Obesity and diabetes

Question 1

energy stores in the body

Answer 1

plasma glucose
glycogen (liver)
glycogen (muscle)
triacylglycerol (adipose, muscle)
protein

Question 2

fuels in the blood

Answer 2

glucose
fatty acids
ketone bodies
aminoacids
lactate

Question 3

what is formed by glycerol and phosphoenolpyruvate

Answer 3

glucose

Question 4

what is formed by glucose in gluconeogenesis

Answer 4

phosphoenolpyruvate

Question 5

what is formed by phosphoenolpyruvate

Answer 5

pyruvate

Question 6

what is formed by lactate

Answer 6

pyruvate

Question 7

what is formed by pyruvate

Answer 7

oxaloacetate
acetyl-CoA

Question 8

what forms acetyl-CoA

Answer 8

ketogenic aminoacids
fatty acids
ethanol
pyruvate

Question 9

what is formed by acetyl-CoA

Answer 9

acetoacetate

Question 10

what does acetoacetate form and what is acetoacetate formed by

Answer 10

3-hydroxybutyrate

Question 11

what glucogenic aminoacids are involved in gluconeogenesis and ketogenesis in the liver

Answer 11

oxaloacetate
fumarate
2-oxoglutarate

Question 12

starting with the acetyl-CoA entry point, what is the cycle of ketogenesis in the liver

Answer 12

citrate
isocitrate > CO2
2-oxoglutarate > CO2
fumarate
malate
oxaloacetate

Question 13

what is gluconeogenesis

Answer 13

the process of making glucose from its own breakdown products or from the breakdown products of lipids or proteins

Question 14

what is ketogenesis and when does it take place

Answer 14

• a metabolic pathway that produces ketone bodies which provide an alternate form of energy for the body
• takes place when the body lacks sufficient carbohydrates to burn for energy

Question 15

what is insulin

Answer 15

‘the hormone of the fed state’

Question 16

functions of insulin in the liver

Answer 16

increased glycogen synthesis
decreased glycogenolysis
decreased gluconeogenesis

Question 17

functions of insulin in the muscle

Answer 17

increased glucose uptake
increased glycogen synthesis
decreased glycogenolysis
increased protein synthesis

Question 18

functions of insulin in adipose tissue

Answer 18

increased glucose uptake
increased TAG synthesis
decreased lipolysis

Question 19

type 1 diabetes mellitus

Answer 19

insulin dependent
failure of insulin production
10-20% of cases

Question 20

clinical signs of type 1 diabetes mellitus

Answer 20

early and rapid onset
weight loss
hyperglycaemia
ketonaemia

Question 21

symptoms of type 1 diabetes mellitus

Answer 21

polydipsia
polyuria
metabolic acidaemia

Question 22

type 2 diabetes mellitus

Answer 22

non-insulin dependent
loss of insulin sensitivity
80-90% of cases

Question 23

clinical signs of type 2 diabetes mellitus

Answer 23

slow onset (usually aged >35 years)
frequently associated with obesity
hyperglycaemia

Question 24

symptoms of type 2 diabetes mellitus

Answer 24

retinopathy
nephropathy
neuropathy
heart disease
circulatory problems

Question 25

effects of type 1 diabetes

Answer 25

insufficient/ineffective insulin produced
liver - hyperglycaemia
muscle - hyperglycaemia, weight loss
adipose - ketoacidaemia, weight loss - due to decreased TAG synthesis and increased lipolysis

Question 26

effects of type 2 diabetes

Answer 26

insulin produced but not detected
liver, muscle and adipose - hyperglycaemia
adipose - due to increase TAG synthesis and decreased lipolysis

Question 27

metformin

Answer 27

drug used in treatment of type 2 diabetes
inhibits gluconeogenesis
activates AMP-activated protein kinase
acts on intestine

Question 28

metabolic effects of AMP-activated protein kinase

Answer 28

increased:
- glucose uptake
- glycolysis
- fatty acid oxidation
- mitochondrial biogenesis
decreased:
- rRNA synthesis
- protein synthesis
- triacylglycerol synthesis
- fatty acid synthesis
- cholesterol synthesis
- glycogen synthesis
- gluconeogenesis

Question 29

metabolic syndrome

Answer 29

affects 20-30% population, males > females
increased abdominal fat
dyslipidaemia
insulin resistance
impaired glucose tolerance
high blood pressure
cardiovascular disease

Question 30

energy intake

Answer 30

food intake

Question 31

energy expenditure

Answer 31

basal metabolism 60%
physical activity 30%
digestion 10%
thermogenesis

Question 32

role of microbiome in obesity

Answer 32

co-evolution with host
fermentation of complex carbs > short chain fatty acids
metabolic health correlated with diversity of gut bacteria

Question 33

leptin

Answer 33

peptide hormone
released by adipocytes
circulating levels correlate with body’s fat content
leptin receptors in brain including hypothalamus
suppression of food intake = motivation to eat, rewards for feeing, satiety
increased metabolic rate

Question 34

hormones affecting digestion

Answer 34

ghrelin
cholycystekinin
gastric inhibitory peptide
peptide YY

Question 35

ghrelin

Answer 35

screted by gastric cells
orixigenic - increases hunger
levels fall after feeding
inhibits insulin secretion

Question 36

cholecystekinin

Answer 36

secreted by duodenum
stimulates secretion of digestive enzymes and bile
slows gastric emptying
anorexigenic - causes loss of appetite

Question 37

gastric inhibitory peptide

Answer 37

secreted by duodenum, jejunum
inhibits gastric acidification, slows digestion
stimulates insulin secretion

Question 38

peptide YY

Answer 38

secreted by ileum, colon
anorexigenic