integration of metabolism

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Integration of metabolism:

Integration of metabolism Dr. Hariharan . V, Assistant Professor, Dept of Biochemistry, Karpagam Faculty of Medical Sciences, Coimbatore. Free ppt download: www.authorstream.com, search drhari

Objectives of this lecture:

Objectives of this lecture At the end of lecture you should understand How metabolism of carbohydrate, protein and lipid are related How energy is stored during fed state How fuel is supplied to different tissues at starved state Free ppt download: www.authorstream.com, search drhari

Introduction :

Introduction Metabolism can be divided into Catabolic pathways- breakdown of larger molecules producing energy Anabolic pathways- synthesis of larger compounds from smaller- Energy requiring Amphibolic- link between anabolic and catabolic pathways. Eg. TCA cycle Free ppt download: www.authorstream.com, search drhari

Provision of Fuels for energy:

Provision of Fuels for energy Energy is needed continuously by the body all day for vital functions and physical activities Since humans eat 3 meals a day with gaps in between, there is a need to form reserves of carbohydrate and lipid to provide continuous energy Enough fuel should be supplied ( through food) or it will lead to emaciation, wasting If more than sufficient fuel is given, it will lead to increased fuel reserve leading to obesity . Free ppt download: www.authorstream.com, search drhari

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ENERGY Physical activity Vital functions – heart, respiration, etc Synthetic functions(like Hormones, etc.,) Active transport Free ppt download: www.authorstream.com, search drhari

Delusion- What u perceive from what u see is not true:

Delusion- What u perceive from what u see is not true Free ppt download: www.authorstream.com, search drhari

Metabolic fuels are interconvertible:

Metabolic fuels are interconvertible Excess of carbohydrate is converted in to fat (Lipogenesis) Fatty acids cannot produce glucose, only rare propionyl coA from odd chain FA and Glycerol from TAG forms glucose (gluconeogenesis) Glucogenic aminoacids can be converted to glucose by entering TCA cycle or becoming Pyruvate Free ppt download: www.authorstream.com, search drhari

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Glucose Fatty acid Ketone bodies Triacyl Glycerol Aminoacids ( Glucogenic ) Only propionyl CoA (rare) Glycerol Free ppt download: www.authorstream.com, search drhari

Supply of fuel in fed and starved state:

Supply of fuel in fed and starved state Glucose is always required for Brain In starvation 20% ketone bodies can be used. But glucose 80% needed RBC They lack mitochondria. So they use glucose for energy through glycolysis and HMP shunt So there should be a continuous supply of glucose to these tissues even in starvation Free ppt download: www.authorstream.com, search drhari

FED state :

FED state Carbohydate metabolism Glucose is the major energy source in fed state Food  increased blood glucose stimulates insulin release insulin stimulates GLUT4 and increases glucose uptake by muscle and adipose tissue . As insulin level falls in starvation, the glucose uptake falls. Free ppt download: www.authorstream.com, search drhari

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In liver glucokinase converts glucose to G6P and stored as glycogen. Insulin stimulates Glycogen synthase and inhibits phosphorylase Excess of glucose converted to fatty acids and formation of TAG In adipose tissue Insulin stimulates Glucose uptake Conversion of glucose to FA and TAG Inhibits lipolysis and release of FFA Free ppt download: www.authorstream.com, search drhari

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Fed state - Lipid Metabolism Lipids after digestion are transported in blood as chylomicrons . Lipoprotein lipase in skeletal muscle and adipose tissue hydrolyzes TAG in Chylomicrons to FFA and glycerol. Glycerol taken up for gluconeogenesis The FFA are taken inside adipose tissue and esterified in to TAG. Remaining FFA taken up by liver- converted to TAG. If excess TAG in liver  released as VLDL Chylomicron remnant is taken up by liver Free ppt download: www.authorstream.com, search drhari

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Ethics and professionalism for Medical students and doctors:

Ethics and professionalism for Medical students and doctors I have been posted in casualty for last 15 days and I have seen more than 100 sutures performed in various styles. I have been practicing this in my free time with orange peel or other resources available. Suddenly a patient comes with a small cut which has been profusely bleeding since half hour and it can be stopped if I did 2 sutures. My PG went for dinner to a nearby restaurant 15 min from here. What should I do?

Summary:

Summary Energy needed for physical activity, vital functions, etc In fed state, Glucose is absorbed taken up by liver converted to glycogen and TAG. Insulin stimulates uptake of Glucose by adipose tissue and muscle. It also stimulates adipose tissue to convert glucose to TAG and store it. Fats are absorbed, transported as chylomicrons and FFA taken up by muscle and adipose tissue and converted to TAG for storage Free ppt download: www.authorstream.com, search drhari

References:

References Harper Free ppt download: www.authorstream.com, search drhari

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Thank You Free ppt download: www.authorstream.com, search drhari

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Integration of metabolism II:

Integration of metabolism II Dr. Hariharan . V, Assistant Professor, Dept of Biochemistry, Karpagam Faculty of Medical Sciences, Coimbatore. Free ppt download: www.authorstream.com, search drhari

Fed State- Protein Metabolism:

Fed State- Protein Metabolism Insulin stimulates synthesis of proteins Takes up 20% of total energy consumption Free ppt download: www.authorstream.com, search drhari

Starved state:

Starved state Small fall in blood glucose, then stabilizes FFA increase first then plateau Initial delay in ketone body production. As starvation continues, ketone body production increases Free ppt download: www.authorstream.com, search drhari

Carbohydrate metabolism:

Carbohydrate metabolism As blood glucose falls  insulin level goes down  Adipose tissue and skeletal muscle glucose uptake falls Free ppt download: www.authorstream.com, search drhari

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Fall in blood glucose Stimulates Glucagon release In liver it stimulates Glycogen Phosphorylase and inhibits Synthase leading to Glycogenolysis and G6P production In liver G-6-Pase is present leading to glucose release into blood for RBC and Brain Muscle don’t have G-6-Pase. So Muscle glycogen is utilized by muscle itself Free ppt download: www.authorstream.com, search drhari

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Free ppt download: www.authorstream.com, search drhari Starvation Fall in blood glucose Increase in glucagon Decrease in insulin Increased glycogenolysis in liver Increased glycogenolysis in Muscle Glucose release to RBC and brain Glycogen utlised by muscle itself

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In muscle FFA  Acetyl CoA  inhibits PDH citrate accumulation Citrate inhibits PFK, sparing glucose. Accumulated pyruvate is transaminated to alanine and alanine transported to liver. In liver, alanine becomes pyruvate  gluconeogenesis Free ppt download: www.authorstream.com, search drhari

Lipid Metabolism:

Lipid Metabolism In adipose tissue, Decreased Insulin and increased Glucagon  inhibition of lipogenesis inactivation of Lipoprotein lipase activation of Hormone sensitive lipase Release of FFA and Glycerol Glycerol goes to liver glucose FFA becomes preffered substrate for muscle, sparing glucose Free ppt download: www.authorstream.com, search drhari

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Muscle don’t have a good system of beta oxidation, so liver takes up much of FFA and converts to ketone bodies They are taken up by Skeletal muscle and heart for energy less than 10% glucose utilized for energy by muscle in prolonged starvation Free ppt download: www.authorstream.com, search drhari

Protein metabolism:

Protein metabolism As insulin falls, protein synthesis reduces Most of the muscle protein are catabolised to aminoacids transaminated to pyruvate  transaminated to alanine  transported to liver  converted to glucose  Leads to muscle wasting Free ppt download: www.authorstream.com, search drhari

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Clinical aspects:

Clinical aspects 1. Essential protein catabolism leads to death In prolonged starvation, when adipose tissue sources are depleted, Muscle proteins catabolised for gluconeogenesis . Later the aminoacids are used to provide energy When essential proteins are used up, leads to death Free ppt download: www.authorstream.com, search drhari

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2. Pregnancy and lactation In pregnancy lot of glucose needed for fetus leading to mild hypoglycemia and ketosis in lactation glucose is needed for lactose synthesis, leading to ketosis and hypoglycemia Free ppt download: www.authorstream.com, search drhari

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3. Type 1 DM Insulin deficiency  Glucose cannot be utilizedhyperglycemia Increased gluconeogenesis from amino acids from muscle proteins In adipose tissue increased lipolysis  FFA ketone body production in liver But ketone bodies cannot be utilized since oxaloacetate is deficient. Severe ketosis comadeath Free ppt download: www.authorstream.com, search drhari

Ethics and professionalism:

Ethics and professionalism : “I am a medical officer in a small hospital. I had interviewed and examined a patient when he was first admitted to the hospital for his intractable cough, and I had gotten to know him very well. We respected each other. When I learned that a biopsy of a lung nodule showed cancer, I was very upset, but I wanted to be there when he was told.

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When I asked my Senior Resident who would inform the patient of the biopsy results, he instructed me that no one on our team was to say anything. Instead, the oncologist would tell him since they knew more about the disease and had more experience telling patients bad news. For the next two days the patient asked me repeatedly if I knew the results, what should I do? Free ppt download: www.authorstream.com, search drhari

References:

References Vasudevan Harper Free ppt download: www.authorstream.com, search drhari

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Thank You Free ppt download: www.authorstream.com, search drhari

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