Exam 4 Physio: Metabolism 1

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EXAM 4 PHYSIO: METABOLISM 1

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EXAM 4 PHYSIO: METABOLISM 1

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Molecules as stored forms of energy:

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1. glycogen
2. protein
3. fat

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What are the forms of energy in the blood?

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1. glucose
2. FAs
3. ketones

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What are the four important tissues of metabolism?

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1. liver
2. skeletal muscle
3. adipose tissue
4. brain tissue

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VLDL content between fat and protein?

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Fat >>> protein

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Liver produces:

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1. ketone bodies
2. glucose
3. VLDL

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Functions of the liver:

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1. gluconeogenesis
2. glucose storage in form of glycogen.
3. capable of releasing glucose into the blood.
4. synthesize and catabolize fat.
5. export TG into blood
6. synthesize and export ketone.

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Which of the listed functions above are only unique to the liver?

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1. capable of releasing glucose into the blood.
2. export TG into blood
3. can synthesize and export ketones.

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Why is the skeletal muscle important to the overall metabolism?

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Because it constitutes a large percentage (20%) of body weight.

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What intermediary molecules do glucose go through to become glycogen?

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First: G6P
Then: G1P

And vice versa for glycogen to become glucose.

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How much do fat and carbohydrates contribute to the daily calories?

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Fat: 55%
Carbo: 45%

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Free FA (FFA) is made from and where does it take place?

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Chylomicrons and VLDL.

Occurs in the blood.

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Where does FFA go once formed?

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Into adipose tissue.

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What occurs in the adipose tissue once FFA makes it way inside?

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TG is formed

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Triglycerides can be used to form what?

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1. glucose
2. glycerol
3. FAs

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How is the brain important in the metabolic process?

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There is a great energy need for the CNS for the viability of the body!

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Brain without glucose for more than 10 mins can result in?

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Coma and death

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Blood glucose less than how much is life threatening?

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3.5mM

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What is the next source of energy for the brain after glucose?

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Ketones.

Can decrease glucose utilization by 2/3.

Brain can get 70% of its energy from ketones.

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Metabolism of glucose and ketone bodies by the brain:

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Glucose--> energy + CO2 + H2O

Ketone bodies--> energy + CO2 + H2O

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What 3 forms of energy currency are available in the postabsorptive phase?

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1. glucose (liver glycogen, muscle glycogen, adipose tissue TG, and muscle aa's)
2. FAs (from adipocytes)
3. ketones (from hepatocytes)

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Events of the postabsorptive phase lead to:

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Energy provisions from glucose, FAs, and ketone bodies.

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In the absorptive state (substrate storage):

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1. aa's form proteins
2. glucose form CO2, H2O, and energy in most cells.
3. glucose form glycogen and fat in the liver.

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In the postabsorptive phase (substrate release):

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1. protein--> aa
2. TAG--> glycerol and FA
3. glycogen--> glucose

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Which hormone is the most important in regulating daily metabolic transitions?

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Insulin

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Pancreatic Beta cells:

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1. acted upon by parasym innervation from sight, smell, and taste of food.
2. releases insulin

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GIP

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Gastric inhibitory peptide

Aka: Glucose Insulin Peptide

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Functions of GIP?

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1. induce secretion of insulin
2. act in conjunction of secretin to protect SI from acid damage.

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What stimulates the release of GIP?

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Hyperosmolarity of glucose in the duodenum.

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What stimulates the beta cells to secrete insulin?

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1. plasma glucose
2. increase aa's
3. GIP
4. sympathetic neurons and epi.
5. parasym neurons

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At what conc of glucose is when the rate of glucose secretion maximal?

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25 mM

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What causes the translocation of glucose transporters?

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The binding of insulin to its receptors.

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Where do the glucose transporters come from?

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Vesicles budding off the endosome.

NOTE: these vesicles fuse with the plasma membrane due to the binding of insulin to the receptors.

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Ability of skeletal muscles to take up glucose is dependent on?

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Insulin. Nearly an absolute relationship!

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Increase plasma insulin has what effect on target cell?

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Causes them (target cells) to increase glucose uptake--> substrate storage.

No ketone synthesis and release

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Decrease plasma insulin leads to what effect on target cell response?

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Causes decrease glucose uptake by target cells--> glycogen catabolism--> substrate release.

Ketone synthesis and release

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What is the insulin level during absorptive phase?

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High

NOTE: low during postabsorptive phase.

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What are the four hormones that counter hypoglycemia?

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1. glucagon
2. catecholamines
3. cortisol
4. GH

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First line of defense for hypoglycemia is?

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Glucagon

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What blood sugar level enhances glucagon secretion?

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5mM

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GH is secreted when blood glucose falls below?

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70 mg/dL

NOTE:
1. GH increases gluconeogensis.
2. reduces effectiveness of insulin.

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At what level of blood glucose will cortisol be secreted?

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60 mg/dL

Pathway:
hypoglycemia--> CNS stress--> hypothalamus--> CRH--> AP--> ACTH--> Adrenal--> cortisol

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What are the effects of of cortisol?

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1. increase GNG
2. increase TG breakdown
3. decrease glucose uptake
4. increase protein cat

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Type I DM

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Low blood insulin level

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Type II DM

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Low insulin receptor number

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What are some consequences of Type I DM?

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1. glucose spills into urine
2. water, Na, K follow glucose into urine.
3. ketones spill into urine
4. decrease CO--> dec BP--> dec brain flow--> coma--> death.