KARBOHIDRAT & LIPID SEBAGAI SUMBER ENERGIDr. LOO HIAN DAO

KARBOHIDRATMENGHASILKAN ENERGI (ATP): GLIKOLISISGLIKOLISIS:AEROBANAEROBMAKAN:GLIKOLISIS ATP GLIKOGENESIS HATI & OTOT

LIPIDMEMBENTUK ENERGI (ATP): OKSIDASI BETA OKSIDASI BETA:TERJADI DALAM MITOKONDRIADIPENGARUHI OLEH:RATIO [ATP]/[ADP]RATIO [NADH]/[NAD+]RATIO [ASETIL-KoA]/[KoA]HORMONALLAPAR : OKSIDASI BETA

LIPIDENERGI DARI OKSIDASI BETA DIPAKAI JUGA UNTUK GLUKONEOGENESIS.MAKAN: FFA KILOMIKRON HATI TG VLDL ADIPOSE TISSUETG : SIMPANAN ENERGI KEBUTUHAN ATP LIPOLISIS FFA OKSIDASI BETA

Energy homeostasis is linked to immune balanceMalnutritionImmunosuppression (susceptibility to infection)OvernutritionImmunoactivation (susceptibility to inflammatory disease)Adapted from Wellen KE, Hotamisligil GS. J Clin Invest. 2005;115:1111-9.Optimal nutritionNormal immune function

Adipose tissue: An endocrine organ CRPIL-6PAI-1AngiotensinogenLeptinResistinMCP-1TNF-AdiponectinLau DCW et al. Am J Physiol Heart Circ Physiol. 2005;288:H2031-41.Wellen KE, Hotamisligil GS. J Clin Invest. 2005;115:1111-9.AtherogenicAntiatherogenic Adipocytokines (adipokines)

OBESITASTERJADI BILA ENERGI INTAKE > ENERGI EXPENDITURE.PERUBAHAN FUNGSI ENDOKRIN DARI JAR. ADIPOSA:ADIPONEKTINRESISTINTNF IL-6 RESISTENSI INSULIN

WAIST CIRCUMFERENCE

OBESITASADIPONEKTIN , RESISTIN RESISTENSI INSULIN HIPERINSULINEMIA PANCREAS FAILURE HIPERGLIKEMIAHIPERGLIKEMIA:PKC PATHWAYALDOSA REDUKTASEHEXOSAMINE PATHWAYAGEs PATHWAYKE-4 HAL TERSEBUT MENIMBULKAN GANGGUAN PEMBULUH DARAH.

Metabolism and the immune system are closely linked. In particular, excess food intake relative to energy requirements is associated with immune activation and increasing risk for inflammatory conditions such as atherosclerosis.As the following slide indicates, this inflammatory response is initiated in the adipocytes themselves.

Energy homeostasis is linked to immune balance Several bioactive molecules produced by adipocytes have been identified. These adipokines participate in diverse metabolic processes.Some adipokines (eg, CRP, IL-6, MCP-1, components of the renin-angiotensin-aldosterone system (RAAS), serum amyloid A, and TNF-alpha) are well known proinflammatory, proatherogenic molecules.Other adipokines such as leptin promote satiety and increase metabolic expenditure.1 Alternatively, data suggest this adipokine may also have proliferative, proinflammatory, prothrombotic, and pro-oxidative effects.Unlike these other adipokines, adiponectin acts as an antiatherogenic and antidiabetic agent. The effects of adiponectin are reviewed in the next 2 slides.Abbreviation used in slide: PAI = plasminogen activator inhibitorAdipose tissue: An endocrine organ 1. Correia MLG, Rahmouni K. Diabetes Obes Metab. 2006;8:603-10.