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Pathophysiology > Obesity and Cardiovascular System I/II > Flashcards

Obesity and Cardiovascular System I/II Flashcards

1
Q

Which two hormones are secreted by adipose tissue?

A

Adiponectin and Leptin

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2
Q

____ is synthesized predominantly by adipocytes but also by skeletal
muscle, endothelial cells, and cardiomyocytes

A

Adiponectin

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3
Q

True or False: The more adiponectin one has, the less body fat one tends to have

A

True

Inverse correlation with insulin resistance and obesity…

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4
Q

Adiponectin binds to ____ Type I, III, and V in vessels

A

Collagen

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5
Q

True or False: More adiponectin is associated with increased insulin sensitivity

A

True
- Has anti-diabetic effects

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6
Q

Three main functions of adiponectin?

A
  1. Anti-atherogenic
  2. Anti-inflammation
  3. Anti-diabetic
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7
Q

What four ways does adiponectin affect the liver?

A
  1. Increased insulin sensitivity
  2. Decreased glucose output
  3. Decreased FFA influx
  4. Increased B-ox
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8
Q

How does adiponectin affect the skeletal muscle?

A
  1. Increases beta oxidation
  2. Promotes glucose uptake
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9
Q

How does adiponectin affect blood vessels?

A
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10
Q

True or False: Adiponectin has an indirect anti-inflammatory effect

A

True

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11
Q

True or False: Adiponectin reduces glucose concentration in plasma (therefore: has hypoglycemic effects)

A

True
- most important effect

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12
Q

How does Adiponectin promote vessel health (in other words: stop endothelial dysfunction)?

A
  1. Increased NO/eNOS
  2. Decreased apoptosis and ROS formation
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13
Q

True or False: If there is plaque initiation and progression (atherosclerosis), Adiponectin will decreased TNF-a and IL-8 levels

A

True

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14
Q

True or False: Adiponectin only prevents against atherosclerosis at early stages of atherosclerosis

A

False - all stages

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15
Q

How does adiponectin protect at later stages of atherosclerosis?

A

Decreased thrombus formation and fibrous thickening; prevents rupture

Increases TIMP-1

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16
Q

____ is regulated by energy level, food intake, several hormones and various
inflammatory mediators. It provides a functional link between the immune system and energy
homoeostasis.
A. Leptin
B. Adiponectin

A

A. Leptin

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17
Q

Leptin acts centrally on the ____ to reduce ____ and increase
____

A

hypothalamus (type II-R) ; food intake; energy utilization

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18
Q

True or False: Levels of leptin correlated directly with mass of white adipose tissue

A

True

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19
Q

True or False: Hyperleptinaemia is associated with atherosclerosis, hypertension and
metabolic syndrome

A

True

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20
Q

True or False: Leptin & Adiponectin have same dependence on body fat

A

False - opposite dependence on body fat

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21
Q
A
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22
Q

In leptin sensitive individuals, leptin leads to a decrease in which four factors?

A
  1. fat storage
  2. TG content (increases FA oxidation)
  3. Activity/expression of lipogenic enzymes
  4. Lipogenic activity of insulin (favors lipolysis)
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23
Q

In leptin sensitive individuals, there is an increased of….

A
  1. Sympathetic mediated energy expenditure
  2. Expression of uncoupling proteins (important for brown tissue)
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24
Q

True or False: Adiponectin activates PKA in muscle and liver

A

False - leptin does this

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25
Q

How does leptin affect ATP-consuming anabolism and ATP -producing catabolism?

A

Decreases ATP-consuming anabolism

Increases ATP-producing catabolism

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26
Q

Which three processes are activated when there is reduced Leptin levels?

A
  1. B-oxidation
  2. Glucose transport/glycolysis
    3.Mitochondrial biogenesis
  • Increase catabolism
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27
Q

If there is energy restriction, there is decrease in fat mass and leptin. As a result, there’s less energy available for what three things? More energy available for which two things?

A

Less energy for:
1. Reproduction
2. Growth
3. Anabolism

More energy for:
1. Maintenance of soma
2. Adrenalcortical axis

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28
Q

True or False: Adiponectin shows an asymmetrical biological response

A

False - leptin does

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29
Q

Reductions in leptin induce ___ effect than increases in leptin
A. smaller
b. bigger

30
Q

True or False: Excess Leptin is associated with decreased energy expenditure and increased fat storage

A

False - increased leptin is associated with…

  1. Decreased fat storage
  2. Increased energy expenditure
31
Q

True or False: Leptin can pass through BBB

32
Q

___ opposes release of Insulin

33
Q

When leptin binds to its receptor, it inhibits ___ entry, leading to less ___; KATP is not blocked; and membrane is ____

A

glucose; ATP; hyperpolarized

Less exocytosis of insulin

  • how leptin is anti-glycemic
34
Q

True or False: Insulin promotes development of adipose tissue

35
Q

Insulin promotes synthesis of ___ and inhibits ____

A

TG; lipolysis

36
Q

If leptin acts on insulin, how does this affect development of adipose tissue?

A

Reduced dev of adipose tissue

37
Q

A leptin sensitive person is…
A. Obese
B. Lean
C. Anorexic

38
Q

What can occur if a person has a Type II Leptin receptor mutation in the hypothalamus?

A
  1. Overweight
  2. Beta cells in pancreas are not inhibited (therefore: insulin is made w/o restraint)
  3. Increase body fat
39
Q

True or False: There appears to be correlation between leptin and insulin resistance

40
Q

True or False: Metabolic syndrome, obesity, and diabetes are associated with insulin resistance

41
Q

How does Leptin increase risk of Atherosclerosis at stage 1: endothelial dysfunction?

A

Increases leukocytes, macrophages, ROS

42
Q

True or False: Leptin can cause release of inflammatory factors (IL2 and 6, TNF-a) and, ultimately, encourage plaque initiation and progression

43
Q

True or False: Leptin increases vascular smooth muscle hypertrophy and proliferation

A

True

  • as a result, leptin increases CO
44
Q

Compare and contrast leptin and adiponectin:

45
Q

Name features of metabolic syndrome:

A
  1. Abdominal obesity
  2. Elevated TG (high FA from adipose tissue)
  3. Decreased HDL (increase LDL)
  4. Insulin resistance*
  5. Increased coagulation
    - vasoactive factors released from adipose tissue
  6. Increased BP
47
Q

True or False: Insulin resistance leads to excess insulin

48
Q

What are the affects of Hyperinsulinemia on
- Insulin-Sex Hormone Axis?
- Insulin -IGF Axis?

How does this favor tumor development?

49
Q

True or False: Obesity leads to adipocyte hypertrophy and elevated leptin (accompanied by downregulation of adiponectin)

50
Q

ER stress in obesity can lead to production of inflammatory cytokines, which can lead to failure of ____

A

differentiation

51
Q

How does adipocyte hypertrophy affect capillary density vasoconstriction?

A

Decreases, leads to altered lipid metabolism

52
Q

Adipocyte hypertrophy leads to hypoxia, which can lead to ____secretion and dysfunction of ____, an organelle

A

chemokine; mitochondria

53
Q

Both ___ and ___lead to chemokine secretion

A

hypoxia; adipocyte hypertrophy

54
Q

True or False: Obesity is associated with adipose tissue vasodilation

A

False - adipose tissue vasoconstriction

55
Q

True or False: Adipose tissue hypoxia can lead to inflammation

56
Q

Via TNF-a, inflammation can cause ____

A

insulin resistance

57
Q

Obesity can lead to increased synthesis of adipokines, which can increased ___, leading to ____

A

insulin; T2DM

58
Q

As one gets fatter, they have expansion in skeletal m., viscera, in skin. How does this affect O2 consumption and CO?

A

Both increase

59
Q

True or False: As you increase CO, you decreased Central Venous Pressure

A

True
(Cardiac Function Curve)

60
Q

In obesity, one can have increased left ventricular filling. How does this volume overload affect chamber dilation, myocardial wall stress/tension, and radius?

A

Increased left ventricular filling…
- Left chamber dilation
- Increased wall tension

61
Q

True or False: Increased left ventricular filling, as seen in obesity, stimulates development of eccentric ventricular hypertrophy

62
Q

Why does increased left ventricular filling lead to elongation of myocytes?

A

Synthesis of new sarcomeres in series with the old

63
Q

In increased left ventricular filling, ___ helps to reduce wall stress

A

hypertrophy

64
Q

How does eccentric hypertrophy affect ventricular compliance?

A

Decreases it

  • Note: Increased in EDV leads to eccentric hypertrophy
65
Q

How do compliance, volume/flow contribute to diastolic dysfunction?

A

Decreased compliance, increased volume/flow lead to diastolic dysfunction

66
Q

Why is hypertrophy good? bad?

A

Bad = reduces compliance
Good = alleviates wall stress/tesnsion

67
Q

How does diastolic dysfunction affect:
a. LVED pressure
b. PA pressure
c. capillary pressure

A

Increases all of the above

68
Q

If hypertrophy does not keep pace with chamber dilation, what can occur?

A

Systolic dysfunction

69
Q

How does systolic dysfunction develop?

A

Increased wall stress leads to decreased ventricular contractility

= systolic dysfunction

70
Q

True or False: In Obesity, Left Ventricular Hypertrophy leads to expanded extravascular volume and decreased preload, leading to CONCENTRIC left ventricular hypertrophy

A

False - In Obesity, Left Ventricular Hypertrophy leads to expanded INTRAvascular volume and INCREASE preload, leading to ECCENTRIC left ventricular hypertrophy

71
Q

How can you develop concentric left ventricular hypertrophy?

A

Increased TPR leads to HTN
=> Increased Afterload

72
Q

True or False: Eccentric-concentric left ventricular hypertrophy can occur in obese patients

Pathophysiology (26 decks)

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