179. Pathophysiology of Obesity Flashcards
Most clinically useful analysis technique
- indirectly related to body fat
Bioelectrical impedance analysis (BIA)
Increased pressure dynamics in the abdominal compartment may lead to __ and __ __
GERD
Urinary incontinence
Most common determinant of Metabolic Syndrome
High waist circumference
Directly decreases insulin sensitivity and increases lipolysis in adipocytes
TNF-alpha
Abundant adipose-derived protein whose levels are reduced in obesity
- enhances insulin sensitivity and lipid oxidation
- also has vascular protective effect
Decreases gluconeogenesis and increases lipid oxidation in muscle
- negatively correlated with obesity
Adiponectin
Pickwickian syndrome is made up of what 2 breathing diseases
- often seen in obese patients
OHS and OSA
Higher the visceral fat, the less glucose disposal occurs which leads to..
Insulin resistance (glucose intolerance)
Last CV consequence of obesity (not CHF)
- occurs d/t increased pressure on LV
Concentric LVH
Deposition of fat in non-adipose tissue
- occurs when adipose depots are unable to adequately accommodate continued excessive caloric intake
Most commonly occurs in the:
- pancreas
- skeletal muscle
- heart
- liver
Detected by MRI
Ectopic adipose
End result of chronic and persistent abnormal cardiac loading
CHF
Volume of visceral adipose tissue is indirectly measured by obtaining a __
Waist circumference
Risk factor for:
- CAD
- HTN
- Stroke
- CHF
- A-Fib
Obesity
Pathophysiology of __-induced hypertension results from underlying:
- hemodynamic alteration - expansion of extracellular water and blood volume
- renal dysfunction - increased tubular Na+ reabsorption
- increase in sympathetic nervous system activity - d/t insulin resistance
- activation of RAS
obesity
Leads to hypertriglyceridemia by stimulating lipolysis and hepatic TG secretion
IL-6
Relationship b/w deteriorating glucose disposal and body fat is directly correlated with …
Visceral adipose tissue
These are secreted factors from adipose tissue that include:
- leptin
- IL-6
- TNF-alpha
- plasminogen activator inhibitor 1 (PAI-1)
- Angiotensinogen
Adipokines
With advancing severity and duration of obesity, ventilatory insufficiency may develop as evidenced by progressive hypercapnia, hypoxemia, and polycythemia
This condition is called..
Obesity hypoventilation syndrome (OHS)
Criteria for __ __: (need 3 for diagnosis)
- Elevated waist circumference (>40 for men, >35 for women)
- Elevated triglycerides (>150)
- Reduced HDL-C (<40 for men, <50 for women)
- Elevated BP
- Elevated fasting glucose
Metabolic Syndrome
Pulmonary function aspect that is the most affected by obesity
- decreases d/t lack of ability of diaphragm to move as much as it should
Functional reserve capacity
Increased energy expenditure and subsequent heat production coupled with redundant fat folds may lead to excessive __ and __ __
Diaphoresis
Skin infections
Excessive accumulation of water and hemodynamic changes may lead to __ and __ __ of the legs
Edema
Stasis pigmentation
Precedes the development of other components of metabolic syndrome
Central obesity
Key studies have demonstrated a positive curvilinear relationship b/w __ and __ __
- begins to plateau at more severe levels of obesity
BMI
Insulin resistance
Two factors intricately linked in the pathogenesis of the metabolic syndrome
Obesity
Insulin resistance
