Metabolic syndrome Flashcards
What is metabolic syndrome?
A group of metabolic abnormalities that cluster together leading to cardiovascular disease. Typically three or more conditions
How many Australian’s have/ get MetS?
22-31%
What are common risk factors for MetS
Genetics, family hx, age, abdominal obesity, physical inactivity, smoking
What is dyslipidaemia?
Elevated triglycerides
True or false, very low dense lipoproteins are the biggest form of lipoprotein.
False, Chylomicrons are. They contain 90% triglyceride
What is an apolipoprotein?
It is part of a protein shell structure in a lipoprotein that acts as a receptor site for cell attachment to bind lipids to protein (LDL, HDL’s)
What is lipoprotein lipase?
They breakdown triglycerides that are circulating in the blood stream. Typically in VLDL
What is hepatic lipase?
They maintain steady levels of HDL, LDL and remove lipoproteins from the blood via hepatocytes
What is hormone sensitive lipase?
It converts stored triglycerides to free fatty acids
During insulin resistance, what happens to the levels of lipoprotein lipase, hepatic lipase and hormone sensitive lipase?
Lipoprotein lipase = decrease (triglycerides aren’t getting broken down)
Hepatic lipase = Increase (trying to remove lipoproteins from blood)
Hormone sensitive lipase = increase (more lipids getting released into the blood)
True or false, VLDL decrease HDL
True, HDL also decrease in insulin resistance
What is the lipid triad?
Elevated triglycerides
Low HDL’s
Small dense LDL’s
How is dyslipidaemia diagnosed?
Full lipid profile, taken 2 or more with a week interval
What is the desirable range for total cholesterol?
<5.17mmol/L, <200mg/dl
What is the desirable range for triglycerides?
<1.69mmol/L, <150mg/dl
What is the desirable range for LDL?
<2.58mmol/L, <100mg/dl
What is the desirable range for HDL?
> 1.55mmol/L, >60mg/dl
What values place a patient at high risk?
Total C = >6.18mmol/L TG = >2.25mmol/L LDL = >4.11mmol/L HDL = <0.9 Chol:HDL = >6 HDL:LDL = 9.5(m), 7(w)
For every 0.77mmol/L increase in LDL’s, CHD risk increases by…?
30%
For every 1% decrease in LDL reduces the risk of CHD by…?
1%
For every 0.26mmol/L increase in HDL, decreases the CHD risk by…?
50%
What are some different risk factors for dyslipidaemia?
Clotting disorders, vessel wall defect, lipoprotein defect
What do statins do? And some common names for them?
Inhibit cholesterol synthesis in the liver. Lovastatin, Atorvastatin, Simvastatin
What do bile acid resins do? And some common names for them?
They bind to bile acids (bad things) and excrete them instead of allowing them to be reabsorbed in the blood. Colestyramine, colestipol
What do fibrates do? And some common names for them?
They reduce triglycerides and increase HDL by preventing the production of VLDL. Bezafibrate, fenofibrate, Gemfibrozil
What do Nicotinates do? And some common names for them?
Reduces lipolysis and free fatty acid release, decrease LDL and increase HDL. Nicotinic acid, Niacin, Acipomox
What do plant sterols do? And some common names for them?
Inhibit absorbtion of cholesterol in the intestine. Phytosterols.
What needs to be considered during exercise for someone with MetS
- Their underlying conditions. Make sure to take all normal measures (BP, HR, SpO2, glucose, etc)
- Make sure the prescription is specific to the person and somewhat based on obesity and T2DM guidelines
What are some common effects of exercise on someone who has diabetic dyslipidaemia?
Increase HDL Decrease LDL and VLDL Decrease Glucose levels Increase LPL and HL activity Less cholesterol ester transfer protein triglyceride exchange Increase insulin sensitivity
True or false, volume is more important than intensity in MetS
True, low to moderate intensity improves lipid profile
