Factors for Diagnosing Metabolic Disease Quiz

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Questions and Answers

Name 3 of the 5 factors needed to diagnose metabolic disease

-high triglycerides -hypertension -insulin resistance -low HDL cholesterol -visceral obesity

What is metabolic syndrome characterized by?

A co-occurrence of: -atherogenic dyslipidemia -HTN -elevated glucose -chronic low grade inflammation -prothrombosis

Which of the following is known to play a role in secreting proinflammatory cytokines and contributing to insulin resistance?

Interleukin-6 (IL-6)

Ectopic adiposity (correct)

C-reactive protein (CRP)

Adiponectin

What is the primary function of the cytokine interleukin-6 (IL-6) in relation to metabolic syndrome?

Stimulates hepatic production of C-reactive protein (CRP) Signup and view all the answers

Which of the following statements about high-sensitivity C-reactive protein (hs-CRP) is true?

It is a useful biomarker for chronic, low-grade inflammation. Signup and view all the answers

Which of the following is NOT a cytokine or adipocytokine mentioned in the text as being associated with insulin resistance or metabolic syndrome?

Ghrelin Signup and view all the answers

What is the primary mechanism by which inflammatory cytokines like TNF-α and IL-6 contribute to insulin resistance?

They interfere with insulin signaling. Signup and view all the answers

Reduced mitochondrial size, density, and function have been implicated in the etiology of ______, metabolic syndrome, and diabetes.

insulin resistance Signup and view all the answers

Obese, sedentary, and insulin-resistant individuals have smaller and fewer ______, with impaired function.

mitochondria Signup and view all the answers

IL-6 = stimulates hepatic production of C-reactive protein C-reactive protein (CRP) = a robust predictor of various features in the metabolic syndrome pro-inflammatory = cytokines, chemokines, CD40L Anti-inflammatory = TGF-B, IL-10 Signup and view all the answers

Accumulation of ____ in non-adipose tissue depots is robustly associated with skeletal muscle insulin resistance

Fatty acids Signup and view all the answers

Concurrent with an increase storage of ____, reductions in mitochondrial size, density and function have been implicated in the aetiology of insulin resistance, metabolic syndromeand diabetes.

ectopic adiposity Signup and view all the answers

How would mitochondria differ in obese and sedentary individuals vs healthy active individuals

Obese, sedentary, and insulin resistant individuals have smaller and fewer mitochondria Signup and view all the answers

Diminished mitochondria density and function may lead to or coincide with

all of the above Signup and view all the answers

Explain the positive feedback loop with mitochondrial dysfunction

With increased sedentary behavior promotes a decrease in mitochondrial density and function. This causes further sedentary behavior further impacting mitochondria. Signup and view all the answers

What are the 5 co-occurring characteristics of metabolic syndrome

-atherogenic dyslipidemia -HTN -elevated glucose -chronic low grade inflammation -prothrombosis Signup and view all the answers

Obesity is an ___ risk factor for insulin resistance, hyperglycemia, hypercholesterolaemia

Independent Signup and view all the answers

What are ways in which EPs can infer fat distribution in persons have changed

Liver function tests results from GPs, inflammatory markers, and markers of insulin sensitivity Signup and view all the answers

What are 2 implication in the aetiology of insulin resistance, metabolic syndrome and diabetes

Ectopic adiposity and reductions in size, density and function of mitochondria Signup and view all the answers

Given abnormally placed adipose tissue and a decrease in function, size, and density of mitochondria, what conditions could this lead to?

Diabetes, metabolic syndrome, and insulin resistance Signup and view all the answers

For someone who is obese, sedentary and/or insulin resistant what would their mitochondria look like?

Smaller and fewer presenting in the body with impaired function Signup and view all the answers

What is the result of diminished mitochondrial density and function

May lead to or coincide with decreased or incomplete lipid oxidation and subsequent accumulation of lipid metabolites, impaired insulin signaling, metabolic inflexibility and oxidative stress Signup and view all the answers

What can diminished mitochondrial density and function lead to

All of the above Signup and view all the answers

What is the ignificance of increased levels of cytokines and adipocyte-derived hormones?

They are significant contributors to insulin resistance Signup and view all the answers

Ectopic adiposity is known to play a role in secreting…

proinflammatory cytokines Signup and view all the answers

Is IL-10 pro or anti inflammatory?

Anti Signup and view all the answers

Is IL-6 pro or anti inflammatory

Pro Signup and view all the answers

TNF-a and IL-6 are inversely associated with triglycerides and total cholesterol and positively with HDLc

False Signup and view all the answers

What are TNF-a and IL-6 positively and inversely associated with?

Positively associated with triglycerides and total cholesterol and inversely with HDLc Signup and view all the answers

what produces Il-6 and TNF-a

Adipose tissue macrophages Signup and view all the answers

What is the significance of CRP and how is it stimulated?

IL-6 stimulates the production of CRP in the liver and serves as a robust predictor of various features in metabolic syndrome especially low grade inflammation. Elevated levels are associated with ASCVD Signup and view all the answers

Elevated CRP is associated with decreased risk of ASCVD

False Signup and view all the answers

Many patients diagnosed with metabolic syndrome also have…

Hyperglycaemia Signup and view all the answers

Cardiorespiratroy exercise is suggested to be dose dependent, such that greater volumes of physical activity are associated with greater cardiometabolic health risk education

True Signup and view all the answers

Abdominal obesity is a modifiable complement of metabolic syndrome and is considered the primary driver of the other risk components

True Signup and view all the answers

Acute effects of exercise on metabolic system

-can significantly increase whole-body glucose disposal thus temporarily attenuate hyperglycaemia. -several hours after an exercise bout, insulin sensitivity increases -repeated bouts lead to a chronic adaptive response, characterized by enhanced cardiorespiratory function and global improvements in insulin action Signup and view all the answers

Name some positive effects exercise has for the metabolic system

<ol> <li>Improve BP and lipid profiles</li> <li>Decrease visceral adiposity even in the absence of weight loss</li> <li>Enhance fatty acid oxidation</li> <li>Increase mitochondrial function an content</li> <li>Attenuate the proinflammatory state</li> </ol> Signup and view all the answers

List the benefits of resistance exercise for metabolic syndrome

<ol> <li>Increase in muscle mass</li> <li>Increased RMR</li> <li>Increased TEE</li> <li>Decreased BF %</li> </ol> Signup and view all the answers

Signup and view all the answers

Which of the following is not a component of metabolic syndrome

High LDLc Signup and view all the answers

Which of the following is incorrect regarding a rise in plasma glucose concentration

It stimulated hepatic glycogenolysis Signup and view all the answers

Which of the following is not a pro inflammatory cytokine

IL-10 Signup and view all the answers

Which of the following is a useful bio marker of chronic low grade inflammation?

high sensitivity C-reactive proteins Signup and view all the answers

Which of the following increases the risk of thrombosis

Elevated plasma plasminogen activator-inhibitor-1 Signup and view all the answers

In metabolic syndrome, what is considered the primary driver of other risk components?

Abdominal obesity Signup and view all the answers

Explain the physiological process associated with insulin and glucose in an insulin sensitive person

In a healthy, insulin sensitive person, glucose stimulates the release of insulin from the pancreatic beta cells, which in turn reduces plasma glucose concentration through the suppression of hepatic glycogenoysis and gluconeogenesis and simultaneous glucose uptake, utilization and storage by the liver, muscle and adipose tissue Signup and view all the answers

The pathophysiology of MetS encompasses multiple genetic and acquired entities that fall under the umbrella of and_

insulin resistance and chronic low grade inflammation Signup and view all the answers

What is the abnormal total cholesterol level in mmol/L

≥5.5mmol/L Signup and view all the answers

What is the abnormal LDLc level?

≥3.5mmol/L Signup and view all the answers

what is the abnormal level for HDLc?

≤1.0mmol/L Signup and view all the answers

Study Notes

Insulin Resistance and Health Costs

Insulin resistance, measured by HOMA-IR, correlates positively with Body Mass Index (BMI) and Waist Circumference (WC).
Annual healthcare costs in the U.S. rise by $3,429 for adults with obesity and $9,601 for those with diabetes.
Total healthcare costs for obesity and diabetes reached $342.2 billion in 2013 and $327 billion in 2017.
A nonlinear (J-shaped) relationship exists between BMI and healthcare costs, with exponential increases in costs observed in obesity classes II and III (BMI > 30 kg/m²).
Class III obesity (BMI > 40 kg/m²) presents a six-fold increase in diabetes risk compared to normal-weight individuals.
Diabetes combined with obesity markedly increases healthcare utilization; a 50-year-old with diabetes incurs costs approximately three times higher than a non-diabetic peer.

Metabolic Syndrome

Characterized by a combination of atherogenic dyslipidemia, hypertension (HTN), elevated glucose, chronic low-grade inflammation, and prothrombotic conditions.
Insulin resistance manifests primarily in the liver, reflecting peripheral resistance in skeletal muscle.
Over time, compensatory hyperinsulinemia leads to increased lipogenesis, hypertriglyceridemia, hypertension, and liver fat accumulation (steatosis).

Pathophysiologic Links

Research confirms connections between insulin resistance, metabolic syndrome, glucose intolerance, and atherosclerotic cardiovascular disease (ASCVD).
Systemic inflammation, oxidative stress, and endothelial dysfunction are linked to metabolic syndrome in both animal and human studies.
Identifying at-risk individuals for metabolic syndrome before severe insulin resistance or hyperglycemia is crucial for early intervention.

Obesity and Health Risks

Obesity is an independent risk factor for insulin resistance, hyperglycemia, dyslipidemia, and hypertension, contributing to chronic diseases and increased mortality.
Insulin regulates various metabolic processes, and simplistic definitions of insulin resistance may overlook its multi-faceted nature.

Mitochondrial Dysfunction

Increased ectopic fat storage correlates with reduced mitochondrial size, density, and function in insulin-resistant individuals.
Impaired mitochondrial function leads to incomplete lipid oxidation and accumulation of harmful metabolites, exacerbating insulin resistance and metabolic flexibility issues.
Hypokinetic diseases, related to sedentary lifestyles, can predict mitochondrial dysfunction, while exercise interventions can enhance ATP production and fatty acid oxidation, irrespective of weight loss.

Adipose Tissue Dynamics

Adipose tissue functions as an active organ with diverse roles in metabolism and may contribute to the pathophysiology of metabolic syndrome.
Visceral adipose tissue (VAT) is particularly influential in metabolic disorders, while intramuscular fat (IMAT) also affects glucose metabolism and insulin sensitivity.

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Description

Test your knowledge on factors required for diagnosing metabolic diseases by identifying 3 out of the 5 key factors commonly used in diagnosis.