Metabolic Syndrome

Question 1

intra-abdominal adiposity
elevated TGs, LDL, bp, bg, inflammation
decreased HDL’s

Answer 1

precursors of CV disease + type II diabetes

Question 2

abd obesity: (men) >40 in waist circumference (women) >35 inch

bp>/= 130/85

TG>/=150

HDL: (men) <40 (women) <50

fasting bg: >/= 100

Answer 2

diagnose metabolic syndrome

Question 3

increase waist circumference=

Answer 3

increase CHD risk

Question 4

secretory products of adipose tissue that are risk factors for CVD

Answer 4

Adipokines

Question 5

2 beneficial products of adipose tissue

Answer 5

Adiponectin and estrogen

Question 6

driving force for metabolic syndrome

Answer 6

abdominal obesity

Question 7

increase in visceral mass=

Answer 7

increase insulin resistance and can lead to type II diabetes

Question 8

normal response of increased glucose after a meal:

Answer 8

1. pancreas releases insulin
2. insulin to target tissues (liver, muscle)
3. GLUT-4 brings glucose in
4. decrease blood glucose

Question 9

when there is an increase in glucose after a meal, what does the liver do

Answer 9

stop making glucose

Question 10

when there is an increase in glucose after a meal, what does the muscle do

Answer 10

converts glucose to glycogen(store) or ATP (energy)

Question 11

when there is decreased glucose in blood what does pancreas beta cell do

Answer 11

at resting state w/ Kach channel open

Question 12

when there is an increase in blood glucose, what does pancreas do (6 steps)

Answer 12

1. glucose binds GLUT-2 on beta cell
2. glycolysis and TCA—> ATP
3. increase ATP closes Kach channel
4. beta cell depolarized
5. Ca2+ channel opens and Ca2+ influx
6. insulin released

Question 13

normal response of insulin at target tissue (liver, muscle) (5 steps)

Answer 13

1. insulin binds receptor
2. receptor dimerizes
3. Tyr residues w/ IRS1 phosphorylate
4. GLUT-4 translocation and glucose in
5. glycogen synthesis too

Question 14

what happens to insulin during metabolic syndrome

Answer 14

resistant and doesn’t bring glucose in

Question 15

signaling that occurs w/ excess adipose tissue (4 things)

Answer 15

1. release of pro-inflammatory factors and ROS
2. insulin binds IRS-1
3. SER residues phosphorylate
4. Ang II phosphorylates SER
   no GLUT-4 translocation

Question 16

early insulin consequence of metabolic syndrome

Answer 16

impaired insulin action (less glucose uptake)

Question 17

late insulin consequence of metabolic syndrome

Answer 17

impaired insulin secretion from beta cells

Question 18

metabolic syndrome can lead to ____ (due to impaired insulin action and secretion)

Answer 18

type II diabetes

Question 19

increase age and w/ diabetes=increase risk for what

Answer 19

CVD

Question 20

how visceral obesity leads to hypertension:

Answer 20

1. activation of RAS
2. increase SNS activity
3. renal compression

Question 21

increased arterial pressure leads to renal damage and increased blood pressure and then what

Answer 21

hypertension

Question 22

increased systemic____ with metabolic syndrome

Answer 22

inflammation

Question 23

3 main things causing atherosclerosis in patients with diabetes

Answer 23

vasoconstriction, thrombosis, inflammation

Question 24

to Rx abdominal obesity

Answer 24

lifestyle changes
GLP-1 agonists (ozempic)
gastric bypass

Question 25

to Rx insulin resistance and diabetes

Answer 25

metformin and ARBs/ACEIs

Question 26

to Rx dyslipidemia

Answer 26

statins and PCSK9 inhibitors

Question 27

to Rx hypertension

Answer 27

ARBs/ACEIs

Question 28

have off target effect of reducing ROS in system

Answer 28

ARBs

Question 29

metformin net effect

Answer 29

lowers hyperglycemia