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65 Cards in this Set
- Front
- Back
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What is the definition of obesity?
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BMI > 30
High ratio of body fat to lean body mass |
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What is the equation of BMI?
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kg/m^2
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What are the defined BMI classes of obesity?
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Class I: 30-35
Class II: 35-40 Class III: >40 |
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What is BMI underweight?
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<18.5
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What is BMI normal weight range?
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18.5 - 25
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At what BMI do you see increases in health risks?
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>25
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What percent of obesity could be genetic?
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40% of cases
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What waist circumference is at health risk?
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Men >40
Women >35 |
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What distribution of fat is at higher risk?
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Waist/Central with visceral obesity
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What percent of Americans are overweight? What percent of children?
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66%
16% of children |
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By 2015, what percent of Americans will be obese?
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41%
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What neurohumoral signals trigger eating?
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Leptin
Adiponectin Ghrelin Peptide YY Insulin |
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What regulates leptin levels?
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Fat stores. Increased fat stores = increased leptin.
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What percent of obesity is due to a loss of function of the leptin system?
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5%
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What does adiponectin injections do in mice?
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Decrease fat mass due to increase muscle fatty acid oxidation
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Where is adiponectin produced?
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in fat cells
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What are the effects of adiponectin?
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1. decreases influx of fatty acids to liver
2. decreases hepatic triglycerides 3. decreases glucose production from liver 4. increase insulin sensitivity |
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Where is Ghrelin produced?
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In the stomach and arcuate nucleus of the hypothalamus
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What is the only known gut hormone that increases food intake?
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Ghrelin
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Where is PYY produced?
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ileum and colon
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When is PYY production increased?
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after food intake
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What cells secrete PYY?
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Endocrine cells in the ileum and colon.
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Where are neurohumoral peripheral signals processed?
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in the hypothalamus
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What are the first order neurons?
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POMC and CART
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How do POMC and CART regulate energy expenditure and weight loss?
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via anorexigenic alpha-melanocytic-stimulating hormone
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Which neurons promote food intake (orexigenic)?
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NPY and AgRP
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Circulating level of which proteins is directly correlated to BMI?
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Plasminogen activator inhibitor
Angiotensin II CRP Fibrinogen TNF-alpha |
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What percent of IL-6 is produced by adipose?
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30%
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What is the function of IL-6 in respect to CRP?
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IL-6 modulates CRP production from the liver. CRP is a chronic inflammatory marker.
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What is the 3rd space?
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adipose tissue
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Over time, what cardiac changes can be expected with obesity?
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Chamber dilation and left ventricular hypertrophy
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What percent of obese patients experience myocardial fat infiltration?
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3%
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Which surface of the heart will become covered with excess adipose?
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Right ventricle
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What type of cardiomyopathy can occur with fat infiltration?
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restrictive
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Which portions of the conduction system can be disrupted by fat infiltration?
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Sinus node
AV node Right bundle branch |
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What are the 3 major defects of DM type II?
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Impaired insulin secretion
Impaired insulin action Excessive glucose production by liver |
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What makes obese pts diabetic?
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Additional defects that are inherited that impair beta cell function.
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What is the relationship of FFAs and insulin in Type II?
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FFAs that are hydrolyzed in the adipose from TGs block the actions of insulin and glucose use by peripheral tissues.
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What molecules can modify insulin resistance?
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Leptin
TNF-alpha IL-6 Resistin Adiponectin |
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What is the effect of TNF-alpha on insulin?
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inhibits action on muscles
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What is metabolic syndrome?
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CV, endocrinopathy, renal, and metabolic disorders present together.
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What is the role of resistin?
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Blocks the action of insulin, mechanism unknown
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Why would obesity lead to right heart failure?
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Cor pulmonale due to increase pulmonary hypertension from hypoxemia and hypercapnia (poor gas exchange).
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Why do obese patients develop soft tissue edema around the neck and airway?
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from the vibrations of heavy snoring (Good Lord)
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What is the difference OSA and OHS?
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OSA pts have normal CO2 when awake
OHS has daytime hypercapnia and hypoxemia |
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What is Pickwickian syndrome?
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Obesity
Hypersomnolence Hypercapnia |
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Why do OSA pts develop lung disease?
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hypoxic pulmonary vasoconstriction
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How does OSA effect HGH?
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Decrease HGH leading to greater central obesity and reduced bone and muscle mass.
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What is the primary treatment for OSA?
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Weight loss
Stop smoking No alcohol |
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What percent of patients cannot tolerate CPAP?
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40-70%, better with heater and humidifier
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Of pts the suffer sudden death syndrome, what percent have OSA?
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41%
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What causes sudden death syndrome?
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Hypoxemia leading to ischemia and arrhythmias
Apnea leads to greater sympathetic activity which increases BP and platelet aggregation. |
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Gallstones in the West are made of _______.
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Cholesterol
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What percent of Pima indian females have gallstone?
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63%
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How does estrogen effect gallstone formation?
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More likely to have cholesterol stone with higher estrogen levels.
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If a female has a BMI >45, they are ______ more like to develop gallstones.
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7 times
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What three factors are required for gallstone formation?
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Supersaturated bile
Nucleation of cholesterol crystals Stasis |
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Why is bile concentration increased with obesity?
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Due to hypersecretion of cholesterol.
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At what BMI levels can you see pulmonary compromise?
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Men >30
Females >28 |
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How does obesity effect pulmonary function?
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Decrease in compliance due to the weight of the thoracic cage.
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How is functional residual capacity (FRC) effected with increasing BMI?
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Decreases
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What is the most common single cause of disability?
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Osteoarthritis
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What is the single most preventable risk factor for osteoarthritis?
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Obesity
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What two joints are most commonly effect by obesity-related osteoarthritis?
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hips and knees
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Why does obesity increase the risk of gout?
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positive association of serum uric acid and obesity measurements
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