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Pathology > Obesity > Flashcards

Obesity Flashcards

1
Q

Obesity

A

Having a very high amount of body fat in relation to lean body mass, or BMI

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2
Q

Diseases associated with obesity

A
  • Diabetes (in 80% of cases)
  • Hypertension
  • Heart disease
  • Cancer
  • Death
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3
Q

Fat storage

A
  • Most fat stored directly into adipose tissue, can also be stored as fat
  • Limited CHOs can be stored as glycogen, mostly used as an energy source, but excessive CHOs will turn into fat for storage
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4
Q

Protein and fat storage

A
  • Protein mostly used for tissue synthesis

- Excess protein used as an energy source or converted to fat for storage

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5
Q

Adipose tissue

A

White: energy, cushion, insulation- involved in pathologies of obesity
Brown: key regulator of energy expenditure
-Hypertrophy- a sresult of an excess triglyceride accumulation in existing adipocytes
-Hyperplasia from recruitment of new adipocytes from precursor cells in adipose tissue and involves proliferation and differentiation

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6
Q

White adipose tissue (WAT)

A

2 fractions:
-Adipocytes
-Stromal vascular fraction consisting of preadipocytes “stem cells”, endothelial cells and macrophages
WAT is central to energy storage, the mobilisation of the energy store is highly regulated. They secrete adipokines which have systemic effects
-Release free fatty acids when systemic energy needs are not being met

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7
Q

Short-term regulation of appetite is governed by

A

Hunger, appetite, satiety

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8
Q

Long-term regulationof appetite is governed by

A

-Feedback mechanism- adipocytokines reelased from the adipose tissue when normal body composition is disturbed

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9
Q

Adiponectin

A
  • Gut hormone
  • An adipocytokine secreted by adipose tissue
  • The level of this hormone is inversely related to BMI, it has a role in metabolic disorders
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10
Q

Leptin

A

An adipocytokine which regulates appetite

  • Changes the feeling of being hungry or not- satiety
  • Leptin-deficient mice fail to sense the adequacy of fat stores- “obese” mice
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11
Q

Ghrelin

A

Produced in stomach and stimulates hunger response

-When stomach is empty, increase in ghrelin leading to an increase in appetite

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12
Q

Petide YY (PYY)

A

Secreted in small bowel in response to foods, in obesity it loses the ability to inhibit energy intake.

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13
Q

Adipkine

A
  • Vascular disease related

- Insulin resistance related

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14
Q

Angiotensinogen (AGE)

A
  • Links obesity with hypertension
  • Positive correlation of blood pressure with AGE levels
  • Primarily produced in liver, but also by WAT
  • Deficiency partially protects against diet-induced obesity
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15
Q

Plasminogen activator inhibitor-1 (PAI-1)

A
  • Impairment of fibrinolytic system contributes to cardiovascular complications of obesity
  • WAT is main tissue source of PAI-1
  • Produced by pre-adipocytes, primarily in visceral WAT
  • Acts to inhibit fibrinolysis (is pro-thrombolytic)
  • Also influences cell-migration and angiogenesis
  • Could impair pre-adipocyte migration leading to WAT growth
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16
Q

Resistin

A
  • Expressed in adipocytes, but mainly in macrophages
  • Increased in obesity and causes tissues (especially the liver) to be less sensitive to the action of insulin
  • Overproduction due to obesity may lead to progression of type 2 diabetes
17
Q

Adiponectin

A
  • Highly expressed in adipocytes, circulates at high concentrations
  • Reduced plasma concentrations on obesity and in insulin resistance
  • Anti-atherogenic
18
Q

TNFα

A
  • Proinflammatory cytokine
  • Produced by adipocytes and macrophages in WAT
  • Over-expressed in obesity
  • Alters insulin signalling and activates MAPK pathway- proliferation of adipocytes
19
Q

IL-6

A
  • 10-30% of circulating IL-6 is from WAT
  • Highly correlated with body mass and inversely related to insulin sensitivity
  • Alters insulin signalling in the liver
  • IL-6 KO mice -mature onset diabetes and glucose intolerance
20
Q

Effects of elevated plasma FFA levels

A
  • Insulin resistance in muscle
  • Inhibition of normal function of insulin to suppress hepatic glucose production
  • FFA are substrates for hepatic triglyceride synthesis leading to increased plasma VLDL (very low) and triglyceride levels
  • Impaired epithelial function

Pathology (23 decks)

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