obesity and cardiometabolic risk Flashcards
what 2 hormones have key roles in obesity
leptin and ghrelin
what is leptin
a hormone released by adipose tissue that regulates hunger by stimulating satiety
what is ghrelin
a multifaceted hormone that stimulates the hunger sensation and thus the drive to eat
6 adverse cardiometabolic effects of products of adipocytes
- hypertension (↑ angiotensinogen)
- atherogenic dyslipidaemia
- type 2 diabetes
- thrombosis
- atherosclerosis
- inflammation (↑ TNFa, ↑IL6 etc.)
how may obesity impact mental health
ma trigger depression, EDs, distorted body image and low self esteem; stigma around being obese may also contribute to the development of these conditions
why might the parent’s opinions causes childhood obesity to persist
many parents don’t recognise obese children =>no motivation for children to lose weight
what is metabolic syndrome
a group of health problems that put you at risk of type 2 diabetes or conditions that affect your heart or blood vessels
4 characteristics of metabolic syndrome
- insulin resistance
- hyperlipidemia
- autonomic dysfunction
- raised BP
metabolic syndrome diagnostic criteria
central obesity (BMI > 20 or high waist circumfrence) + and 2 of:
- high triglyceride (>1.7mmol/L on statin)
- reduced HDL
- raised BP (>130/85)
- raised fasting plasma glucose (5.6mmol/L or diagnoses T2DM)
what is blount’s disease
a growth disorder that affects the bones of the lower leg, causing them to bow outward -> excess weight on growth plates
what are the main resp obesity complications (3)
- hypoventilation
- Obtructive sleep apnoea
- central apnoea
what are the main derm obesity complications (2)
- hirsutism
- sweating
what are the main hepato-billary obesity complications (3)
- gall stones
- non alcoholic fatty liver
- colon cancer
what are the main endocrine obesity complications (3)
- sex hormone disorders
- pituitary hormone abnormalities
- impaired immunity
what are the main cardio obesity complications (3)
- hypertension
- ischaemic heart disease
- thromboembolism
what are the main reproductive obesity complications (3)
- hypogonadism
- infertility
- menorrhagia
what are the main ortho obesity complications (2)
- OA
- gout
how does obestiry lead to heart failure (pathway)
obesity -> expansion of intravascular volume -> increase cadiopulmonary volume/preload -> eccentric left ventricular hypertrophy -> ventricular dysarrythmias and systolic/diastolic heart failure
which cancers are at highest risk of developing due to obesity (8)
- endometrial
- oesophageal
- pancreatic
- kidney
- breast (post menopausal)
- colorectal
- ovarian
- gall bladder
what is key to find out in an obesity history
cause for weight gain -> is this treatable
what is overweight bmi
> 25 is overweight, obese is >30
what is acanthosis nicgrans
areas of dark, thick velvety skin in body folds and creases -> associated with insulin resistance -> often seen in obesity
what 3 visual findings are associated with insulin resistance
- acanthosis nicgrans
- skin tags
- lipoedema
obesity mgx
non surgical:
1. lifestyle changes (regular exercise, healthy eating, alcohol recommendations and smoking cessation etc.)
2. drug treatment (onlyif not responsive to lifestlye change) - orlistat and liraglutide
surgical:
bariatric surgery e.g. Roux-en-Y gastric bypass, sleeve gastrectomy, and gastric bypass
