L3 Obezity Flashcards

1
Q

What is obesity and what is the main issue

A

Metabolic disorder leading to a positive energy ratio between energy intake v energy expenditure

If energy intake is sustained

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2
Q

What are the major causes

A

Genetics
Epi genetics
Environment ie diet or activity

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3
Q

How is bmi measured and what is obese

A

30kg/m-2

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4
Q

How else is obesity measured

A

Fat percentage and waist circumference

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5
Q

Why was it thought obesity could be evolutionary

A

Because some animals have adapted to store fat eg during hibernation or migration if birds

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6
Q

Why is this discredited

A

70% of the western population isn’t obese even though food is plenty

Plus the disadvantages weigh out the advantages

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7
Q

What was the first experiment linking genetics to obesity

A

Ob/of mouse with ob gene for leptin being mutant the mouse because obese with increased adiposity and reduced appetite control

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8
Q

Which type of obesity is extremely rare and Mendelian (mutations)

A

Monogenic affecting appetite centre and satiety centre

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9
Q

What does congenital leptin deficiency obesity mean

A

A type where you have a v rare leptin gene mutation = loss of leptin

(Treatment with leptin)

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10
Q

Which other major types of mutations are there

A

Leptin receptor deficiency obesity

Pomc mutation

Mc4r mutations (most common) - loss of signalling to appetite control

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11
Q

Which is autosomal recessive

A

Congenital leptin deficiency

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12
Q

What does leptin deficiency cause

A

Extreme hunger and hyper insulin anemia leading to resistance

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13
Q

Where are leptin receptor and pomc gene expressed

A

Arcuate nucleus in hypothalamus

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14
Q

What is pomc

A

A precursor which is cleaved into hormones like acth, msh, b lipotropin

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15
Q

Explain how leptin can cause satiety and increase energy expenditure

A

Binds to lepr on arcuate nucleus which then expresses more pomc which then is cleaved into msh etc

A- msh then binds to mc4r activating it and this causes satiety signals

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16
Q

Other than leptin what also stimulates pomc neurones

A

Insulin from b cells

17
Q

Which hormones block pomc signalling aswell as antagonise mc4r receptors

A

Npy and agrp

18
Q

What stimulates production of these/ gene exp increase

A

Ghrelin from the stomach

19
Q

Is there a snp which is protective from obesity which blocks agrp antagonising the mc4r receptor

20
Q

Is polygenic obesity due to lack of leptin suually or leptin reisstance

A

Leptin resistance eg due to snp in lepr

21
Q

Candidate approach was used to study polygenic, why was monogenic used for this

A

Because they looked at genes in the hypothalamic pathway / melanocortin and leptin pathway

22
Q

What sort of genes had snps associated

A

Agrp, lepr, mc4r, npy and pomc

23
Q

What protein gene did Gwas see associated which isn’t in the hypothalamic path

A

FTO (fat mass obesity gene)

24
Q

What traits is fto associated with

A

Waist circumference and bmi (see fr)

25
What protein is fto
Mrna de methylases eg works on leptin to de methylate- more leptin?
26
Where is it expressed
Hypothalamus
27
What else in fr seen it increase levels of if you have this certain snp (rs9939609)
Ghrelin via demethylation
28
What genotype is this seen in (in further reading article)
AA genotype
29
When is fto expression high
Feeding but stops during fasting as lack of leptin release
30
If the odds ratio for fto is 1.6 what does this mean
The odds of you getting the disease is 1.6x more likely than baseline
31
Give some examples of epi genetics affecting risk
Nutrition impacts methylation Eg breastfeeding longer seen to reduce methylation of leptin gene but smoking during pregnancy increases it Maternal obesity also linked to increased risk of offspring obesity
32
How is microbiome incolved
Dysbiotic towards increased firmicutes Also increased levels of scfa but unknown and it is controversial.
33
How does leptin have effect on the orexigenic neurone with npy and agrp
Inhibits the neurone so stops agrp antagonistic effect
34
What is sim1 mutation in monofenic obesity (fr)
Allows exp of more pvn neurones where mc4r are so if it’s mutated there are less