Obesity Flashcards
What is sucrose?
Glucose + fructose
What is the main fate of glucose?
80% to muscle glycogen
Remaining 20% to liver glycogen
What is the main fate of fructose?
Cannot get into muscle
Goes to liver; cannot be stored as glycogen, broken down into 3 units which can then be used to make glucose
What form of glucose is fructose converted to?
3C glucose
What happens to fructose when there is already plenty of glucose around?
Insulin promotes conversion to fat
Triglyceride levels increase
What 5 findings are associated with NAFLD in men?
High fasting insulin High triglycerides High HDL High ALT High GGT
What appears in urine in dyslipidaemia and why?
Apo A-1, which is the “skeleton” of HDL
HDL is used up trying to help carry the excess lipid and excreted via the kidneys
What occurs in dyslipidaemia to predispose to atheroma?
LDL becomes small dense (SD) LDL, which is poorly recognised by the liver and well recognised by the scavenger receptor on macrophages
What ratio is now most commonly used when assessing lipid status?
TC/HDLC
What are the 4 predictors of SD LDL?
High glucose
High insulin
High TGs
Low HDL
What is the most important result to consider when interpreting blood fats?
High TGs
What is the relationship between vitamin D and risk of DM?
Low vitamin D may increase risk of DM
What is the relationship between vitamin D and insulin secretion and action?
Vit D receptor present in islets controlling insulin expression
Vit D receptor in muscle, adipose and liver controlling the expression of insulin receptor and glucose metabolism
What should be measured to assess “metabolic health”?
Glucose TGs HDL ALT Insulin (fasting, OGTT, C peptide, SHBG) HbA1c
SHBG
Sex hormone binding globulin
