147b/148b - Etiology and Pathophysiology of Obesity Flashcards
List 4 determinants of obesity
- Genetic
- Epigenetic
- Psychosocial
- Microbiota
What hormones are released by fat? (6)
- Leptin
- Fatty acids
- Adiponectin
- TNF-alpha
- PAI-1
- Cytokines (Esp IL-6)
Losing 5-10% of body weight = ____% reduction in visceral fat
Losing 5-10% of body weight = 30% reduction in visceral fat
(Visceral fat is estimated by waist circumference)
What are the 5 possible components of metabolic syndrome?
How many are needed for diagnosis?
- Increased waist circumference
- Men > 40 in, women > 35 in
- Elevated triglycerides
- Elevated blood pressure
- Elevated fasting glucose
- Reduced HDL-C
Need at least 3 for diagnosis
Why does deposition of fat in the lower body segments (butt, hips, thighs) carry less risk for obesity-associated morbidity than deposition in the abdominal area?
Fat in the lower body is associated subcutaneous fat
Abdominal fat is associated with visceral fat
Visceral fat = increased risk of obesity-related morbidity
Why is obesity pathological?
(What changes occur in obesity that are detrimental to health?
- Release of cytokines and adipokines -> inflammation
- Mechanical burden on joints
- Increased abdominal pressure -> GERD
- Increased repiratory burden
- Increased CV burden (Due to fluid and hemodynamic changes)
Is obesity heritable?
Yes
Genetic + epigenetic factors
Are energy requirements higher or lower in obesity, compared with a lean state?
Energy requirements are higher
Increased Fat Free Mass and Total Energy Expenditure
More weight = more calories burned for a given activity
Describe the pathogenesis of the inflammatory state related to obesity
Signlaning becomes abberent when growth outpaces angiogenesis
- Adipocytes are fine and happy to grow until they get too big for their blood supply
- -> Stress due to hypoxia
- -> Adipokine release
- -> Inflammatory cells (macrophages) are recruited
- -> More adipokine, cytokine relesase
- -> Inflammation
