Intermediary Metabolism Flashcards
CNS needs a constant supply of
must maintain constant ___ for use by brain, which is ___ independent
major homeostatic variable is control of
if BG falls below ___, brain fxn is compromised
if BG remains above ___, leads to morbidity/shortened LE
glucose
BG, insulin
BG
50
110
Carbs provide ___ kcal
stored as ___ in liver/muscle
___ days need
Fat kcal
stored as ___ in adipose
___ abundant energy store
___ efficient energy reserve
Protein kcal
Stored in
major source of __ when fasting
4kcal
glycogen
1
9
TG
most, most
4
muscle
BG
Gluco only occurs in
forms glucose from
in most tissues, neither ___ can be converted to glucose
liver/kidney
AA, lactate, glycerol (not FA)
prot/fat
Absorptive rxn occur after__, glucose is ___, used for ____
TG broken down into glycerol/FA by
Fat storage depends on
meal, plenty, fuel storage
lipoprotein lipase (cap endo)
activity of LPL, glucose uptake
Post absorptive rxn occur bw ____, tissues switch to ___ met, used for ___
Breakdown of TG to FA by
Insulin synth/sec by
___/___ sec in equal amounts
little ___ degraded by liver, indicating B ells
meals, FA/ketone, fuel utilization
hormone sensitive lipase
B cells of panc islets
insulin/c peptide
C peptide, secretory capacity
Insulin release in __ phase
1 is
2 is
brings about rxn of
Insulin receptor- IC portion has ___ activity, similar to ___ receptor
2
stored insulin
newly formed
absorptive phase
tyrosine kinase
IGF
Insulin involved in
Translocates ____ from IC to PM
activates/inhibits enzymes mediating ____ metabolism
Alters gene expression for
indirectly inc ____ in liver
liver/B cells us
activates ____ enzyme
main target
numerous cell responses
GLUT4
carb/lipid/prot
cell growth
glucose uptake
insulin insensitive GLUT2
glucokinase enzyme
muscle/adipose
Insulin effects
___ glucose uptake in muscle/adipose via
does not afect
___ glycolysis, glycogen synth (synthease)
___ glycogen breakdown (inhibits phosphorylase), gluco, ketogenesis
___ TG synth (activates LPL)
___ TG breakdown (inhibits HSL)
Inc ____, ____
Dec
Net result- ___ plasma glucose/FA/AA
____ glycogen/TG storage/protein synth
inc, GLUT4
CNS, kidney medulla, RBC, exercising muscle, SI
inc
dec
inc
Dec
aa uptake, prot synth
protein breakdown
dec
inc
____ is primary regulator of insulin sec
Stim signals
___ plasma glucose/aa/FA/ketones
____ PNS activity (Ach)
___ gut hormones (incretins, GLP1)
Pharm agents
Inhib signals
___ symp activity (NE/Epi)
___ somatostatin (used to treat insulinomas)
inc plasma glucose
inc
inc
inc
SFU, DPP4 inhib, GLP1 analog
inc
Inc
Absence of insulin
mimics events of ___
mobilizes ____
inc
dec
stimulates
long term fasting- once BG falls below a certain level, the CNS begins to
only after ___ days are plasma ketone levels high enough to provide brains energy needs
fasting
fuels
BG, FFA, ketones
glyogen, fat
post aborptive rxn
metabolize ketones
4-5
T1DM is insulin ___
no
AI Destrxn of
T2DM has defective
sx
in Type 2, insulin is
dependent, insulin synth, b cells
insulin receptors
inc BG, dec glucose tolerance
inc, tissues insensitive
NIDDM caused by
Leads to adipose tissue ____ releasing adipocytokines ___
these block insulins actions, releasing ______ from macros to inc
dec number of ___ due to inc apoptosis
mito become
may lead to ___ due to exhausted B cells
Reversible w
overeating/obesity
macro infiltration, TNFA/IL6
resistin, insulin resistance
B cells
dysfxn
T1DM
diet/exercise
Hormones opposing insulin
____ synth by panc ____-
___ from AM
___ from AP
___ from AC
glucagon, alpha cells
Epi
GH
Cortisol
hormones opposing insulin leads to
inc ____, via ___ in liver, __ in muscle
Inc ___ by all 4 hormones
Inc ___ via all 4 &
cortisol is __ for both
dec __ into cells via
net result inc
glycogenolysis, glucagon, epi
gluco
lipolysis, HSL
permissive
glucose uptake, Epi/GH/cortisol
plasma Glucose/FA
Stimulatory control of glucagon
___ BG (most important), ie
___ symp activity, ie
____ plasma AA
____ gut hormones
____ PNS activity via
Inhib by ____ at pharm doses
dec, fasting hypogly
inc, stress/exercise/dec BP
inc
inc
inc, Ach, VIP
somatostatin
Epi sec inc by dec, inc
GH sec inc by dec, inc
cortisol sec inc by
plasma glucose, symp output
plasma glucose, symp output/plasma AA
stress, symp activity
Food intake and energy expenditure are _____ regulated day to day and
obesity results when energy in >
BMI =
normal BMI
overweight BMI
obesity BMI>
highly, LT
energy out
weight kg/ht (m2)
20-25
25-30
30
Short term control of appetite
learned via
___ avail
Gut __ signals sent via __ to brainstem
Gut \_\_\_ signals for satiety CCK via P O G P, such as PP/A
behav, social cues, enviro, emotion
Nutrient
neural, vagus
hormonal vagus Peptide YY Oxyntomodulin (OXM) GLP1 Panc iselt satiety signals, Panc polypep, amylin
LT control of appetite
Satiety signal
____ signals adiposity, dec appetite
___ sec by adipose tissue
plasma levels + correlate w
acts via __ receptors
insulin
Leptin
% body fat
Ob-Rb
Hunger signals
____ released by stomach/GI
stimulates __ release
use ___ receptor
plasma levels inc ___ and when
negatively correlates w
Ghrelin
GH
GHS1a
pre-prandially/during fasting
% bf/weight
Hypothalamic arcuate (infun) nucleus has orexigenic ___ neurons
anorexigenic ___ neurons
POMC acts via ____, acting on ___ receptors to inhibit food intake
____ is MC4 recep antag
Leptin activates
inhibits
dec ___ and inc
Ghrelin activates
inhibits
dec and inc
NPY/AgRP
POMC/CART
AMSH, MC4
AgRP
POMC/cart
NPY/AgRP
food intake, energy expend
NPY,AgRP
POMC/CART
energy expend, food intake
Other areas of brain express ____ receptors
MCH in ___ is the hunger center
inc
inhibits ___ actions
MCH knockouts are
Ob-Rb, GHS1a
lateral hypo
food intake, obesity
MC4 receptor
lean
Leptin defic leads to early onset
Hyper
Hypo
Defects in T cell
Leptin receptor mutant early onset
MC4R mutant dec ___ signaling
POMC def
dec ___, presents w
onset obesity
Insulin
gonad/thyroid
#/fxn
obesity
MSH
MSH/ACTH, hypocortisol
Conseq of obesity Inc morbidity due to D A/C S O Reduces \_\_ responsiveness H inc risk for \_\_\_ cancer in men \_\_ in women M
Diabetes Athero/CAD stroke osteoporosis GH hypogonad prostate/colon breast/endometrial/biliary Metabolic syndrome
Tx obesity w
difficult due to
exercise seems to lower the ___ to regulate ____
diet, exercise, drugs, bariatric surgery
hypothalmaic set point
set point, total body fat stores
