PFOS Lecture 5 Disorders of Lipid Metabolism

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1、PFOS1Disordersoflipidmetabolism:(i)obesity,(ii)dyslipidemia,(iii)lipidstoragedisease,and(iv)inbornerrorsofsteroidbiosynthesisNGTziBunPFOS1-LE0582013-2014(Materialsshadedandwordsingreycanbeignored,onlyincludedforreference.Importantinformationinboldface.)1I.OBESI

2、TY:Assessmentmethods,causes,consequencesandtreatments.(NoteassociationbetweenObesityandtype2diabetes)2DefinitionofObesity(肥胖症)weight(kg)Bodymassindex(BMI)=height2(m2)i.Overweight=BMIof25-30kg/m2=gradeIobesityii.ClinicalorgradeIIObesity=BMI>30kg/m2iii.Morbidorgr

3、adeIIIobesity=BMI>40kg/m2(a)severeobesity>40kg/m2(b)morbidobesity40-50kg/m2(c)superobesity>50kg/m2Morbid病態3Othermethodstoassessobesity(1)Waistcircumference(men>40inches,women>35inches)(2)Waistcircumferencetohipcircumferenceratio(=waist:hipratio)(3)Usecalipertog

4、augeskinfoldthicknesstobiceps+triceps+subscapular+abdomen4Medicalcomplicationsassociatedwithobesity•nLDL-cholesterolandtriglyceride,pHDL-cholesterolinblood•Hypertension(=HT).nriskforheartfailure,kidneyfailureforuntreatedHT•AtherosclerosisofCoronaryarteryandcard

5、iomyopathy•Stroke5•Gallstones胆石(=concretioningallbladder/bileductcomposedchieflyofcholesterolcrystals,occasionallymixedwithCa2+),canleadtocholecystitis胆囊炎•gout•arthritis(=inflammationofjoints)ofkneesnstressonweight-bearingjoints6•type2diabetesmellitus•increase

6、driskforendometrialcarcinoma(=cancerofinnerlayerofuterinewall)andvariousothercancers•predispositiontowardvenousthrombosis靜脈血栓形成(=clottingwithinbloodvesselwhichmaycauseinfarctionoftissuessuppliedbythevessel)7Continuationofmedicalconsequencesofobesity•Sleepapnea睡

7、眠窒息症hypoventilationandpulmonarydysfunctioncausedbynsofttissueinupperairways(apnea=absenceofbreathing)•Non-alcoholicsteatohepatitis(NASH)(steato=fatty)Accumulationoflipidinliverandhepatomegaly.Reducedmetabolicfunctionofliver.nriskforhepatocellularcarcinoma,liver

8、failureandcirrhosis.Associatedwithinsulinresistance.Insulinsensitizersmayimprovecondition.8•nriskformenstrualirregularities,ovulatoryinfertility,gestationaldiabetesthatcanaf