Appetite Flashcards

1
Q

What 3 factors cause thirst?

A

Body fluid osmolality
Blood volume is reduced
Blood pressure is reduced

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2
Q

What is the most potent stimulant of thirst?

A

Plasma osmolality increase is the more potent stimulus – change of 2-3% induces strong desire to drink. Decrease of 10-15% in blood volume or arterial pressure is required to produce the same response.

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3
Q

What are osmoreceptors and where are they found?

A

Sensory receptors responsible for osmoregulation. Found in the hypothalamus - Organum vasculosum of the lamina terminalis and subfornical organ.

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4
Q

How do osmoreceptors control ADH?

A
  1. Cells shrink when plasma more concentrated
  2. Proportion of cation channels increases – membrane depolarizes
  3. Send signals to the ADH producing cells to increase ADH
  4. Fluid retention - Invokes drinking
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5
Q

How does the sensation of thirst change?

A

Thirst is decreased by drinking even before sufficient water has been absorbed by the GI tract to correct plasma osmolality. Receptors in mouth, pharynx, oesophagus are involved. Relief of thirst sensation via these receptors is short lived. Thirst is only completely satisfied once plasma osmolality is decreased or blood volume or arterial pressure corrected.

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6
Q

What 2 findings underlie the body weight homeostasis hypothesis?

A

Neuman 1902 – his weight was stable for a long time despite no conscious effort to balance out intake and expenditure
Passmore 1971 – most individual adults maintain a relatively stable weight over long periods

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7
Q

How is body weight homeostasis maintained?

A

A reduction in fat mass increases food intake and reduces energy expenditure.
Adipose tissue expansion reduces food intake and increases energy expenditure.

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8
Q

How does dysfunction of weight homeostasis occur?

A

In an overfed state, increase in sympathetic nervous system activity and energy expenditure reduces hunger and food intake causing weight loss. In an underfed state, decrease in thyroid function, energy expenditure and sympathetic nervous system activity results in weight regain.

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9
Q

What is involved in appetite regulation?

A

Inputs include ghrelin, PYY, leptin and other gut hormones as well as neural input from the periphery and other brain regions which travel through vagus nerve to the brainstem. Brainstem communicates with hypothalamus which communicates with high brain centres like amygdala. Hypothalamus then coordinates and synthesises responses by increasing/decreasing energy expenditure and need for food intake.

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10
Q

What are the words for appetite stimulant and depressant?

A

Orexigenic – appetite stimulant

Anorectic – appetite suppressive

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11
Q

What is the role of the paraventricular nucleus?

A

Paraventricular nucleus lies adjacent to the third ventricle and projects neurons to the posterior pituitary. Also where ADH is stored which affects osmoregulation, appetite and stress reaction of the body.

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12
Q

What is the role of the lateral hypothalamus?

A

Lateral hypothalamus only produces orexigenic peptides.

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13
Q

What is the role of the ventromedial hypothalamus?

A

Ventromedial hypothalamus is associated with satiety and lesions in this region in rats lead to severe obesity. Debate as to extent of relation but most recent studies show that the melanocortins found in the ventromedial hypothalamus regulate feeding behaviour.

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14
Q

What other hypothalamic factors influence appetite?

A

Food intake decreases when arcuate nucleus POMC neurons activate (ACTH precursor). Other hypothalamic factors implicated in appetite regulation include endocannabinoids, AMP activated protein kinase and protein tyrosine phosphatase.

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15
Q

What is the arcuate nucleus and what are its roles?

A

Brain area involved in the regulation of food intake. Incomplete blood brain barrier, allows access to peripheral hormones. Integrates peripheral and central feeding signals. Has 2 neuronal populations: Stimulatory (Neuropeptide Y and Agouti-Related Protein) and Inhibitory (POMC neuron).

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16
Q

What pathway increases food intake?

A

NPY neurons make peptides that potently stimulate food intake by increasing NPY signally and reducing melanocortin signalling via AGRP release, an endogenous melanocortin receptor antagonist. Also express receptors for leptin and insulin as are activated by decrease of leptin/insulin signalling.

17
Q

What are 3 reasons food intake is increased through NPY pathway?

A

Fasting, uncontrolled diabetes and genetic leptin deficiency

18
Q

Outline functioning of arcuate nucleus

A

Incomplete blood brain barrier allows circulating factors to activate NPY/Agrp or POMC (decreases food intake). The arcuate nucleus beside feeding is involved in fertility and cardiovascular regulation.

19
Q

How does the melanocortin system work?

A

Melanocortins are products of POMC for example alpha-MSH. Melanocortin-4 receptors are expressed in paraventricular nucleus and these receptors are stimulated by serotonin which leads to reduction in appetite and weight as well as decreased food intake.

20
Q

What are human CNS mutations affecting appetite?

A

No NPY or Agrp mutations associated with appetite discovered in humans.
POMC deficiency and MC4-R mutations cause morbid obesity.
Mutations not responsible for the prevalence of obesity - but useful to explain signaling.

21
Q

What is the adipostat mechanism?

A

Circulating hormone is produced by fat which is sensed by hypothalamus. Hypothalamus then alters neuropeptides to increase or decrease food intake. Potentially problems with this homeostat may lead to obesity.

22
Q

What is leptin?

A

Discovered in 1994. Missing in the ob/ob mouse. Made by adipocytes in white adipose tissue and circulates in the plasma. Acts upon the hypothalamus regulating appetite (intake) and thermogenesis (expenditure).

23
Q

Describe leptin defects

A
  1. Insufficient production
  2. Receptor signalling/regulatory signalling can be defective and reduce leptin levels despite high adipose tissue mass.
  3. Decreased sensitivity to leptin
24
Q

What are systemic effects of leptin?

A

Proportional to body fat. Replacement in the ob/ob mouse decreases weight. Hormone that decreases food intake and increases thermogenesis.

25
Q

What is leptin resistance?

A

Leptin circulates in plasma in concentrations proportional to fat mass. Obesity due to leptin resistance- hormone is present but doesn’t signal effectively. Hence, leptin ineffective as a weight control drug.

26
Q

Where are GI hormones secreted?

A

Secreted byenteroendocrine cellsin thestomach, pancreas & SB. Control various function of digestive organs.

27
Q

Which hormones control appetite?

A

Ghrelin - Stimulates appetite, increases gastric emptying

Peptide YY - Inhibits food intake

28
Q

What are the impacts of ghrelin?

A

Blood levels of ghrelin are highest before meals - help prepare for food intake by increasing gastric motility and acid secretion. Directly modulates neurons in the arcuate nucleus: stimulates NPY/Agrp neurons and inhibits POMC. Increases appetite. Regulation of reward, taste sensation, memory, circadian rhythm.

29
Q

Describe variations in ghrelin concentration

A

Clear pre-prandial rise and post-prandial fall indicates ghrelin plays a physiological role in meal initiation in humans.

30
Q

What is the role of peptide tyrosine tyrosine?

A

Short peptide released in the terminal ileum (TI) and colon in response to feeding (36 Amino acids). Reduces appetite – can be digested or injected IV. Food arriving to the TI and colon results in PYY release. Inhibits NPY release. Stimulates POMC neurons.

31
Q

What comorbidites is obesity associated with?

A

Depression, Sleep Apnoea, Bowel cancer, Osteoarthritis, Gout, Peripheral vascular disease, Diabetes, Hypertension, Myocardial Infarction and Stroke.