Metabolic Syndrome Overview Flashcards
Group of symptoms that happen together that characterise a condition or an abnormality
syndrome
cluster of risk factors that predispose to CVD and T2D
metabolic syndrome
CVD
cardiovascular disease
T2D
type 2 diabetes mellitus
metabolic syndrome risk factors (4)
high blood pressure, raised fasting glucose, central obesity, dyslipidaemia
dyslipidaemia is characterised by (2)
high triglycerides and low HDL cholesterol
HDL
high density lipoprotein
other names for metabolic syndrome (8)
Syndrome X, dysmetabolic syndrome, insulin resistant syndrome, plurimetabolic syndrome, cardiometabolic syndrome, dyslipidemic hypertension, hyper triglyceridemic waist, deadly quartet
BMI
body mass index
how is BMI calculated
weight kg/height m^2
annual incidence of metabolic syndrome
3%
what % of Australian adults have Metabolic syndrome
35%
elevated waist circumference cut off
population dependent
triglyceride cut off
> 1.7 mmol/L
HDL cut off men
<1.0 mmol/L
HDL cut off women
<1.3 mmol/L
systolic blood pressure cut off
> 130 mmHg
diastolic blood pressure cut off
> 85 mmHg
fasting blood glucose cut off
> 5.5 mmol/L
central obesity increases risk of
CVD and T2D
risk factors for CVD (3)
high triglycerides, reduced HDL, elevated blood pressure
what increases risk of T2D
insulin resistance
what % of insulin resistant patients have normal glucose tolerance
25%
European/North American men waist
> 102 cm
European/North American women waist
> 88cm
Asian men waist
> 90 cm
Asian women waist
> 80 cm
Central and South American men waist
> 90 cm
Central and South American women waist
> 80 cm
Middle easter and mediterranean men waist
> 94 cm
Middle eastern and mediterranean women waist
> 80 cm
sub saharan african men waist
> 94 cm
sub saharan african women waist
> 80 cm
where is subcutaneous fat
under the skin
what is viscereal fat also known as
hidden fat
what is visceral fat associated with (4)
high tiglycerides, insulin resistance, inflammation, altered cytokines
what does visceral fat lead to less of
leptin
what does visceral fat produce more of
cortisol
TOFI
thin outside fat inside
can you be metabolically fat but still fit
yes
how many alcohols on glycerol
3
3 glycerols on a mixed triacylglycerol (3)
stearoyl, linoleoyl, palmitoyl
what is inside a white adipocyte (2)
triacylglycerols and cholesteryl esters
what is the membrane of a white adipocyte
phospholipid monolayer
what is in the membrane of a white adipocyte
free unesterified cholesterol
what is on the surface of white adipocytes
ApoB 100
TAG
triacylglycerol
What can TAGs be broken down into
free fatty acids
stage 1 of TAG breakdown
beta oxidation
stage 1 of TAG breakdown produces (3)
28 electrons, NADH, FADH2
stage 2 of TAG breakdown
citric acid cycle
beta oxidation in TAG breakdown prroduces
8 Acetyl Co A
citric acid cycle in TAG breakdown produces (4)
NADH, FADH2, 64 electrons, 16CO2
Stage 3 of TAG breakdown
oxidative phosphorylation
NADH and FADH2 are transferred to
respiratory (electron transfer) chain with an electron
what is produced in the respiratory chain (2)
water and ATP
why are fatty acids good
energy rich
where do triglycerides and cholesterol circulate
blood
what does high TG contribute to
atherosclerosis
what is atherosclerosis
thickened and hardened blood vessels
what do high triglycerides normally coincide with
low HDL
high triglycerides is a risk factor for
fat accumulation in pancreas
pancreatic fat accumulation can lead to
pancreatitis
what is HDL cholesterol a precursor for (3)
steroid hormone, bile salts, vitamin D
is cholesterol made in plants
no
what is cholesterol needed for
cell membrane
where does cholesterol come fun
we make it
cholesterol becomes (4)
hydroxysterols, steroid hormones, cholesteryl esters, bile acids
bile acid
taurocholic acid
cholesterol to choleseryl ester uses (2)
ACAT, fatty acyl-CoA to CoA-SH
ACAT
acyl-CoA-cholesterol acyl transferase
how is cholesterol prepped for transport
fatty acid esterification 3-OH
why is fatty acid esterification 3-OH needed for
makes it hydrophobic
How is cholesterol transported
in lipoprotein
lipoprotein example
VLDL
VLDL
very low density lipoprotein
what is on the surface of lipoproteins
ApoB 100
inside of lipoproteins (3)
triaacylglycerols, cholesteryl esters, phospholipid monolayer
what is in the lipoprotein phospholipid monolayer
free unesterified cholesterol
types of lipoproteins (4)
chylomicrons, VLDL, LDL, HDL
what does ingested fat first encounter
gallbladder
what does the gallbladder release
bile salts
what do bile salts do
emulsify dietary fat
where is dietary fat emulsified
small intestines
what does dietary fat become once emulsified
mixed micelles
what degrades triacylglycerols in the small intestines
intestinal lipases
what uptakes fatty acids and broken down products
intestinal mucosa
when fatty acids are uptaken what are they converted to
triacyglycerols
what makes up chylomicrons (3)
triacylglycerols, cholesterol, apolipoproteins
apolipoprotein example
ApoCII
where do chylomicrons move to
tissue
where do chylomicrons travel (2)
lymphatics and bloodstream
where is lipoprotein lipase located
capillaries
what activates lipoprotein lipase
ApoCII
what does lipoprotein lipase convert triacylglycerols into (2)
fatty acids and glycerol
where do fatty acids go
into cells
where are fatty acids stored (2)
myocytes or adipocytes
what are fatty acids oxidised for
fuel
what happens to fatty acids for storage
reesterified
TAGs cross the intestinal mucosa into
intestinal enterocytes
what is located on the surface of chylomicrons (3)
ApoCII, ApoB48, ApoE
where do chylomicron remenants go
liver
what are chylomicron remenants converted into
cholesterol
free fatty acids are stored where (3)
muscle, adipose tissue, mammary glands
chylomicron pathway is the what pathway
exogenous pathway
dietary fat uptake via bile salts is the which pathway
enterohepatic pathway
cholesterol in the liver enters what (3)
enterohepatic pathway, cholesterol ester, reverse cholesterol transport
cholesterol esters enter which pathway
endogenous pathway
cholesterol esters become
VLDL
VLDL are transported in the
blood
VLDL become
IDL
IDL becomes
FFA or LDL
LDL converted to (3)
cholesterol and stored, hepatic cholesterol, cholesterol in macrophage foam cells
cholesterol converted to what in reverse cholesterol transport
HDL
HDL take to
macrophage foam cells
cholesterol from macrophage foam cells bind to which receptors on live (2)
SRBI or LDL receptor
where are HDL precursors from (2)
liver and intestines
where do VLDL remnants go (IDL)
liver
LDL can go to
extrahepatic tissue
what happens to chylomicron remnants in liver
degradation in lysosomes
when is endogenous pathway used
excess dietary fat
what happens to VLDL when insulin is high
lipids to adipose storage
what happens to VLDL when insulin is low
lipids from adipose to muscle for oxidation for energy
when cholesterol is converted to bile salts what happens to the bile salts
reabsorbed and returned to the gall bladder
what is a risk factor for atherosclerosis
dyslipidaemia
how is atherosclerosis avoided
HDL transporting cholesterol back to liver
what happens to blood vessels in atherosclerosis
damaged
in atherosclerosis what do monocytes become
macrophages
what do macrophages do in atherosclerosis
engulf modified LDL
what are atheroscleroic plaques high in
cholesterol
what do macrophages become in atherosclerosis
foam cells
what do monocytes and lipoproteins do in atherosclerosis (2)
aggregate and stick to ECM
where does free cholesterol accumulate in atherosclerosis (2)
membranes and droplets
where do atherosclerotic plaques form
arterial wall
HDL picks up cholesterol via
LCAT
LCAT
Lecithin Cholesterol Acyltransferase
atherosclerosis can lead to (7)
apoptosis, necrosis, tissue damage, atherosclerosis, thrombosis, myocardial infarction, stroke
what type of LDL accumulates in plaques
oxidised
what favours LDL accumulation in plaques
high LDL
how do endothelial cells react to LDL accumulation in plaques
display adhesion molecules
what invades tissue when adhesion molecules displayed
monocytes and T cells
monocytes and T cells are
white cells
what accumulates in artery walls
modified oxidised LDL
what favours LDL accumulation in artery walls
high LDL
how do endothelial cells in the artery react to LDL accumulation
display adhesion molecules
when endothelial arterial cells display adhesion molecules what invades (3)
white blood cells (monocytes and T cells)
what do monocytes and T cells secrete
inflammatory mediators/cytokines
what responds to cytokines in atherosclerosis
macrophages
what do macrophages do in atherosclerosis
take up modified LDL with scavenger cells
when do macrophages become foam cells
when engorged with cholesterol
what develops to trap foam cells
atheroma
what is an atheroma
fibrous tissue plaque
what do foam cells produce
tissue factor
what can tissue factor do
blood clot when plaque ruptures
how do LDL stay in arterial walls (2)
aggregate and stick to ECM
