Obesity And Metabolic Syndrome

Question 1

Function of adipose tissue

Answer 1

Insulates, mechanical support for body, secretes adipokines which secrete hormone-like molecules and have an immune fxn and are the body’s main energy reserve

Question 2

Adipocytes

Answer 2

Fat storing cells that store calories as TGs; hypertrophy which increases fat mass

Question 3

Major areas of fat storage

Answer 3

SQ tissue, peripheral adipose tissue (subdermal and healthier), visceral adipose tissue (between organs and worse health outcomes)

Question 4

Adipokines

Answer 4

Have cell-signaling proteins that regulate appetite, coagulation, food intake, energy use, lipid storage, insulin secretion, immune/inflammatory process, coagulation, angiogenesis, fertility, BP, vascular fxn, bone metabolism

Question 5

Leptin

Answer 5

“Good” adipokine; Adipokines that increase as fat increases; builds resistance with obestity bc leptin controls satiety, if become resistance, you are more likely to overeat and feel less satiated; also works with adiponectin to increase sensitivity to insulin, dec TGs, inhibit fat accumulation, stimulate inflammatory response

Question 6

Angiopoietin-related protein

Answer 6

Insulin resistance and inflammation

Question 7

Angiotensinogen

Answer 7

BP, precursor to angio 1 and 2l regulator BP, insulin resistance, inflammation, lipogenesis

Question 8

Retinol-binding protein

Answer 8

Insulin resistance in muscle

Question 9

IL-6 and TNFalpha

Answer 9

Biomarkers of inflammation

Question 10

Adiponectin

Answer 10

Inverse relationship with fat in the body (adiposity); as fat content increases, adiponectin decreases; enhances cell sensitivity to insulin, anti-inflammatory, protects against arteriosclerosis

Question 11

Measure of obesity

Answer 11

BMI over 30

Question 12

Obesity puts you at risk for what?

Answer 12

DM2, CVD, cancer, HTN, GERD, arthritis, infection, sleep apnea

Question 13

Obesogens

Answer 13

Chemicals that contribute to obesity development

Question 14

Polygenic

Answer 14

Mix of environmental and several genetic mutations that contribute to diabetes like the gene which increases leptin resistance

Question 15

Risk factors for obesity

Answer 15

Excess caloric intake, sedentary, low SES, age, smoking, genetics, smoking CESSATION, cultural aspects of eating, secondary disease like Cushing’s

Question 16

BMI calculation

Answer 16

Wt (kg)/h(m)^2 OR wt(lbs)/h(in)^2*703

Question 17

BMI classifications

Answer 17

Ideal 18.5-24.9; overweight 25-29.9; obese 30-39.9; morbidly obese >40

Question 18

Ghrelin

Answer 18

Made in the stomach; normally stimulates hunger, controls gastric motility and acid secretion, stimulates GH; decreased in obesity

Question 19

Glucagon-like peptide (GLP1)

Answer 19

Decreased in obesity; stimulates insulin secretion, inhibits glucagon release, slows gastric emptying, increases satiety

Question 20

Peptide YY

Answer 20

Decreased in obesity; Dec appetite, inhibits gastric motility, inc energy use (why obese people might feel more fatigued)

Question 21

Cholecystokinin (CCK)

Answer 21

Probably Dec in obesity (not always decreased); inc satiety, Dec food intake, stimulate gallbladder contraction, pancreatic enzyme release, slows gastric emptying

Question 22

Obesity and inflammation

Answer 22

Ppl with obesity often in chronic, low-grade inflammatory state; cytokines released bc macrophages, lymphocytes, neutrophils, and mast cells infiltrate adipocytes

Question 23

FDA approves obesity meds

Answer 23

Orlistat, phentermine/topiramate (appetite suppressant), lorcaserine, naltrexone/bupropior (antidepressant), liraglutide—DPP4 inhibitor injection

Question 24

Orlistat

Answer 24

OTC med used for obesity

Question 25

Orlistat MOA

Answer 25

Binds to gastric and pancreatic enzymes and blocks these; dec fat abs by 30%

Question 26

Side effects of Orlistat

Answer 26

Black box for liver injury, GI—oily spotting, flatulence, fecal incontinence, Dec vitamin concentrations

Question 27

Orlistat nursing consideration

Answer 27

Take multivitamin on it, especially with A, D, E, and beta-carotene, Dec fat intake to less than 30% to combat GI sx, takes 3 MONTHS to work

Question 28

Obesity drug considerations

Answer 28

Need to change diet, exercise, only use with BMI over 30 or over 27 with health probs like heart attack/stroke, limited effectiveness, will need to take them forever and often have rebound effect on weight after you stop taking

Question 29

Is bariatric surgery helpful?

Answer 29

Often yes, even if you only lose weight short-term

Question 30

Metabolic syndrome

Answer 30

Risk factors that put pt at higher risk of stroke and heart disease; need 3 of the following to count—waist circumference, triglycerides, low HDL, BP, fasting blood glucose

Question 31

Tx for metabolic syndrome

Answer 31

Treat conditions individually with meds, weight loss, exercise, healthy diet, smoking cessation

Question 32

Metabolic Syndrome Criteria

Answer 32

Waist circumference (over 40 in men, over 35 in women); TGs (over 150 or drug tx for elevated TGs); HDL (under 40 in men, under 50 in women); BP (over 130 systolic or 85 diastolic); blood sugar (Over 110 fasting blood glucose or tx for elevated glucose)

Question 33

Android obesity

Answer 33

More likely to have visceral fat (fat between the organs—assoc with worse health risks)

Question 34

Gynoid obesity

Answer 34

More likely to have subcutaneous fat (stored away from the organs, under the skin)

Question 35

What waist circumference puts you at a greater risk for coronary artery disease?

Answer 35

Men over 40 inches and women over 35 inches

Question 36

Adipose tissue

Answer 36

Endocrine organ that secretes adipokines