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Metabolism CC > Obesity > Flashcards

Obesity Flashcards

1
Q

Obesity

A

Abnormal or excessive fat accumulation sufficient to adversely affect health + reduce life expectancy

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2
Q

Obese BMI

A

30 +

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3
Q

Morbidly obese BMI

A

40 +

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4
Q

Girls with obesity 1975 –> 2016

A

5 million –> 50 million

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5
Q

Boys with obesity 1975 –> 2016

A

6 million –> 74 million

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6
Q

EU average obesity

A

14%

% of population 16+ with BMI 30 or greater

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7
Q

Obesity Tower Hamlets children starting primary school

A

1 in 8

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8
Q

Obesity Tower Hamlets children leaving primary school at 11

A

1 in 4

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9
Q

Tower hamlets borough child obesity

A

5th highest London

6th highest in country

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10
Q

Chicken shop mile

A

197 hot food takeaways

Average of 42 junk food outlets PER SCHOOL

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11
Q

Tower hamlets worst areas compared to England

A

Deprivation
Children under 16 in poverty
Obese children in yr 6

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12
Q

Food deserts (limited food options) in US associated with..

A

Increase in obesity + diabetes

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13
Q

Obesogenic environment

A

Increased food intake
Less exercise
Food industry more interested in profit than public health

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14
Q

Medications + weight issues

A 
10-15% weight issues linked to medication
Mood stabilisers
Diabetes Medicines
Corticosteroids
Beta blockers
Allergy relievers
Drugs that prevent seizures + migraines
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15
Q

Insulin + weight gain

A

Inhibits breakdown + release from fat cells
Decreases rate of lipolysis in adipose tissue (lowers plasma FA level)
Stimulates FA and triacylglycerol synthesis in tissues
Increases uptake of triglycerides from blood into adipose tissue
Decreases rate of FA oxidation in muscle + liver

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16
Q

Lipohypertrophy

A

Enlargement of fat cells local to where insulin is injected

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17
Q

T2D drugs that increase insulin and weight

A

Insulin
Sulfonylureas (Glyburide, Glicizide)
TZD

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18
Q

T2D drugs that don’t affect insulin and weight

A

Metformin

DPP IV inhibitors (Januvia, Onglyza, Trajenta)

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19
Q

T2D drugs that decrease insulin and weight

A

SGLT-2 inhibitor

Acarbose

20
Q

Heritability for obesity

A

High (typically 70%)

21
Q

Thrifty gene hypothesis

A

Genes that predispose to obesity would have had a selective advantage in populations that frequently experience starvation
–> ppl that have these genes now in obesogenic environment might be those that overreact –> extremely obese, not just slightly overweight

22
Q

Thrifty gene hypothesis support

A

Many genes in glucose + lipid metabolism subject to positive selection in last 10,000 years
–> especially Asian + African ethnic groups
CREBRF variant?

23
Q

Syndrome monogenic obesity

A

Exceptionally rare
Characterised by mental retardation, dysmorphic features + organ specific abnormalities
–> in ADDITION to obesity

24
Q

Prader-Willi syndrome

A

SNRPN gene
Autosomal dominant
Short physique
Hypotonia + hypogonadism

25
Fragile X syndrome
FMR1 gene Autosomal dominant Psychological + speech defect Macro-orchidism
26
Bardet-Biedl + Alstrom syndrome
Ciliopathy The primary cilium has key role in differentiation of adipocytes --> pathogenesis of obesity is in part attributed to defect in adipogenesis Cilia mediated leptin receptor (LEPR) signalling
27
Non-syndromic monogenic obesity
Currently 12 genes have been identified that have roles in energy maintenance as part of leptin-melanocortin pathway LEP, LEPR, BDNF etc
28
Non- syndromic
Single gene disorder that leads to a highly penetrant form of obesity
29
Adipocyte differentiation- obesity
Ciliopathies- primary cilia dysfunction Mutations in Peroxisome-proliferator-activated receptor gamma 2 (PPARgamma2) --> transcription factor that has key role in adipocyte differentiation
30
Peroxisome-proliferator-activated receptor gamma 2
Transcription factor Key role in adipocyte differentiation Targeted by TZD drugs
31
Polygenic obesity
``` 227 genetic variants involved in different biological pathways have been identified CNS food sensing + digestion adipocyte differentiation insulin signalling lipid metabolism muscle + liver biology gut microbiota ```
32
Epigenetic variation
Environmental + nutritional influences during critical periods in development (particularly gestation) can have permanent effects on an individual's predisposition to obesity
33
Adipose tissue
Bonafide endocrine organ Defects can originate in the tissue itself, or its ability to communicate to the brain or the brain response itself, or the downstream effectors, or a combination
34
Apple shape
More visceral fat | higher risk weight-related health problem
35
Pear shape
Less visceral fat | Lower risk of weight-related health problem
36
Lifespan
Obesity-related diseases could cut lifespan by 11 years
37
Obesity as a risk factor
``` CV diseases Pulmonary diseases Metabolic diseases Osteoarticular disease Cancer Psychiatric illness ```
38
Childhood obesity
Associated with early onset type 2 diabetes + increased mortality risk of CHD in adulthood
39
Obesity + T2D
Chronic inflammation Altered adipokine levels (high leptin) Breakdown of fat metabolism (accumulation lipids in tissues) Breakdown of regulation of glucose metabolism
40
Non alcoholic fatty liver disease
Build up of fat in liver Overweight/obese Associated with high cholesterol/high BP/T2D 5% UK population
41
Orlistat
Gastric and pancreatic lipase inhibitor | Reduces absorption of dietary fat--> doesn't allow lipase to attach to fat + break it down into absorbable size
42
Surgery
``` First do weight management course Laparoscopically Morbid obesity BMI>35 AND obesity related complications --> only after conventional medical treatments have failed ```
43
Surgery procedures- restrictive procedures
Restrict ability Band restricts food passage Removal of part of stomach
44
Surgery procedures- malabsorptive procedures
Reduce ability to absorb nutrients Can cause nutrient deficiencies, malnutrition, and in some cases anastomotic leaks + dumping syndrome (rapid gastric emptying)
45
Malabsorptive procedures examples
Biliopancreatic diversion | Roux-en-Y gastric bypass
46
Restrictive procedures example
Adjustable gastric banding Vertical banded gastroplasty Sleeve gastroplasty
47
Restrictive plus malabsorptive procedures
Dudoenal switch Roux-en-Y gastric bypass Intragastric balloon

Metabolism CC (29 decks)

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