INP final - METABOLIC SYNDROME Flashcards
Flashcards for the second half of the INP course. This set will cover METABOLIC SYNDROME
What is the WHO definition of metabolic syndrome?
• Glucose intolerance, impaired glucose tolerance, or diabetes, and/or insulin resistance
And 2 or more of:
• Impaired glucose regulation
• Insulin resistance
• BP ≥140/90 mmHg
• TG ≥150 mg/dL and/or HDL: <34 mg/dL (men) and <39 mg/dL (women)
• WHR : >0.9 (men) or >0.85 (women) and/or BMI >30 kg/m2
• Microalbuminuria (moderate increase in the level of urine albumin due to leakage by kidney)
What is the NCEP definition of metabolic syndrome?
3 of the following:
• Waist circumference: >102 cm (men) or >88 cm (women)
• TG ≥150 mg/dL
• HDL: <40 mg/dL (men) or <50 mg/dL (women)
• BP ≥130/85 mmHg
• Fasting glucose >100 mg/dL
What is the harmonized definition of metabolic syndrome?
NCEP with waist circumference cut points
Explain and describe the metabolically healthy obesity phenotype. What are the risks associated with this and potential underlying causes?
Despite lack of metabolic syndrome/increased risk of CVD or T2D, they may have other obesity-related complications:
- Altered physical and physiological functional status
- Sleep problems
- Articulation/postural problems
- Stigma
Increased duration of obesity status, even in the absence of metabolic syndrome in younger age, is associated with increased risk of developing metabolic syndrome
Explain and describe the metabolically unhealthy normal weight phenotype. What are the risks associated with this and potential underlying causes?
Presence of the metabolic syndrome in individuals with normal weight
Characterized by insulin resistance & increased risk of CVD and T2D
Due to enlarged adipocytes
Describe the concept of “adiposopathy” and visceral adipose tissue as an endocrine organ.
- Increased adipocyte size
- Increased circulating FFA
- Increased secretion of inflammatory markers
- Ectopic fat deposition
- Adipose tissue hypoxia
- Increased reactive oxygen species
- Impaired fatty acid storage in peripheral subcutaneous adipose tissue
How is liver fat associated with metabolic disorders? Is it protective or adverse?
Deposition of fat into the liver
- Non-alcoholic fatty liver (NAFL)
Associated with obesity
- Excessive intake of simple sugars
- Physical inactivity
Associated with increased risk of diabetes, CVD, non-alcoholic steatohepatitis (NASH)
- Over production of glucose and triglycerides in the liver
ADVERSE
How is intramuscular adipose tissue associated with metabolic disorders? Is it protective or adverse?
- Associated with insulin resistance and inflammation
- Associated with greater functional impairments in older adults
- Higher in older adults
- Higher in sedentary individuals
ADVERSE
How is pericardial and epicardial adipose tissue associated with metabolic disorders? Is it protective or adverse?
- Higher pericardial fat and epicardial adipose tissue thickness associated w/ higher metabolic syndrome risk factors: Blood pressure, fasting glucose, fasting insulin, insulin resistance, triglycerides, waist circumference, Lower HDL-C
- Pericardial fat associated with lower physical activity and more sedentary time and with increased risk of CVD, incident CVD events, and all-cause mortality
ADVERSE
How is brown adipose tissue (BAT) associated with metabolic disorders? Is it protective or adverse?
- adipose tissue depot whose function is heat production
- Important in newborn
- Present in adults in varying degree
- Located in the supraclavicular and perivascular region along the aorta & carotid artery
- Rich in mitochondria
- Uncoupling protein-1 activates BAT, resulting in dissipation of energy as heat rather than ATP
- Not useful energy production
PROTECTIVE
What healthy eating behaviors improve MetSyn?
o Following a Therapeutic Lifestyle Change (TLC) Dietary Pattern:
~ Moderate fat/low saturated fat and trans fat
~ Complex carbohydrates with 25-30 g of fiber
~ Adequate energy to maintain weight (or lose weight)
o Following the DASH Diet or Mediterranean Diet or Portfolio
~ Rich in fruits and vegetables, low-fat dairy
~ Low in sodium
~ Rich in vegetable proteins (think soy beans)
o Including “functional foods”
o Consume a moderate amount of alcohol
Refraining from smoking helps improve MetSyn. True or false.
True.
How is sleep and MetSyn related?
o Insufficient sleep and sleep disorders are associated with an increased risk of CVD, T2D, metabolic syndrome
~ Sleep disordered breathing
~ Insomnia
o Insufficient sleep is associated with reduced fat mass loss in the context of negative energy balance
o Poor sleep is associated with unhealthy eating behaviors, psychosocial stress, and depression
What physical activity helps improve MetSyn.
o Aerobic exercise reduces the risk of CVD
~ Strong, inverse, dose-response relation between amount of moderate-vigorous physical activity and incident atherosclerotic CVD and death
o Resistance exercise improves physical function, glycemic control, blood pressure
o Physical activity does not lead to weight loss without concomitant caloric restriction
~ Redistribution of body composition: loss of fat mass/gain lean mass
o Recommendations:
~ 50 min/wk of moderate intensity activity or 75 min/wk of vigorous-intensity aerobic activity (doesn’t have to be continuous)
