Wk 3 Obesity Flashcards
Adipose tissue
provides insulation and mechanical support for the body
- secretes hormone like molecules: adipokines
- contributes to our immune cell function
Adipocytes
fat-storing cells
- stores calories as triglycerides
- can increase in number and HYPERTROPHY to increase fat mass
Major areas for fat storage
- subcutaneous or peripheral adipose tissue (subdermal, healthier fat storage, less inflammation)
- visceral adipose tissue (omentum, in between our organs)
—- more hormonally active, more increased risk for certain types of cancer, insulin resistance, etc.
Body shapes
android obesity - apple, males, CAD, HTN, stroke, DM
gynoid obesity - pear, female, doesn’t have as much risk
waist circumference important
adipose tissue is…
an endocrine organ, secretes things like adipokines
Adipokines
cell-signaling proteins
help regulate:
- appetite
- food-intake
- energy expenditure
- lipid storage
- insulin secretion + sensitivity
- immune/inflammatory processes
- coagulation
- fertility
- BP
Angiopoietin-related protein
associated with inflammation and insulin resistance
Angiotensinogen
- influences BP, insulin resistance, lipogenesis, and inflammation
Retinol-binding protein
influences insulin resistance in our muscles
IL-6 and TNF-alpha
markers related to inflammation in the body at the systemic level
Adiponectin
“good” adipokine
- inverse relationship with the fat content in the body (adiposity)
- so ↑ fat content in body = ↓ adiponectin produced
Adiponectin - what does it do
- increases energy expenditure
- enhances cell sensitivity to insulin
- anti-inflammatory effects
- protects against arteriosclerosis
- low levels = HLD, increased insulin resistance, CAD
Leptin
“good adipokine
- influences appetite and energy
- predominately made by adipocytes
- ↑ fat = ↑ leptin
- obese individuals become leptin resistant
What does leptin do
- leptin normally tells our body that we have had enough to eat = satiety
- leptin also works with adiponectin to increase sensitivity to insulin, reduce triglyceride levels, and inhibit fat accumulation
- high leptin levels are ineffective at decreasing appetite and energy expenditure
Obesity in adults
BMI > 30
- risk factor for most diseases
- considered a polygenic condition, multiple genes that influence the development of obesity
Risk factors for obesity
- excess caloric intake
- sedentary lifestyle
- socioeconomic status
- age
- smoking cessation
- environmental obesogen exposure
- cultural aspect of eating
- genetics and epigenetics
- secondary disorders (cushings, PCOS, hypothyroidism)
BMI calculation
weight in kg/height in meters²
[weight in pounds/height in inches²] x 703
BMI index
< 18.5 = underweight
18.5 - 24.9 = ideal
25 - 29.9 = overweight
30 - 39.9 = obese
≥ 40 = morbidly obese
Ghrelin
- decreased level in obesity
- produced in stomach
- stimulates hunger, controls gastric motility and acid secretion, stimulates growth hormone
Glucagon-like Peptide 1 (GLP-1)
- decreased level in obesity
- produced in intestinal endocrine cells
- stimulates insulin secretion, inhibits glucagon release, slow gastric emptying, increases satiety
Peptide YY
- decreased level in obesity
- reduces appetite, inhibits gastric motility, increases energy expenditure
Cholecystokinin (CCK)
- decreased level in obesity
- increases satiety, reduces food intake, stimulates gallbladder contraction, pancreatic enzyme release, slow gastric emptying
Obesity and inflammation
- pts are in chronic, low-grade inflammatory state
The systemic effects of these cytokines, coupled with other endocrine responses in obesity, results in insulin resistance, metabolic syndrome, and health issues associated with obesity
orlistat (Xenical/Alli)
OTC medication
