Nutritional diseases –I
190 likes | 719 Views
Nutritional diseases –I. Shoukat Ali Arain Senior Lecturer, Pathology Shali@alfaisal.edu. Learning Objectives. To outline the nutritional disease To describe factors responsible for energy balance in the body To describe causes and effects of obesity To outline causes of malnutrition
Nutritional diseases –I
E N D
Presentation Transcript
Nutritional diseases –I Shoukat Ali Arain Senior Lecturer, Pathology Shali@alfaisal.edu
Learning Objectives • To outline the nutritional disease • To describe factors responsible for energy balance in the body • To describe causes and effects of obesity • To outline causes of malnutrition • To describe different clinical syndromes associated with PEM • To compare the features of marasmus and kwashiorkor • To describe causes and clinical features of anorexia nervosa and bulimia
Nutritional diseases • Diseases of energy imbalance • Obesity • Protein-Energy Malnutrition • Marasmus • Kwashiorkor • Anorexia nervosa/bulimia • Vitamin Deficiencies • Vitamin A deficiency • Vitamin D deficiency • Rickets and osteomalacia • Vitamin C deficiency
Obesity • Definition • State of increased body weight due to adipose tissue accumulation • 20% excess in weight is associated with health risks • BMI • Skin fold measurement • Mid-arm circumference • Waist-hip ratio • Central vs. peripheral • Energy imbalance
Mechanisms of obesity • Poorly understood! • Mutations in leptin gene or any of the receptors in this pathway (4-5%) • In many obese persons serum leptin levels are high suggesting leptin resistance • Environmental influences • Type and amount of dietary intake • Psychological factors
Consequences of obesity • Increases risk for • Hypertension: Insulin resistance – increased insulin – increased Na retention and norepinephrine, smooth muscle proliferation • Diabetes • Hypertriglyceridemia • Low HDL • Metabolic syndrome • Obesity, dyslipidemia, hypertension, insulin resistance • NASH • Cholelithiasis • Osteoarthritis • Stroke • Breast and endometrial cancers
Malnutrition • Causes • Poverty • Ignorance • Chronic alcoholism • Self-imposed dietary restrictions • Acute and chronic illnesses • Malabsorption syndromes
Malnutrition • PEM • Inadequate protein and calories • A weight of < 80% of the normal • Ends of the spectrum are Marasmus and Kwashiorkor • Two protein compartments • Somatic and Visceral • Mid-arm circumference • Serum proteins (albumin, transferrin etc.)
Malnutrition Marasmus Kwashiorkor Because of protein deficiency Weight from 60-80 % Visceral affected more than somatic Serum proteins are decreased - edema Loss in muscle mass is masked by edema Fatty liver and abdominal distention • Because of caloric deficiency • Weight less than 60% • Somatic component is affected more • Serum proteins are normal or marginally decreased • Extremities are emaciated – head large for the body • Fatty liver not present
Anorexia nervosa and Bulimia • Obsession for thinness • M/F ratio • Anorexia nervosa • Self induced starvation • Features of malnutrition • Endocrine deficiency • Amenorrhea • Osteoporosis • Hypothyroidism • Electrolyte imbalances • Bulimia • Lot of eating followed by induction of vomiting • Weight is near normal • Menstrual irregularities – amenorrhea is less common • Electrolyte imbalances • Complications of vomiting like aspiration and rupture of esophagus and stomach
References • Robbins Basic Pathology 8th ed. • Davidsons Principles and Practice of Medicine 21st ed. Thanks ?
