Metabolic Syndrome from chronic positive energy balance Flashcards
5 risk factors of MS include:
-___________
-Hyperlipidemia (fasting blood triglycerride great than _____)
-Low HDL (less than ___ for males and 50 for females)
-Prehypertension (______/85)
-Fasting blood glucose _______ than 100
-waist circumference
150
40
130
greater than
The three factors that result in increased abdominal adiposity (intra, not subcutaneous) and impaired glycemic control include ___________ and hyperinsulinemia, ___________ blood glucose, nonenzymic glycation leading to ___________________
Insulin resistance
Elevated
AGE formation
_____________________ expansion is caused by chronic positive energy balance and leads to insulin resistance and hyperinsulinemia
Adipocyte expansion
Adipocyte enlargement results in ____________________ when beta cells work harder to produce more insulin but the adipocytes still don’t respond
insulin resistance
advanced glycation end products are proteins with increased nonezymatic glycation as a result of _________________. This results in a decrease in ________ of artery, decline of ________ function and filtration rate in kidney and exacerbation of atherosclerotic lesions.
Exposure to sugars. elasticity, glomerular,
Increased adipose lipolysis is initiated by __________ when energy need arises. This increases cAMP which activates __________. The resulting phosphorylation of ________ and perlipin stimulates lipolysis in adipocytes.
epinephrine
PKA
Hormone sensitive lipase
The reduction of basal lipolysis is caused by __________ as it activates PDE3 which degrades ___________ to reduce PKA activity. PKA phosphorylates __________ which is the rate limiting factor of free fatty acid release.
insulin
cAMP
hormone sensitive lipase
Basal lipolysis _________________ when adipocytes develop insulin resistance because insulin prevents excess fatty acids from being released. They can’t be utilized by other organs so they are converted to ________________ and picked up by liver
increases
triglycerides
When basal lipolysis increases, excess fatty acids relased from the adipose are taken up by the ______, repackaged and secreated as ___________________
liver
VLDL
HbA1c (amadori product) represents how many hemoglobin proteins have been _____________ and eventually leads to AGE. This is known as the ________________ reaction (browning)
Glycated
Millard
Elevated blood pressure is common in obesity given that the ________________ nervous system is often activated, increasing the vascular ___________ and blood pressure
sympathetic
constriction
An upregulation of the ________________ is also common in obesity resulting in higher sodium retention –> increased blood volume expansion. This is long term regulation
renin-angiotensin aldosterone system
Chronic hypertension increases risk for stroke, mechanical stress damages ___________ leading to gradual loss of filtration leading to less sodium excretion further impairing control
glomerulus in kidney
hypertension exacerbates atherosclerosis as it causes tiny tears where plaque can stick, weakens the walls and forms aneurysms. Chronic inflammation of the _____- and accumulation of _________ occurs
intima
cholesterol
Heart failure occurs when ventriculuar __________ increases to maintain blood supply. However, as it progresses, leads to congestive heart failure
hypertrophy
Decreased HDL is a concern for MS as it transports excess __________to the liver to be excreted. With low HDL, excess cholesterol then stored in ________-
cholesterol
adipose tissue
___________________ in adipose resulting from chronic positive energy balance is likely the primary event that leads to secondary complications such as metabolic disorders and disease conditions
insulin resistance
Adipose insulin resistance occurs when
1.) __________ increases in adipocytes (leading to expansion)
2.) increased ___________ activity causes more fatty acid release from adipose (usetohydrolizestoragemolecules)
3.) More fatty acids enter other tissues
4.) Results in secondary metabolic disorders
fat storage
hormone sensitive lipase
Secondary metabolic disorders associated with adipose insulin resistance include
1.) ______________
2.) lipotoxicity
3.) oxidative stress/motichondrial malfunction
4.) _______________
Nonalcoholic fatty liver
insulin resistance in other tissues such as liver and skeletal muscle
Reversal of insulin resistance can be achieved under _______________.
negative energy balance
Liposuction removes subcutaneous fat. But it doesn’t impact insulin sensitivity because the ________________ composition is still the same even if the quantity is lower. If anything, it further impairs the cell function
adipocyte
Thiazolidinediones can improve insulin sensitivity despite increasing body fat mass as it is a specific agonist of _________ which increases fatty acid oxidation
PPARy
Dietary saturated fats with 12,14,16 carbons increase the ______ cholesterol which is major risk factor for ____________
LDL
atherosclerosis
Dietary sodium and potassium influence blood pressure; sufficient _________ is required to excrete excess _______ efficiently
potassium
sodium
Physical activity can increase bone health and reduce blood pressure regardless of diet. Not ideal for creation of a ______________as it can be easily overridden.
caloric deficit
Reversal of MS through weight reduction by the keto diet resulted in 20% of population within the target range of an HBA1c less than ____mM and within a year close to 70% reached this goal
48
Glucagon inhibitors inhibit glucagon release and often results in decreased ________ as it interacts with brain function as well, reducing overall intake
appetite
