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14 Cards in this Set
- Front
- Back
5 categories of metabolic syndrome
(must have 3/5) |
obesity
high LDL low HDL elevated BP elevated glucose |
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result of visceral adiposity
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higher tissue volume of visceral fat = more insulin resistant
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adipokines secreted by adipocytes
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TNFa, IL-6, adiponectin, plasminogen activator, leptin
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TNFa
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directly affects insulin signalling by inhibitng tyrosine kinase phosphorylation of insulin receptor
stimulates lipolysis |
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IL-6
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icreases circulating FFA
decreases adiponectin secretion |
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Plaminogen activator inhibitor 1
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PAI-1 inhibits plasminogen activator
creates prothrombic milleu in body acceleration of atherthrombosis hyper coag |
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Resistin
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increased in pts with insulin resist
decreases insulin sensitivity |
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adiponectin
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low levels in metab synd pts
associated with MI dec in pts with insulin resist decreases TNFa and serum FFA |
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Leptin
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regulates appetite
may increase insulin sensitivity |
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Take Home point of visceral adipocytes:
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visceral more metabolically active
metabolic activity mediates insulin resistance: problematic |
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normal vs abnormal skeletal muscle glucose disposal
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normal: tyr kin phos insulin receptor. then go thru PI3 kin to make a GLUT4 receptor: takes glucose out of circ and puts into skeletal muscle
abnormal: FFA and adipokines change tyr kin to ser/thre; reduces PI3, shunt to MAP kin. reduces GLUT4, pull less glucose out of circ |
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SD-LDL
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more athergenic than LDL
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prediabetic
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people can have insensitivity to insulin for 10-12 years befor Dx of diabetes
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Metformin
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durg that increases insulin sensitivity
but lifestyle change is more important |