDL cholesterol, leading to an adverse effect on cardiovascular health."
75
What is the role of omega-3 fatty acids in lipid metabolism
Omega-3 fatty acids reduce triglyceride levels and may have anti-inflammatory effects that benefit cardiovascular health."
76
How does obesity affect lipid metabolism
Obesity is associated with increased triglyceride levels, reduced HDL cholesterol, and a higher risk of insulin resistance and cardiovascular disease."
77
What is the function of adipose tissue in lipid storage
Adipose tissue stores triglycerides and releases free fatty acids during periods of energy demand."
78
What is the relationship between insulin resistance and lipid metabolism
Insulin resistance impairs the ability of insulin to inhibit lipolysis, leading to elevated free fatty acids and dyslipidemia."
79
What is the role of peroxisome proliferator-activated receptors (PPARs) in lipid metabolism
PPARs regulate the expression of genes involved in fatty acid oxidation, lipid storage, and insulin sensitivity."
80
How does alcohol consumption affect lipid metabolism
Alcohol increases triglyceride levels and can contribute to fatty liver disease."
81
What is non-alcoholic fatty liver disease (NAFLD)
NAFLD is the accumulation of excess fat in the liver not caused by alcohol, often associated with obesity and insulin resistance."
82
What is the significance of lipoprotein(a) in cardiovascular risk
Lipoprotein(a) is a lipoprotein variant that can increase the risk of atherosclerosis and cardiovascular disease."
83
What is the process of fatty acid oxidation
Fatty acid oxidation is the breakdown of fatty acids in the mitochondria to produce acetyl-CoA, which enters the TCA cycle for energy production."
84
What enzyme is key in transporting fatty acids into the mitochondria
Carnitine palmitoyltransferase I (CPT1) is the key enzyme that facilitates the transport of fatty acids into the mitochondria."
85
What is the role of the enzyme lipoprotein lipase
Lipoprotein lipase hydrolyzes triglycerides in lipoproteins, releasing free fatty acids for tissue uptake."
86
How does the liver regulate cholesterol homeostasis
The liver regulates cholesterol homeostasis through synthesis, uptake via LDL receptors, and excretion as bile acids."
87
What is the function of very low-density lipoproteins (VLDL)
VLDL transports endogenous triglycerides and cholesterol from the liver to peripheral tissues."
88
How does cholesterol ester transfer protein (CETP) affect HDL function
CETP transfers cholesterol esters from HDL to other lipoproteins, affecting HDL's role in reverse cholesterol transport."
89
What are the consequences of a deficiency in LDL receptors
LDL receptor deficiency leads to familial hypercholesterolemia, characterized by high LDL levels and increased cardiovascular risk."
90
What is the function of lecithin-cholesterol acyltransferase (LCAT)
LCAT is an enzyme that converts free cholesterol into cholesterol esters, which are then incorporated into HDL particles."
91
How does diabetes mellitus impact lipid metabolism
Diabetes mellitus is associated with dyslipidemia, characterized by elevated triglycerides, low HDL, and often increased LDL cholesterol."
92
What is the impact of physical activity on lipid metabolism
Physical activity increases HDL cholesterol, lowers triglycerides, and can improve overall lipid profiles."
93
What is the significance of apolipoprotein E (ApoE) in lipid metabolism
ApoE is involved in the clearance of chylomicrons and VLDL remnants from the bloodstream, playing a role in cholesterol and triglyceride metabolism."
94
How do polyunsaturated fats affect cholesterol levels
Polyunsaturated fats, particularly omega-3 and omega-6 fatty acids, can lower LDL cholesterol and reduce cardiovascular risk."
95
What is the role of the liver in fatty acid metabolism
The liver is central in fatty acid metabolism, responsible for fatty acid synthesis, oxidation, and the regulation of lipoproteins."
96
How does oxidative stress influence atherosclerosis
Oxidative stress leads to the oxidation of LDL particles, contributing to the formation of atherosclerotic plaques."
97
What is Gilbert Syndrome?
A mild genetic disorder where the liver does not properly process bilirubin, leading to jaundice due to increased levels of unconjugated bilirubin.
98
What genetic mutation causes Gilbert Syndrome?
Mutations in the TATA-box promoter region upstream of exon 1 in the UGT1A gene, reducing the expression of bilirubin-UGT enzyme, causing unconjugated hyperbilirubinemia.
99
What are the typical bilirubin levels in Gilbert's Syndrome?
1.5 to 3.0 mg/dL, which is higher than the normal range of 0.3-1.0 mg/dL.
100
What are the common symptoms of Gilbert Syndrome?
Jaundice, abdominal discomfort, fatigue, and sometimes cognitive difficulties.
101
What regulatory event is the rate-limiting step in heme synthesis?
The catalysis of the reaction by ALA synthase.
102
How does heme regulate ALA synthase?
Heme inhibits ALAS1 by feedback repression and hematin inhibits ALAS1 allosterically.
103
What role does ALAS1 play in heme synthesis?
ALAS1 is the key enzyme for heme synthesis in the liver and is regulated by heme through feedback mechanisms.
104
What is the difference between ALAS1 and ALAS2?
ALAS1 is the primary enzyme in the liver and is regulated by heme, while ALAS2 is the primary enzyme in erythroid cells and is regulated by iron availability.
105
What effect does lead have on heme synthesis?
Lead inhibits δ-aminolevulinic acid dehydratase, which is crucial for heme synthesis.
106
What regulatory effects do certain drugs like barbiturates have on heme synthesis?
Barbiturates can induce heme synthesis by upregulating ALAS1 in the liver, which is necessary for cytochrome P450 production.
107
Describe the feedback inhibition mechanism of ALA synthase by heme and explain how it differs between ALAS1 and ALAS2.
Heme inhibits ALAS1 in the liver by feedback repression, decreasing its expression and transport to mitochondria. Hematin further inhibits ALAS1 allosterically. In contrast, ALAS2 in erythroid cells is not directly inhibited by heme but is regulated by iron availability instead.
108
How does the mutation in the TATA-box promoter region of the UGT1A gene specifically lead to the symptoms of Gilbert Syndrome?
The mutation in the TATA-box promoter region reduces the transcriptional efficiency of the UGT1A gene, resulting in lower levels of the bilirubin-UGT enzyme. This impairs bilirubin conjugation, leading to an accumulation of unconjugated bilirubin in the blood, which causes jaundice and other symptoms of Gilbert Syndrome.
109
What role does iron play in the regulation of ALAS2, and how might this relate to conditions like sideroblastic anemia?
Iron availability regulates ALAS2 in erythroid cells, linking heme synthesis to iron levels. In conditions like sideroblastic anemia, mutations in ALAS2 can impair its function despite normal iron levels, leading to ineffective heme synthesis and iron overload within erythroid precursors.
110
Discuss the interplay between drug metabolism, cytochrome P450 enzymes, and heme synthesis in the context of liver function.
Cytochrome P450 enzymes require heme as a cofactor for drug metabolism. Induction of heme synthesis, such as by barbiturates, increases cytochrome P450 activity, enhancing the liver's ability to metabolize drugs. However, excessive demand for heme in cytochrome P450 production can lead to imbalances in heme synthesis, potentially contributing to liver dysfunction if not properly regulated.
111
How might a disruption in the transport of ALAS1 to mitochondria affect overall heme synthesis and what are the potential consequences of this disruption?
ALAS1 must be transported to mitochondria to catalyze the first step in heme synthesis. Disruption of this transport could severely limit heme production, leading to deficiencies in heme-dependent processes such as oxygen transport (via hemoglobin) and drug metabolism (via cytochrome P450 enzymes), potentially resulting in conditions like anemia or impaired drug detoxification.
112
Explain how high glucose levels inhibit ALAS1 and the potential implications for individuals with metabolic disorders such as diabetes.
High glucose levels inhibit ALAS1, likely as a metabolic adaptation to reduce heme synthesis when cellular energy sources are abundant. For individuals with metabolic disorders like diabetes, this inhibition could exacerbate issues related to heme deficiency, such as reduced red blood cell production or impaired liver function, contributing to the complications of the disease.
113
Given that Gilbert Syndrome generally does not require treatment, under what circumstances might intervention become necessary, and what treatments might be considered?
Treatment for Gilbert Syndrome might become necessary if bilirubin levels rise significantly, leading to severe jaundice or associated complications like gallstones. Potential treatments could include phototherapy to reduce bilirubin levels or medications to increase bilirubin conjugation, although these are rarely needed. Avoiding triggers like fasting or certain medications that elevate bilirubin levels may also be advised.
114
Discuss how the availability of pyridoxal phosphate (PLP) affects the activity of ALA synthase and its implications for heme synthesis disorders.
PLP is a necessary cofactor for ALA synthase, and its availability directly impacts the enzyme's activity. Deficiency in PLP, such as from vitamin B6 deficiency or drug interactions, can lead to reduced ALA synthase activity, impairing heme synthesis. This can exacerbate conditions like sideroblastic anemia or lead to symptoms related to heme deficiency, such as fatigue and anemia.
115
Analyze the role of uroporphyrinogen synthase and ferrochelatase in erythroid heme synthesis and how their regulation by heme ensures balanced red blood cell production.
Uroporphyrinogen synthase and ferrochelatase are key enzymes in the later stages of heme synthesis in erythroid cells. Heme regulates these enzymes to ensure that heme production matches the demand for new red blood cell synthesis. Disruptions in this regulation can lead to conditions such as porphyrias, where heme precursors accumulate, or anemia, where insufficient heme is produced for proper red blood cell function.
116
How do environmental factors such as lead exposure influence the heme synthesis pathway, and what are the broader health implications?
Lead inhibits δ-aminolevulinic acid dehydratase, a crucial enzyme in the heme synthesis pathway. This inhibition leads to a buildup of heme precursors and a deficiency in heme itself, contributing to lead poisoning symptoms such as anemia, neurological deficits, and other systemic health issues due to impaired cellular respiration and detoxification processes.
117
What is the normal function of the UGT1A gene?
The UGT1A gene encodes the bilirubin-UDP-glucuronosyltransferase enzyme, which conjugates bilirubin, making it water-soluble for excretion.
118
What is the significance of the TATA-box promoter region in the UGT1A gene?
The TATA-box promoter region is crucial for the proper transcription of the UGT1A gene. Mutations here can reduce enzyme production, leading to conditions like Gilbert Syndrome.
119
How is Gilbert Syndrome diagnosed?
Diagnosis is primarily through blood tests showing elevated bilirubin levels with normal liver function tests, and absence of bilirubin in urine.
120
What is the role of pyridoxal phosphate (PLP) in heme synthesis?
PLP is a coenzyme for ALA synthase; its availability regulates heme synthesis. Inhibition of PLP can reduce heme production.
121
What happens when there is a loss-of-function mutation in ALAS2?
It results in X-linked sideroblastic anemia and iron overload due to impaired heme synthesis in erythroid cells.
122
What is the role of ferrochelatase in heme synthesis?
Ferrochelatase catalyzes the final step in heme synthesis, inserting iron into protoporphyrin IX to form heme.
123
How does glucose concentration affect heme synthesis?
High cellular glucose concentration inhibits ALAS1, thus reducing heme synthesis in the liver.
124
What are the effects of high bilirubin levels in Gilbert Syndrome?
While generally mild, high bilirubin can cause visible jaundice and, in rare cases, may require treatment if levels become very elevated.
125
Why should patients with Gilbert Syndrome avoid acetaminophen?
Acetaminophen is metabolized by glucuronidation, a process impaired in Gilbert Syndrome, increasing the risk of drug toxicity.
126
How does subcellular localization affect heme synthesis?
Transport of cytoplasmic ALAS1 to mitochondria is a regulated step crucial for efficient heme synthesis.
127
What is the relationship between heme and cytochrome P450 enzymes?
Heme is a critical component of cytochrome P450 enzymes, which are involved in drug metabolism. Induction of heme synthesis increases cytochrome P450 activity.
128
How does heme regulate uroporphyrinogen synthase?
In erythroid cells, heme regulates uroporphyrinogen synthase, an enzyme involved in the early steps of the heme synthesis pathway.
