Lipids - Clinical Applications

Question 1

organic molecules that are soluble in nonpolar solvents but not in polar solvents (e.g., water)

Answer 1

Lipids

Question 2

After ingested fats (lipids) are cleaved by enzymes they are

Answer 2

absorbed in the small intestine and transported via the lymphatic system into the bloodstream.

Question 3

circulating lipids are transported in

Answer 3

lipoproteins (insoluble in plasma)

Question 4

Structural lipids:

Answer 4

Phospholipids, sphingolipids, and glycolipids

Question 5

Steroids/sterols:

Answer 5

cholesterol, bile acids, and steroid hormones

Question 6

Lipid classifications

Answer 6

• Simple: Fat/Oil: Fatty acids + Glycerol (Wax: Fatty acids + cetyl alcohol)
• Complex: Phospholipids; Glycolipids; Lipoprotein
• Derived: Derived by hydrolysis: Sterols, fat soluble vitamins and steroid hormones

Question 7

Function of Lipids

Answer 7

Main function: building blocks of cellular membranes

Other functions:

• Energy storage, mobilization, and utilization
• Prostaglandin, cytokine synthesis
• Cell differentiation and growth
• Signal transmission
• Hormone synthesis
• Bile acid synthesis

Question 8

Fats are triglycerides that are:

Oils are triglycerides that are:

Answer 8

solids at room temperature.

• usually derived from animals
• mostly saturated fatty acids

Liquids at room temperature

• usually derived from plants or fish
• mostly unsaturated fatty acids

Question 9

Loose packed fats have _______ melting points

Answer 9

lower

which is why unsaturated fats, such as vegetable oils, are commonly liquid at room temperature

Question 10

a form of lipid with carbon atoms arranged into four rings

Answer 10

steroids

Question 11

recommended mg/day of cholesterol as part of the Therapeutic Lifestyle Changes diet

Answer 11

<200 mg/day

Question 12

the main role of lipoprotein is

Answer 12

to help transport lipids (hydrophobic) in water

Question 13

Apolipoproteins mainly function as ________ but also serve as _________ for enzymes that metabolize lipoproteins and help in lipid component exchange amoung lipoproteins.

Answer 13

carrier proteins; cofactors

Question 14

Some examples of lipoproteins include:

Answer 14

• chylomicrons
• very-low-density lipoproteins (VLDL)
• intermediate-density lipoproteins (IDL)
• low-density lipoproteins (LDL)
• high-density lipoproteins (HDL).

Question 15

large triglyceride-rich particle made in the endoplasmic reticulum of enterocytes of the small intestine.

Answer 15

chylomicrons

They play a role in carrying dietary triglycerides and cholesterol to peripheral tissues and the liver.

Question 17

an apolipoprotein that is involved in chylomicron assembly, thus having a vital role in the absorption of dietary fats and fat-soluble vitamins.

Answer 17

Apo B-48

Question 18

triglyceride-rich particles made in the liver.

_______ is important for its production

Answer 18

VLDLs; Apo B-100

Question 19

are created when triglycerides are removed from VLDL by muscle and adipose tissue.

Answer 19

IDL particles

cholesterol-rich

Question 20

are formed from VLDL and IDL particles and are also rich in cholesterol.

Answer 20

LDL particles

transports most of the cholesterol in the blood

Question 21

plays a key role by acting as a ligand for the LDL receptor-mediated uptake of LDL particles by the liver and other tissues

Answer 21

Apo B-100

Question 22

are cholesterol and phospholipid-rich, and aid in reverse cholesterol transport from peripheral tissues to the liver, where it is removed

Answer 22

HDL particles

Question 23

Defective lipid metabolism is well known to modulate a wide range of chronic diseases such as:

Answer 23

• cardiovascular diseases
• cancer
• several other genetically defective lipids pathways with severe health implications

Question 24

Pathophysiological relevance of lipolysis, lipophagy

Answer 24

• Neural Lipid synthesis disease
• Obesity
• Fatty liver disease
• Cholesterol Ester storage disease
• Atherosclerosis
• Lipodystrophies

Question 25

Abnormal levels of cholesterol and triglycerides in the blood are often due to

Answer 25

the unusual assembly, breakdown, or transport of their lipoprotein particles

Question 26

are good indicators of the risk of cardiovascular disease (CVD)

Answer 26

levels of plasma lipids

Question 27

is related to a greater risk of atherosclerotic cardiovascular disease, as well as a higher occurrence of ischemic vascular disease and development of fatty deposits under the skin, known as xanthomas and xanthelasmas.

Answer 27

hyperlipoproteinemia

Question 28

Cardiovascular disease (CVD) contributes to more than __________ deaths per year globally, which accounts for nearly half of all deaths from non-communicable diseases

Answer 28

17 million

Question 29

CVD is primarily caused by \_\_\_\_\_\_\_\_\_\_\_, a chronic inflammatory disease of the arteries in which the deposition of cholesterol and fibrous materials in artery walls forms a plaque or lesion.

Answer 29

atherosclerosis

Question 30

Key risk factors that associate with the number of atherosclerotic CVD events include

Answer 30

•include the total concentration of cholesterol found in the blood, as well as the cholesterol found in individual lipoprotein subclasses.

Question 31

a primary, major risk factor for ASCVD and may even be a prerequisite for ASCVD, occurring before other major risk factors come into play.

Answer 31

Dyslipidemia

Question 32

Increasing evidence also points to insulin resistance, which results in increased levels of plasma triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) and a decreased concentration of high-density lipoprotein cholesterol (HDL-C) as an important risk factor for

Answer 32

peripheral vascular disease

Question 33

There are several types and subtypes of lipid-related disorders

Answer 33

Hypertriglyceridemia hypercholesterolemia

Question 34

Five main disorders result in hypertriglyceridemia

Answer 34

1. Familial hypertriglyceridemia: An autosomal dominant disorder that results in elevated VLDL levels in plasma 2. Familial combined hyperlipidemia: An autosomal dominant disorder, characterized by the excessive synthesis of lipoproteins containing apolipoprotein B 3. Congenital lipoprotein lipase deficiency: An autosomal recessive disorder, which results in low to no lipoprotein lipase activity; typically, chylomicrons build up in the blood and eruptive xanthomas develop 4. Apoprotein CII deficiency: An autosomal recessive disorder, characterized by the lack of apoprotein CII, an essential cofactor for lipoprotein lipase activity; there is usually chylomicron and VLDL accumulation in the plasma 5. Familial dysbetalipoproteinemia: A disorder in which there is a defect in apolipoprotein E; due to the buildup of remnant VLDL particles in the blood, there are higher plasma levels of cholesterol and triglyceride

Question 35

Three main conditions result in hypercholesterolemia

Answer 35

1. Polygenic hypercholesterolemia: The most common disorder to raise cholesterol levels; there are many genes involved that elevate LDL concentration in plasma 2. Familial hypercholesterolemia: An autosomal dominant disorder in which the gene for the LDL receptor is defective, so removal of LDL from plasma is less than effective. 1. Familial hypercholesterolemia is associated with premature ischemic cardiovascular disease; 3. Familial combined hyperlipidemia: Discussed previously

Question 36

High levels of plasma lipids can also be due to dietary factors, such as

Answer 36

* ingesting excess calories * saturated fatty acids * cholesterol * medication use

Question 37

linked to dysregulation of lipid metabolism, which may result in abnormal levels of blood lipids, ectopic lipid deposition and associated metabolic diseases such as non-alcoholic liver disease (NAFLD) and atherosclerosis.

Answer 37

obesity

Question 38

Overweight and Obesity % or young people age 2 to 19 years % of adults

Answer 38

19% 40%

Question 39

Two of the leading causes of heart disease and stroke are

Answer 39

high blood pressure and high blood cholesterol

Question 40

Abnormal lipid levels in childhood and adolescence are linked to

Answer 40

increased risk for CVD in adulthood

Question 41

Accumulation of LDs in tissues in high amounts may cause chronic inflammation which is identified as one of the hallmarks of

Answer 41

obesity-related metabolic disorders

Question 42

act like soaps and other emulsifiers: they contain both polar and nonpolar regions, helping to break fats in foods into smaller pieces, allowing them to be hydrolyzed more easily.

Answer 42

bile salts

Question 43

if cholesterol levels are too high or the levle of bile salts is too low the cholesterol precipitates and forms

Answer 43

gallstones

Question 44

gallstones can block the duct that allows bile toe become secreted into the duodenum which causes fats to no longer be digested properly, and the bile pigments absorbed into the blood causes:

Answer 44

the skin to become yellow and the stool to become gray

Question 45

There is no physicological need for: It is recommended to consume no more than \_\_\_\_\_% of total calories from it.

Answer 45

saturated fat 10%

Question 46

Essential fatty acids (FA) and deficiency Only two FA are essential: Both are:

Answer 46

Linoleic and alpha-linolenic Both are (poly)unsaturated

Question 47

Deficiencies in Linoleic and alpha-linolenic acids can lead to:

Answer 47

* Dermatitis * Thrombocytopenia * Increased susceptibility to infections * Failure to thrive * History of low fat intake

Question 48

Elevated plasma triglycerides and very-low-density lipoproteins are directly associated with the risk of

Answer 48

atherosclerotic heart disease, although not as independent as LDL

Question 49

Disorders associated with malfunctioning of sphingolipid metabolism

Answer 49

* Probably the best known is Tay-Sachs disease, which strikes infants and is typically fatal by age 3. * Niemann-Pick disease also strikes infants and is fatal early in life. * Gaucher’s disease and Fabry’s disease strike later in life and are generally less devastating.

Question 50

Reactive oxygen species (ROS) and ROS-induced oxidative modification of HDL cause

Answer 50

endothelial dysfunction and progression of atherosclerosis

Question 51

Evidence has accumulated during the past several years that strengthens long-standing AHA recommendations to replace \_\_\_\_\_\_\_with _________ and \_\_\_\_\_\_\_\_\_to lower the incidence of CVD

Answer 51

saturated fat; polyunsaturated and monounsaturated fat

Question 52

Cardiovascular disease (CVD) is the leading global cause of death, accounting for \_\_\_\_\_deaths per year, comprising \_\_\_\_\_% of total global deaths in 2013. Nearly \_\_\_\_\_\_people in the United States died of heart disease, stroke, and other CVDs in 2014, translating to about \_\_\_\_\_\_\_deaths. The annual direct and indirect costs of these deaths total more than \_\_\_\_\_\_\_

Answer 52

17.3 million; 31.5 808 000; 1 of every 3 $316.1Bill

Question 53

Dietary intake of \_\_\_\_\_fatty acids is associated with both increased LDL-C and decreased HDL-C levels.

Answer 53

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