Week 9- Endocrine and Metabolic Systems 2 *didn't finish Flashcards
The largest endocrine organ in the body
Adipose tissue
The proteins released by adipocytes after being induced by neurotransmitters and glucose (along with other molecules)
Adipokines
Adipokines act locally as _________ hormones and through the ________ as endocrine hormones
Autocrine
Bloodstream
Function of adipokines
Maintain the balance of energy by regulating appetite, energy expenditure, insulin sensitivity, and lipid uptake
A specialized tissue that is important in thermoregulation, converting energy from food into heat
Brown fat
True or false: The amount of fat increases into adulthood
False
(decreases)
True or false: Some brown fat remains in specific locations through the life span
True
The classic adipose tissue responsible for storage of triglycerols to provide a long-term reservoir of energy for the body
White fat
True or false: White fat is involved in cardiovascular and metabolic complications (e.g., atherosclerosis and T2DM), inflammatory- (OA) and immune-related disorders (RA))
True
Fat accumulated in the lower body (subcutaneous fat) results in a __________ figure
Pear-shaped
Fat in the abdominal area (visceral fat) produces more of an _________ shape
Apple
Visceral fat produces _________ (e.g., TNF or IL-6) that increase the risk of _______ by promoting insulin resistance and low-level chronic inflammation
Cytokines
CVD
True or false: BMI is a stronger predictor than waist circumference and waist-to-height ratios
False
(WC and WTH are stronger)
True or false: “Keep your waist circumference to less than half your height” may be a useful screening tool across cultures
True
Central obesity has been linked with serious health consequences such as…
CVE
Insulin resistance
Diabetes mellitus
A multifactorial disease with complex interactions between lifestyle, environment, and genetics
Obesity
A communicable disease because it is a “socially contagious feature of globalization”
Obesity
The branch of medicine concerned with the management of obesity
Bariatrics
BMI of <18.5
Underweight
BMI of 18.5-24.9
Normal range
BMI of 25-29.9
Overweight
BMI of over or on 30
Obese
BMI of 30-34.9
Obese class I
BMI of 35-39.9
Obese class II
BMI of greater than or on 40
Obese class III (morbid obesity)
Overweight for children
BMI 85th-94th percentile
Obese for children
Greater than 95th percentile
Obesity if occurs when there is an imbalance between ____________ and ________, with more energy ___________ than is _____________
Energy intake
Energy expenditure
Consumed
Expended
Risk factors for obesity
-Sedentary lifestyle
-High glycemic diet
-Underlying illness
-Genetic disorder
-Genetic, familial, or biological factors
-Environmental or psychosocial/behavioral factors
SLIDE 19
SLIDE 20
Clinical manifestations of obesity
-Metabolic syndrome
-Type 2 diabetes mellitus
-Liver diseases
-Osteoarthritis
-Sleep apnea
-Atherosclerosis, hypertension, cardiovascular diseases
-Stroke
-Asthma
-Cancer
-Menstrual disorders and infertility
-Lymphedema
-Impaired mobility
-Gallbladder disease
-Psychologic disturbances such as irritability, loneliness, depression, binge eating, and tension
-Premature death
SLIDE 22
Disease pertaining to the pancreas
Diabetes mellitus (type 1 DM, type 2 DM, other types and categories of DM)
German pathologist, physiologist, and biologist who discovered the cells that secrete insulin
Dr. Paul Langerhans
Islets constitute ______% of pancreas
1-2%
Beta cells produce and secrete ____________
Insulin
Insulin regulates ____________
Blood glucose
Impaired beta-cell function results in ____________
Diabetes
Diabetes mellitus is characterized by __________ and disruption of the metabolism of ___________
Hyperglycemia
Carbohydrates, fats, and proteins
DM is a group of metabolic diseases resulting from defects in the secretion of…
Insulin, action of insulin, or both
Insulin-dependent or juvenile-onset
Type I DM
Non-insulin-dependent or adult-onset DM
Type II DM
DM type in which the body doesn’t make enough insulin
Type I
DM type in which the body can’t use insulin properly
Type II
True or false: Both types of DM can develop at any age
True
True or false: Most cases of Type I DM can be prevented
False
(no known way to prevent it)
SLIDE 36- don’t worry about HLA and insulin antibodies
An autoimmune type of diabetes that begins in middle to late adulthood, referred to as latent autoimmune diabetes in adults (LADA)
Type 1.5 DM
True or false: With increased obesity, type 1 DM is being diagnosed in younger and younger children
False
(Type II)
Obesity-dependent diabetes in childhood
Diabesity
Diabesity is considered an __________ metabolic condition
Inflammatory
Any degree of glucose intolerance recognized with the onset of pregnancy
Gestational DM
Gestational DM accompanies approximately ____% of all pregnancies
8
True or false: Gestational DM is most evident among women who are overweight and sedentary
True
True or false: Most women who have gestational DM do not return to normal glucose metabolism after pregnancy
False
(they do return)
Most women who have gestational DM return to normal glucose _____ weeks or more after pregnancy ends
6
True or false: Type 2 DM occurs more frequently in women with prior gestational DM
True
SLIDE 40
Occurs when the body cannot utilize glucose the way it should
Prediabetes
True or false: In prediabetes, the body cells do not recognize all of the insulin (decreased insulin sensitivity) or the cells stop responding to the action of insulin (increased insulin resistance)
True
With less glucose moving into the cells, the blood glucose levels start to ______
Rise
SLIDE 42- KNOW THIS
A measure of the % of blood sugar attached to hemoglobin and is indicative of a person’s average blood sugar level for the previous 3 months
Hemoglobin A1C (HbA1c or A1c)
SLIDE 44
HbA1c measures..
The average blood glucose control for the past 2-3 months
True or false: HbA1c gives the patient and health care providers a good idea of how well the diabetes treatment plan is working
True
According to the U.K. Prospective Diabetes Study, a ____% reduction of the A1c level reduces the risk of microvascular complications such as retinopathy and nephropathy by ____% and heart attack by ____% or more
1%
25%
14%
__________ people have diabetes (give a number)
37 million
True or false: About 1 in every 10 people have diabetes
True
True or false: 96 million American adults- more than 1 in 3- have prediabetes
True
26.4 million people aged 65 years or older (_____%) have prediabetes
48
_________ and ________ subgroups are at higher risk for diabetes
Hispanic
Asian
By 2060, the percent prevalence of US adults with diagnosed diabetes is projected to ______ and the number of people nearly ________
Double
Triple
_____ is caused by cell-medicated autoimmune destruction of β cells of the pancreas and usually leads to absolute insulin deficiency
T1D
True or false: T1D commonly occurs in childhood and adolescence
True
Those with T1D need to check ________ frequently
Blood glucose
True or false: Those with T1D do not receive multiple insulin rejections per day
False
(they do)
Adult-onset (non-insulin-dependent) diabetes
Type 2 Diabetes
T2D accounts for ____% of diabetes in the US
90-95%
True or false: The risk of developing T2D increases with age, obesity, and sedentary lifestyle
True
Insulin resistance —> ? —–> ?
Beta cells stress
Decrease beta cells mass
____% eventually become insulin dependent
50%
Type 1 DM Risk Factors
Presence of type 1 diabetes in a first-degree relative
Type 2 DM Risk Factors
-Positive family history
-Ethnic origin
-Obesity (BMI > 25)
-Increasing age (45 and older)
-Habitual inactivity; sedentary lifestyle
-Previous history of gestational diabetes (GDM) or delivery of babies weighing more than 9 lbs
-Presence of other clinical conditions associated with insulin resistance
-History of vascular disease
-Previously identified impaired fasting glucose or impaired glucose tolerance
-Hypertension
-HDL cholesterol level <35 mg/dL and/or triglyceride level >250 mg/dL
-Cigarette smoking