Lecture 26/27: Obesity Flashcards

1
Q

How do you calculate BMI?

A

BMI = 703 * (weight) / (height)^2

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2
Q

____ Syndrome precedes the development of T2DM in obese patients

A

Metabolic Syndrome

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3
Q

True or False: MetS and T2DM are associated with obesity and sedentary lifestyle

A

True

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4
Q

True or False: T2DM is associated with insulin resistance

A

True

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5
Q

___, ____, and ____ are important for control of blood glucose

A

Insulin, glucagon, and epinephrine

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6
Q

True or False: Exercise, diet, and behavioral changes can reverse MetS and T2DM

A

True

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7
Q

What is the treatment for obesity of the cause is metabolic syndrome?

A

Weight loss

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8
Q

____ _____ are metabolic abnormalities associated with obesity (hyperglycemia, CVD, hyperinsulinemia, insulin resistance)

A

Metabolic Syndrome

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9
Q

Ectopic accumulation of TAG in liver can cause _____ disease

A

non-alcoholic liver disease
(higher risk of liver cancer/cirrhosis)

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10
Q

What drug is an oral anti-diabetes medication that inhibits gluconeogenesis?

A

Metformin

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11
Q

HBA1C that is greater than 6.5 means ___

A

diabetes

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12
Q

What should one’s FBG/RBG be for a diagnosis of DM?

A

FBG: more than 125
RBG: more than 200

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13
Q

Stress can trigger hyperglycemia in DM patients through ____

A

epinephrine

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14
Q

Insulin decrease what four processes?

A

-Gluconeogenesis
-Ketogenesis
-Lipolysis
-Glyogenolysis

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15
Q

Glucagon/Epi increase what four processes?

A

-Gluconeogenesis
-Ketogenesis
-Lipolysis
-Glyogenolysis

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16
Q

Higher levels of ___ are required to control blood glucose in insulin-resistant, obese person

A

insulin

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17
Q

Blood glucose is kept within the same narrow __ through the day in both normal weight and obese individuals

A

range

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18
Q

When pancreas is unable to make more insulin, ____ will arise

A

T2DM

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19
Q

___ is hormone made in alpha cells of the pancreas

A

Glucagon

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20
Q

Secretion of glucagon is stimulated by low ___ levels and ___

A

glucose; epinephrine

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21
Q

___ is a catabolic hormone made in alpha cells of the pancreas that signals the fast state

A

Glucagon

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22
Q

Glucagon stimulates ___, ___, and ___ in the liver, as well as ___ in the adipose tissue

A

liver: glycogenolysis; gluconeogenesis; ketogenesis

adipose: lipolysis

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23
Q

Epinephrine stimulates what three processes?

A

Gluconeogenesis
Glycogenolysis
Lipolysis

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24
Q

What hormone is made in the beta cells of the pancreas and is secreted in response to ingestion of glucose?

A

Insulin

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25
Q

What anabolic hormone signals the fed state?

A

Insulin

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26
Q

True or False: Glucagon stimulates TAG synthesis in adipose tissue

A

False - insulin stimulates TAG synthesis in adipose tissue

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27
Q

True or False: Insulin stimulates transport of glucose into muscles and stimulates adipose tissue (GLUT4)

A

True

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28
Q

Insulin inhibits _____ and _____ in the liver and ___ in adipose tissue

A

Liver: Gluconeogenesis/ketogenesis
Adipose: Lipolysis

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29
Q

What three processes does insulin stimulate in the liver?

A

1) Glycogenesis
2) Lipogenesis
3) Protein synthesis

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30
Q

Insufficient insulin production or insulin resistance causes ____

A

hyperglycemia

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31
Q

True or False: Not all obese individuals develop T2DM and not all T2DM patients are obese

A

True

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32
Q

What two hormones control glucose homeostasis?

A

Insulin
Glucagon

33
Q

DM is a disease characterized by _____

A

hyperglycemia

34
Q

What is the cure for Metabolic Syndrome?

A

Diet, exercise, behavior modification

35
Q

What is the cause of MetS?

A

Insulin resistance induced by obesity and sedentary lifestyle (and genetics)

36
Q

____ are metabolic abnormalities associated with obesity that predisposes individuals to CVS and T2Dm

A

Metabolic Syndrome

37
Q

How is MetS diagnosed?

A

1) waist circumference - more than 40” for men and more than 35” for women
2) hyperglycemia
3) dyslipidemia (high TAG, low HDL)
4) HTN

38
Q

____ is a pathological state characterized by the excessive accumulation of body fat in a person, which puts them at higher risk of developing chronic illnesses (T2DM or CVD)

A

Obesity

39
Q

BMI greater than 25 signifies that one is ___ while BMI that is greater than 30 signifies ___

A

Overweight; obesity

40
Q

The idea that body weight returns to its initial starting point after either experimental over/underfeeding describes what idea?

A

Set Point Hypothesis

41
Q

___ , a DNA demethylase, was the first gene to be linked to high BMI

A

FTO gene

42
Q

True or False: Mutations and polymorphisms are associated with obesity

A

False - polymorphisms are associated with obesity (but not mutations)

43
Q

____is a hormones that signals satiety and suppresses appetite

A

Leptin

44
Q

Mutations in what hormones or hormone receptor results in early onset childhood obesity?

A

Leptin or leptin hormones

45
Q

~5% of early onset childhood obesity cases are ______

A

monogenic

46
Q

Where is leptin made? Do obese people have it?

A

1) Made: adipose tissue
2) Obese people have it? Yes - in excess! Have leptin resistance

47
Q

Why can leptin not be use to treat common obesity?

A

Leptin resistance is so strong that there is no effect

48
Q

Causes of common obesity?

A

Multifactorial and polygenic (genetic, environment, and behavioral components)

49
Q

Genetics plays an important in the development of obesity. It’s likely that genetics ___ individuals to obesity and if behavior and environment are appropriate, then this genetically pre-disposed individual will develop obesity

A

pre-disposes

50
Q

Two types of fat disposition?

A

Android and Gynoid

51
Q

What type of fat deposition tissue is more metabolically active, has high lipolysis rates, promotes release of FFA/leptin/other cytokines into portal vein?

A

Android

52
Q

What type of fat deposition tissue has larger adipocytes (store TAG better), lower rates of lipolysis, and FFA are release into general circulation/absorbed by muscle tissue?

A

Gynoid

53
Q

Which type of fat deposition is associated with lower body obesity and lower risk for developing chronic conditions?

A

Gynoid

54
Q

Adipose tissues behave like an organ by releasing ___

A

Adipokines

55
Q

True or False: Adipokines affect appetite, satiety, energy expenditure, fat distribution, insulin sensitivity, and inflammation

A

True

56
Q

Modest weight gain or loss in a non-obese person mainly affects the __, but not the number, of adipocytes

A

size (hypertrophy)

57
Q

When adipocytes reach their max size, further weight gain is achieved by recruitment and proliferation of new ______

A

preadipocytes

58
Q

Weight loss occurs mainly by a decrease in adipose ___

A

size (hypertrophy)

59
Q

How does overnutrition affect number and size of adipocytes?

A

Overnutrition increase number and size of adipocytes

60
Q

True or False: Obese individuals do not have insulin

A

False - they have insulin at higher levels and develop resistance

61
Q

___ is a hormone that signals energy storage and suppresses appetite

A

Insulin

62
Q

True or False: Insulin treatment can result in weight gain

A

True

63
Q

___ is an appetite-stimulating hormone (“hunger hormone”) that signals hunger. It comes from the stomach and GI and regulates energy expenditure and thermogenesis.

A

Ghrelin

64
Q

Do obese individuals have ghrelin?

A

Yes - lower levels

65
Q

____ is a adipokine with various benefits in terms of glucose metabolism, blood pressure, serum lipids, and body weight. It is located in adipocytes.

A

Adiponectin

66
Q

Do obese people have adiponectin?

A

Yes - lower levels

67
Q

Leptin is made by adipocytes and acts on ___, a brain structure

A

hypothalamus

68
Q

How does leptin signal satiety?

A

Inhibits orexigenic signaling and stimulates anorexigenic signaling

69
Q

___ and ____ inhibit orexigenic neurons

A

POMC; CART

70
Q

Circulating leptin levels correlate with ____mass

A

fat mass

71
Q

Obese people typically experience ____ resistance

A

leptin

72
Q

True or False: Leptin decreases AMPK activity

A

True

73
Q

Adiponectin is made almost exclusively by ___

A

adipocytes

74
Q

True or False: Higher levels of adiponectin in lean people are correlated with better lipid profiles, lower blood pressure, and improved insulin sensitivity

A

True

75
Q

Treatment of obesity with exogenous ___ has deleterious effects on bone density

A

adiponectin

76
Q

Dietary restriction may cause decrease in metabolic rate, but must be implemented with ____ changes

A

behavioral

77
Q

Glucagon-like peptide 1 (incretins) is a T2DM medication. It is secreted by the __ and slows ____ empty. It increase glucose control and suppresses hunger.

A

gut; stomach

78
Q

True or False: Semaglutide is administered once a week, allows for better glucose control, lower blood pressure, and lower markers for inflammation

A

True

79
Q

True or False: Gastric bypass surgery, sleeve gastrectomy, and adjustable gastric band may cause decrease in metabolic rate and must be implemented with behavioral changes

A

True