Obesity

Question 1

اللهمّ أكرمني بجودة الحفظ وسرعة الفهم وثبات العقل والذهن والذاكرة بحق قولك: «الرَّحْمَـنُ، عَلَّمَ الْقُرْآنَ، خَلَقَ الْإِنسَانَ، عَلَّمَهُ الْبَيَانَ، الشَّمْسُ وَالْقَمَرُ بِحُسْبَانٍ».

Answer 1

آمين

Question 3

Obesity is associated with _________dysfunction.

Answer 3

adipose tissue

Question 4

Excess fat mass is often associated with:

Answer 4

elevated systemic free fatty acids (FFAs) altered cytokine secretion
local and systemic inflammation

Question 5

Although obesity may be defined as an excess of body________, it is currently well recognized that the distribution of body fat influences disease risk.

Answer 5

adiposity

Question 6

Excess intra-abdominal fat accumulation (visceral obesity) is believed to be more important than total body fat in predicting morbidities associated with obesity.

Answer 6

🔴

Question 7

central, abdominal, android pattern of fat accumulation (apple-shaped) confers an ____________of obesity-related diseases, while the gluteal–femoral adipose tissue (peripheral, gynecoid or pear-shaped) acts as a_______________.

Answer 7

independent risk

protective energy store.

Question 8

Abdominal (Visceral) Adiposity
🔺Waist circumference (WC) >102 cm in men and >88 cm in women, and waist-to-hip ratio (WHR), >___ for men and >_____ for women are used as measures of central obesity.

Answer 8

0.9, 0.85

Question 9

Various studies have found that markers of abdominal adiposity are more strongly related to the risk of obesity-associated
complications compared to BMI alone.

Answer 9

H

Question 10

Increased visceral fat has been associated with:

Answer 10

🔴Reduction in high-density lipoprotein (HDL),
🔴 Elevation in triglycerides,
🔴 Glucose intolerance/ hyperglycemia,
🔴 Hypertension,
🔴 Proinf lammatory and prothrombotic profile

Question 11

These metabolic derangements observed in obese individuals increase the risk of the development of:

Answer 11

🔴Type 2 diabetes,
🔴 Cardiovascular disease,
🔴 Various types of cancers, and
🔴 Overall mortality.

Question 12

In mammals, adipose tissue exists in two forms

Answer 12

white adipose tissue (WAT) and brown adipose tissue (BAT).

Question 13

The primary role of BAT is to

Answer 13

store small amounts of fat that can be used, when needed, to produce heat and maintain body temperature.

Question 14

WAT is designed to store

Answer 14

large amounts of excess energy in the form of triglycerides for use during periods of food deprivation

Question 15

The size of the white adipose tissue is highly variable, representing from____to____ of total body weight.

Answer 15

5% to 60%

Question 16

White Adipose Tissue is distributed throughout the body, and divided into two main components:

Answer 16

🔴Subcutaneous tissues (SAT).

🔴Internal adipose tissues.

Question 17

SAT generally store more than___% of total body fat in the body.

Answer 17

80

Question 18

The most commonly studied subcutaneous depots are the____ ,______and_____.

Answer 18

abdominal, gluteal, and femoral.

Question 19

Internal adipose tissues are associated with internal organs and include:

Answer 19

🔴Intra-thoracic and 🔴Intra-abdominal fat depots.( 🔺Intra-peritoneal and
🔺Extra-peritoneal depots.)

Question 20

Intraperitoneal, or visceral adipose tissues (VAT) are associated with digestive organs and are include:

Answer 20

⏺The omental tissue (attached to the stomach)
⏺ The mesenteric tissue (associated with the intestine)
⏺ The epiploic tissue (along the colon).

Question 21

________is a complex and active metabolic organ.

Answer 21

Adipose tissue

Question 22

Adipose tissue expresses numerous receptors that allow it to respond to afferent signals from the central nervous system and hormone systems.

Answer 22

✅

Question 23

Adipocytes are not the only cell type present in the adipose tissues. Immune cells, mesenchymal cells, and vascular and nervous
elements are found in the adipose tissue.

Answer 23

✅

Question 24

Obesity develops when fat cells increase either in

Answer 24

🔴Number (called hyperplasia)
🔴 Size (called hypertrophy) or
🔴 Very often in both.

Question 25

Humans can grow more fat cells as an adult.

Answer 25

Fat tissue is one of the few tissues in the human body that has the ability to considerably expand after puberty.

Question 26

There are many patients with type 2 diabetes who, while not overtly obese, have increased visceral fat; they are termed the

Answer 26

“metabolically obese.”

Question 27

Sex, age, genetics, and likely environmental factors affect the____ distribution.

Answer 27

WAT

Question 28

Women generally have_______ adiposity than men and accumulate more the lower body subcutaneous area (gluteal–femoral), 🔴while men accumulate more fat in the____________(both VAT and abdominal subcutaneous).

Answer 28

higher,

central abdominal region

Question 29

Sex hormones (estrogen and testosterone) are thought to affect adipose tissue mass and distribution. -Testosterone-treated men have less fat mass with selective loss of central fat.

• Premenopausal women often have increased amounts of______ adipose tissue.
• Postmenopausal women are prone to increases in ___________fat.

Answer 29

subcutaneous,

intra-abdominal

Question 30

🔴Testosterone
🔴 Low testosterone levels are associated with__________(visceral obesity plus decreased muscle mass), increased risk of insulin resistance, metabolic syndrome, and type 2 diabetes.

Answer 30

🔴is a critical steroid hormone in reproductive functioning. It is also an important hormone in maintenance of lean body mass, and regulation of adipogenesis including the visceral fat depot.

🔴 sarcopenic obesity

Question 31

Fat tends to accumulate in______ areas with aging (both subcutaneous and visceral depots).

Answer 31

central

Question 32

Genetics as well as environmental factors play a role in determining differences
in fat distribution. Twin and population studies have revealed that both BMI and
WHR are inherited traits.

Answer 32

✅

Question 33

Aging is associated with a progressive________ in GH availability.

Answer 33

decline

Question 34

Older individuals with relative reductions in GH have

Answer 34

osteopenia, sarcopenia (decreased muscle mass due to aging), visceral adiposity, insulin resistance, hyperlipidemia, and increased risk of cardiovascular disease.

Question 35

Chronic psychological stress can lead to________ cortisol secretion.

Answer 35

increased

Question 36

Cortisol bind to glucocorticoid receptors (GRs) on fat cells, activating___________ leading to fat storage in adipocytes.

Answer 36

lipoprotein lipase

Question 37

A greater density of GRs are found on________ compared to__________

Answer 37

visceral, peripheral fat cells.

Question 38

_______was in the ancient human diet primarily in fruits, which also contain antioxidants and dietary fiber.

Answer 38

Fructose

Question 39

the hepatic metabolism of fructose results in sustained elevations in postprandial______ levels.

Answer 39

TG

Question 40

hepatic metabolism of glucose, which principally leads to________

Answer 40

glycogen

Question 41

Increased________ consumption, particularly in the form of sugar-sweetened beverages (HFCS), has been implicated in promoting weight gain and visceral obesity.

Answer 41

fructose

Question 42

Sedentary lifestyles and inadequate protein intake are associated with________ obesity, a condition of reduced muscle and increased body fat even when body weight is normal or low, leading to an increase in visceral fat.

Answer 42

sarcopenic,

Question 43

With the development of obesity, the adipose tissue becomes increasingly____________

Answer 43

dysfunctional.

Question 44

Both elevated _____and________________are found in obesity, and are thought to play critical roles in the etiology of obesity-related metabolic complications.

Answer 44

FFAs and altered adipokine and cytokine production

Question 45

Elevated circulating FFAs:

Answer 45

• Increase pancreatic insulin secretion.
• Decrease insulin sensitivity in muscle and liver.
• Increase hepatic VLDL secretion.
• Induce endothelial dysfunction.

Question 46

VAT have a greater number of________&________, per gram of tissue, compared to subcutaneous adipose tissues (SAT).

Answer 46

stromal cells (nonadipocytes) and immune cells

Question 47

These differences in cellularity contribute to the heterogeneity in_________ production and the association of the VAT with a ________state.

Answer 47

cytokine, proinflammatory

Question 48

In response to a high caloric diet, the growth of adipose tissues occurs by a combination of hypertrophy and hyperplasia.

Answer 48

🥲🥲

Question 49

The capacity of proliferation is lower in_______ than subcutaneous depots.

Answer 49

visceral

Question 50

This limited capacity for hyperplasia may contribute to the excessive hypertrophy, resulting in tissue hypoxia and stress on the existing adipocytes in VAT.

Answer 50

😏مهم

Question 51

Increasing intra-abdominal fat deposition involves angiogenesis, which forms new blood vessels (analogous to what occurs with tumor growth).

The tortuous nature of the newly formed blood vessels, results in

Answer 51

poor oxygenation.

Question 52

As with tumors, the tissue is poorly
oxygenated (hypoxia), and some fat cells
ultimately die, sending signals to mobilize immune cells and activate macrophages.

Answer 52

Several cytokines are implicated in macrophage chemotaxis and activation.

Question 53

there is much greater rates of adipocyte death in VAT reflected in an increased number of macrophages which enter the abdominal visceral fat from the circulation in order to phagocyte dead fat cells.

Answer 53

Ok

Question 54

__________is a limited storage depot for fat.

Answer 54

Abdominal visceral fat

Question 55

As long as the amount of fat is in the physiological range and is not growing rapidly, the adipose tissue macrophages remain in the___________ or__ alternatively activated state.

Answer 55

unstimulated, M2

Question 56

rapid growth of intra- abdominal fat where there is evidence of tissue hypoxia and dead fat cells, there is activation of____________:

Answer 56

M1 classically activated macrophages.

Question 57

As adipocytes become hypertrophic, macrophages and other immune cells infiltrate the fat tissues and become activated.
 M1 classically activated macrophages:

Answer 57

Impair insulin signaling.
Secrete proinflammatory cytokines.
Suppress the production of anti- inflammatory adipokines.
This contributes to inflammation within the tissue.

Question 58

Fat accumulation in the adipocyte is achieved by fatty acid uptake and synthesis of fatty acids (_______), while fat mobilization is achieved by_______.

Answer 58

lipogenesis, lipolysis

Question 59

lipogenesis and lipolysis

are regulated by various hormones including______&_______

Answer 59

insulin and catecholamines.

Question 60

In the postprandial state, lipogenesis is greater in_______ fat than______ adipose tissue.

Answer 60

visceral, subcutaneous abdominal

Question 61

Insulin regulation is critical in the postprandial state where it favors FA uptake and storage and limits hydrolysis of triglyceride in adipocytes.

Answer 61

Kkkk

Question 62

is a key organ in the genesis of the chronic low-grade inflammation associated with obesity and diabetes and that has so many organ-specific disease implications.

Answer 62

Visceral fat

Question 63

اللهم افتح لي أبواب حكمتك، وانشر عليّ رحمتك، وامنن عليّ بالحفظ والفهم، سبحانك لا علم لنا إلا ما علمتنا، إنّك أنت العليم الحكيم.

Answer 63

❤️❤️💚

Question 64

A combined program of resistance exercise to build muscle combined with
 balanced nutrition including adequate protein to maintain muscle mass,
 may represent the best approach to reducing intra-abdominal fat.

Answer 64

🤌🏻🤌🏻🤌🏻