DYSLIPIDEMIA

Question 1

with constant excess caloric intake, what cell increases?

Answer 1

adipocytes (cells of adipose tissue)

Question 2

what do adipocytes secrete?

Answer 2

adipokines
- a combination of hormones and cytokines - these are small immune system molecules (TNF - alpha)

Question 3

what can an excess of TNF alpha increase?

Answer 3

free fatty acids in the bloodstream by causing some of the fat in adipose tissue to break down

Question 4

what do the adipokines inhibit?

Answer 4

the clearance of VLDL (which is the main transporter of triglycerides (& cholesterol) in the bloodstream

Question 5

what is the function of lipoproteins?

Answer 5

bodys mechanism for transporting lipids (fat) through the bloodstream (water based system)

Question 6

what are the adipokines?

Answer 6

1. angiotensinogen
2. leptin
3. resistin
4. adiponectin
5. TNF-alpha

Question 7

what adipokine has anti-inflammatory and insulin sensitizing effects and is reduced with increased adiposity?

Answer 7

adiponectin

Question 8

what is resistin?

Answer 8

(FOR INSULIN RESISTANCE)
is elevated in obesity and is an important link between obesity, insulin resistance and development of DM
- plays a role in development of atherscerlosis, CV, non alcoholic fatty liver disease and other disorders associated with obesity

Question 9

what is leptin?

Answer 9

elevated in obesity and plays role in energy regulation and glucose homeostas

Question 10

what does leptin inhibit?

Answer 10

apetite and food intake and stimulates energy expenditure

Question 11

leptin resistance in obesity. is this an issue?

Answer 11

no

Question 12

is a pro inflammatory adipokine an issue?

Answer 12

yes

Question 13

what does leptin promote?

Answer 13

promotes production of other pro inflammatory cytokines from immune cells, which contributes to the overall ‘pro inflammatory state’ observed in obesity

Question 14

what is excess leptin production stimulated by?

Answer 14

pro inflammatory cytokines, TNF alpha and IL-1 - resulting in vicious cycle of chronic inflammation in obesity

Question 15

leptin has been shown to act on hypothalamus and evoke what?

Answer 15

sympathetic activation, leading to peripheral vasoconstriction, increase BP which contributes to hypertension

Question 16

what is angiotensinogen?

Answer 16

synthesized by adipocytes in direct proportion to their adiposity
- eventually converted into the vasoactive compound angiotensin II by passing through the kidneys and lungs

Question 17

what does angiotensinogen elevate?

Answer 17

BP by DIRECTLY promoting vasoconstriction and by INDIRECTLY increasing renal water retention by promoting release of aldosterone

Question 18

angiotensin provides a link between?

Answer 18

increased adiposity/obesity and development of hypertension

Question 19

what is adiponectin?

Answer 19

normally produces insulin sensitizing effects and reduces the production of TNF alpha by adipocytes

Question 20

what happens to the beneficial effects of adiponectin?

Answer 20

they are reduced in obesity as the levels of adiponectin decline with increasing adiposity

Question 21

what does adiponectin have beneficial effects on?

Answer 21

lipid metabolism

Question 22

what is adiponectin is negatively correlated with?

Answer 22

triglycerides

Question 23

what is adiponectin is positively correlated with?

Answer 23

HDL levels

Question 24

what does adiponectin helps to enhance?

Answer 24

VLDL clearance

Question 25

what is TNF alpha increase production of?

Answer 25

more VLDL by the liver, lowering levels of HDL in response to increased weight gain

Question 26

what do the extra triglycerides and free fatty acids interfere with?

Answer 26

insulin signalling in muscle and liver tissue

Question 27

what do the receptors on cells in skeletal muscle and adipose tissue signal to the cells?

Answer 27

signal the cells to take up glucose that is floating into the bloodstream from digestive system

Question 28

high concentration of free fatty acids in the blood interfere with what?

Answer 28

signalling, preventing the cells from taking up glucose in response to insulin (this is beginning of insulin resistance)

Question 29

does the pancreas produce greater or less insulin in response to insulin resistance?

Answer 29

much greater

Question 30

can the pancreas compensate for insulin resistance?

Answer 30

yes, for a LITTLE WHILE.
it produces more insulin to compensate

Question 31

what are the first symptoms presented with T2D?

Answer 31

elevated triglycerides and impaired glucose tolerance

Question 32

why does the pancreas only compensate for insulin resistance for a little while?

Answer 32

the beta cells get exhausted from producing all the extra insulin and failure of beta cells is the point at which glucose levels in the blood begin to rise and hyperglycaemia results