Obesity And Metabolic Syndrome Flashcards
Function of adipose tissue
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
Adipocytes
Fat storing cells that store calories as TGs; hypertrophy which increases fat mass
Major areas of fat storage
SQ tissue, peripheral adipose tissue (subdermal and healthier), visceral adipose tissue (between organs and worse health outcomes)
Adipokines
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
Leptin
“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
Angiopoietin-related protein
Insulin resistance and inflammation
Angiotensinogen
BP, precursor to angio 1 and 2l regulator BP, insulin resistance, inflammation, lipogenesis
Retinol-binding protein
Insulin resistance in muscle
IL-6 and TNFalpha
Biomarkers of inflammation
Adiponectin
Inverse relationship with fat in the body (adiposity); as fat content increases, adiponectin decreases; enhances cell sensitivity to insulin, anti-inflammatory, protects against arteriosclerosis
Measure of obesity
BMI over 30
Obesity puts you at risk for what?
DM2, CVD, cancer, HTN, GERD, arthritis, infection, sleep apnea
Obesogens
Chemicals that contribute to obesity development
Polygenic
Mix of environmental and several genetic mutations that contribute to diabetes like the gene which increases leptin resistance
Risk factors for obesity
Excess caloric intake, sedentary, low SES, age, smoking, genetics, smoking CESSATION, cultural aspects of eating, secondary disease like Cushing’s
BMI calculation
Wt (kg)/h(m)^2 OR wt(lbs)/h(in)^2*703
BMI classifications
Ideal 18.5-24.9; overweight 25-29.9; obese 30-39.9; morbidly obese >40
Ghrelin
Made in the stomach; normally stimulates hunger, controls gastric motility and acid secretion, stimulates GH; decreased in obesity
Glucagon-like peptide (GLP1)
Decreased in obesity; stimulates insulin secretion, inhibits glucagon release, slows gastric emptying, increases satiety
Peptide YY
Decreased in obesity; Dec appetite, inhibits gastric motility, inc energy use (why obese people might feel more fatigued)
Cholecystokinin (CCK)
Probably Dec in obesity (not always decreased); inc satiety, Dec food intake, stimulate gallbladder contraction, pancreatic enzyme release, slows gastric emptying
Obesity and inflammation
Ppl with obesity often in chronic, low-grade inflammatory state; cytokines released bc macrophages, lymphocytes, neutrophils, and mast cells infiltrate adipocytes
FDA approves obesity meds
Orlistat, phentermine/topiramate (appetite suppressant), lorcaserine, naltrexone/bupropior (antidepressant), liraglutide—DPP4 inhibitor injection
Orlistat
OTC med used for obesity
Orlistat MOA
Binds to gastric and pancreatic enzymes and blocks these; dec fat abs by 30%
Side effects of Orlistat
Black box for liver injury, GI—oily spotting, flatulence, fecal incontinence, Dec vitamin concentrations
Orlistat nursing consideration
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
Obesity drug considerations
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
Is bariatric surgery helpful?
Often yes, even if you only lose weight short-term
Metabolic syndrome
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
Tx for metabolic syndrome
Treat conditions individually with meds, weight loss, exercise, healthy diet, smoking cessation
Metabolic Syndrome Criteria
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)
Android obesity
More likely to have visceral fat (fat between the organs—assoc with worse health risks)
Gynoid obesity
More likely to have subcutaneous fat (stored away from the organs, under the skin)
What waist circumference puts you at a greater risk for coronary artery disease?
Men over 40 inches and women over 35 inches
Adipose tissue
Endocrine organ that secretes adipokines
