GLYCEMIA
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Glucose transporters
Glut T1 - steady state- cerebral vessels Glut T2 - concentration dependent on glucose - intestin, (J cells of pancreas Glut T3 - steady state - neurons Glut T4- internalisation - migration -muscle + fett tissue
EXIHACEL
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GLUT 4
(MUSCLE AND FAT TISSUE)
fusion ^Hfr-
ccin E   ■ rT
^J|_-Vi  pus 10(1 7-
DIABETES MELLITUS
■ SACHARIDS lutMzation of gl. + 1 glycogenosis -* hyperglycemia - glycosuria -* osmotic diuresis.. Na, K -» hemoconcentration (polydipsie) hypotension -*anurie
Glykosylatlon of proteins microangiopatia nefropatia, retinopatia, dg glycosylated Hb
■ Lipids liipogenesls, Tlipoiysis-tlipemia-* ketogenesis-acidosis (Kussmaul respiration) -*i^a ...dehydratation
■ PROTEINS tcatabollsm -gluconeogenesis -» loss of N in urine....
• Cell dehydratation
Diabetes mellitus type I
IDDM (insu linde pendent)... insulinopenie, juvenil
damage öf ß cells, genetic disposition, autoimune, th. insulin
Diabetes mellitus type II
NIDDM (non insulindependen)...
insulinoplethoric, resistent to In. - no response of cells (IGlutTi).... Change in receptors for I., disturbance of fusion of Glut T4 with membrane. p cells 1 secretion tili exhaustion
Disposition of 20% of population
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DIRECT t OF THERMOGENESIS
■ BROWN FAT (some rodents, newborns; color by big amount of mitochondria with cytochrome eniymes) - expresses a mitochondrial THERMOGEN1N (UCG uncoupling protein, that dissociates oxidative phosphorylation from ATP generation);    beta3 receptors take part in it;
■ UCG is H+ channel, protons generated by electron transport system enter the mitoch. through thermogenin instead of taking part in ATP-synthests      circulation of H+ ->tenergy is not incorporated in ATP; free fatty acids open UCG channels because of activated liposysis of triacy (glycerol by adrenalin (also consuming energy for phosphorylation of protein kinase)
CIRCULATORY AND RESPIRATORY RESPONSE TO ^ METABOLISM
t VENTILATION
* CARDIAC OUTPUT-TACHYCARDIA AND
* CONTRACTILITY     pulse pressures
CUTANEOUS VASODILATION {thermoregulation) ->1 PR
-» hyperclrelation and hypotension
VITAMINS Formation of vit. A from carotene in liver •t1 consumption of vtt, ^ resorption of B 12
GROWTH, DEVELOPMET
• CNS development of synapses, myelimsation -^thyroidal hormons -mental retardation, replacement therapy till 6M {later irreverible changes)
> Bones - permissive effect for STH, hypothyreosis - dwarf
• Metamorphosis in amphibian tadpole -frog (axolotl, Laufberger)
----
GOITER
• Chronic treatment by TSH -hypertrophy-an enlargement
ENDEMIC - decreased iodine Intake in food
■ EU ...HYPO..-HYPETHYRE01DISM
' Lowthyorofd h.-tTSH
• Antithyroid substances inhibition of acumulatfon of I- anions as
perchlorate, nitrate, thiocyanate Inhibition of iodinatian of thyrosirt - thiouracil, excesive r 1-
HYPOTHYREOIDISM
Biotogy congenital, liodine in water, autoimune thyroiditis - Hashimoto' goiter In children cretinism, bone growth delayed - dwarf
in adults J.BMR, cold intolerance -hypothermia, i neuromuscular excitability, voice is husky and slow, sleepy, loss of memory, depression, weight increase, hyperlipidemia, hypercholesteroemia, J. CO and BP, deposit of mucopolysaccharlds in skin - myxedema
HYPERTHYREOIDISIV1
Ethiotogy thyreoid-stimulating immunoglobulins TSIg thyreotoxikosis - Graves' disease Symptoms f BMR, hyperreflexia, tremor, muscular weakness, insomnia, anxiety, hyperphfagia and weight loss, heat intolerance, T HRand BP, - and 1PR (cutaneous vasodilation)*   Ireaction time, exophthalmos - swelling of the eye muscle, accumulation of mucopolysaccharides High- output failure tachycardia and I BP -tCO
PLASMATIC TRANSPORT of T3 and T4 * Bound to proteins <-> free
dynamic balance Tyroztn binding globulin TEG (23) „ „  prealbumin T6P*
Svnini albumin USA i ! capacity,! affinity)
T4 Irt cells desonldated to T3 - higher activity (transformation iduring starvation -1 rT3 with low activity)
Excretion - liver conjugated with sulfates, glukuronides
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EFFECT OF T3 a T4
■ ACTIVATION OF THYROID HORMONE RECEPTORS IN NUCLEUS REGULATES TRANSCRIPTION OF GENES . T3 is more effective than T4 [ $0% of effect) 50x more T4, but more bound to plasma proteins, deiodinated in cells, THR in nucleus have 10x I afiriity to T3, (conversion of T4 to T3 i during starvation, illnes&ea spare of E at unchanged level of TSH)
* f BASAL METABOLISM .  | 02 CONSUMPTION
- 1 HEAT PRODUCTION
* GROWTH and DEVELOPMENT
- DIFERENTiATION , METAMORPHOSIS
* i Of REACTION TIME
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SYNTHESIS OF Na-K PUMP
« Muscle, kidney, liver
* Incorporation of Na-K pump in membrane
■^nf consumption of Overactivity of pump
-^activity of pump compensated by ^ leak
ofNaaK
cycle of cations whereby energy is
consumed without useful work
SYNTHESIS OF ENZYMES
■ CARBOHYDRATES tglUKoneogenesis, f glykogenolysis, glycemia buffered by t insulin, ^resorption of glucose - postprandial hyperglycemia)
- PROTEINS f proteolysis in muscles together with ^proteosynthesis, during hyperthyroidism neg. N bilance, uraturia, kaliuria, calciuria, creatinuria, weakness
■ LIPIDS ■flipolysis, t-number of receptors for LDL In liver-* i cholesterolemia
• SYNTHESiS OF ENZYMES IN MITOCHONDRIA
ADRENERGIC STIMULATION HEART
• BETA RECEPTORS - synthesis in heart, muscle, fat tissue -tachycardia
Therapy - Seta blockers
• EXPRESSION OF GEN FOR ALFA MYOSIN HEAVY CHAIN IN MYOCARDIUM -3"t" contractility and rapid fiber shortening
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