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13 Cards in this Set
- Front
- Back
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What criteria are used to determine obesity? |
BMI = kg/m2
Waist to hip ratio thought to be better indicator of risk (m>.9, w>.85 = abnormal)
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What are different types of body fat distribution?
Why is one riskier than the other? |
Apple is more dangerous than pear.
Correlation with increased BP and insulin resistance. |
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What are the adverse cardiovascular risks associated with obesity (six listed)? |
Diabetes, dyslipidemia, hypertension, LVH, AF, atherosclerosis |
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What do adipocytes release? |
Adiponectin (good thing, but secrete LESS in obesity) Angiotensinogen FFAs Plasminogen activator inhibitor (could cause prothrombosis) Cytokines (TNF, IL-6) |
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What are the CV benefits of adiponectin? |
Increased insulin sensitivity Decreased vascular inflammation |
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What's different between large and small adipocytes? |
Large adipocytes are insulin resistant, increase adrenergic receptors, increased lipolysis
Small adipocytes are insulin sensitive and have fewer adrenergic receptors |
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What is the definition of metabolic syndrome? |
"On the way to diabetes and incr. risk for heart disease and stroke" Patient must meet three or more of following criteria: Abdominal obesity: m>40" w>35" TG: >150mg/dL HDL: m<40 w<50 BP: >135/>85 Fasting glucose: >100mg/dL
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How much weight loss is significant to improve CV risk factors? |
5-10% over six months |
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What improvements in metabolic and CV function are seen with weight loss? |
Metabolic factors: lower HbA1c, increased sensitivity to insulin
CV factors: Lower BP, lower total cholesterol, higher HDL, lower TG, increased arterial pliability |
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What are the two mainstay drugs to promote weight loss? |
Phentermine - amphetamine derivative
Orlistat - lipase inhibitor |
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What are the contraindications of phentermine? |
Children, HTN, coronary artery disease |
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Which weight loss drugs were not approved/pulled from the market? |
Sibutramine Fen/Phen Cannabinoid receptor antagonists |
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What are the three new drugs for Rx of obesity? |
Belviq - stimulates serotonin receptors in satiety receptors in the brain
Qysmia - sympathomimetic, carbonic anhydrase inhibitor
Contrave - Dopa and NE reuptake inhibitor and opioid antagonist |
