14 - Obesity Flashcards
What is obesity (WHO0
abnormal or excessive fat accumulation sufficient to adversely affect health and reduce life expectancy
How to work out BMI
weight (kg)/ height(metres)2
Underweight BMI
<18.5
Normal weight BMI
18.5 - 24.9
Overweight BMI
25 - 29.9
Obese BMI
30 +
Morbidly obese BMI
40+
Why take waist circumference
Helps to distinguish between muscular and obese people
Contributing factors to obesity
Sugar-sweetened bevarages
Increased food intake
Less exercise
Medication that can cause weight gain
Mood stabilizers Diabetes medicine Corticosteroids Beta blockers allergy relieverss
Why does insulin cause weight gain
Inhibits breakdown and decrease from fat cells
- Decreases rate of lipolysis in adipose
- Stimulates triacylglycerol synthesis
- Increases uptake of triglycerides from blood to adipose
- Decreases rate of FA oxidisation
What is lipohypertrophy
Enlargement of fat cells where insulin is injected
Which T2D drugs increase weight
Insulin, Sulfonlyureas, TZD (pparg stimulates adipogenesis and uptake)
Which T2D drugs have no effect on weight
Metformin, DPP IV inhibitors,
Which T2D drugs decrease weight
SGLT-2 Inhibitor
Acarbose
Heritability of obesity
> 0.70
higher than HT (0.29) and depression (0.50)
Neel’s thrifty gene hypothesis
Obesity is more prominent in black and South Asian population
Syndromic Monogenic Obesity
Rare group of 30 sydromes
- Also causes mental retardation, dysmorphic features and organ specific abnormalities
Bardet-Biedl + Alstrom syndrome
Ciliopathy
- Cilium has a role in differentiation of adipocytes
- Obesity - defect in adipogeneseis
What receptor signalling does Cilia mediate
Leptin receptor signalling
LEPR
Non-syndromic monogenic obesity
Single gene disorder that leads to highly penetrant form of obesity
12 genes identified with roles inthe leptin-melanocortin pathway
Polygenic obesity
Using genome wide association
227 genetic variants
Causes of adipocyte differentiation
Ciliopathies
Mutations in PPARy2 (peroxisome-proliferator-activated receptor gamma 2)
What is PPARy2 and what drug targets it
TF that has a role in adipocyte differentiation
Targeted by thiazolidinedione druge
