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Transcript
Endocrine & Metabolism Makeup: Briefly discuss the functions of the liver M.I.S.S.R.E.A.D Metabolic Immunological (complement, RES) Synthetic Storage (amino acid, iron, glycogen, lipid) Reservoir (blood) Endocrine Acid-Base Drug biotransformation General: Liver has multiple functions Anabolic / Catabolic Metabolism - Role is hormonally influenced o Catabolic hormones: glucagon, cortisol, adrenaline o Anabolic hormones: Insulin, GH - Anabolic Functions: o CHO: glycogenesis ↑glucose trapping (hepatocytes) 2° ↑glucokinase activity o Fat: Fatty acid formation • Once maximal glycogen stores → glucose metabolised to pyruvate → AcetylCoA → fatty acid Cholesterol / phospholipid formation o Protein synthesis Lipoproteins - Catabolic Functions: o CHO: Glycogenolysis, gluconeogenesis (via acetyl CoA formation from fatty acid breakdown) → maintain BSL o Fats: ↑lipolysis Ketone body formation Bile Acid formation (for fat absorption) o Proteins Ammonium formation (via glutathione synthesis for transport to PCT renal) Urea: by product aa metabolism → ↑concentrating ability of kidney - Immune System o Complement proteins o Kupffer cells (reticuloendothelial system within sinusoids) Filtration Storage of Iron as ferritin - Haematological o Coagulation factor formation (II, VII, IX, X) o Haematopoiesis (<10% adult liver, more important in fetal liver) By Amanda Diaz Endocrine & Metabolism - - Drug Biotransformation o Phase I: Oxidation (enzyme systems eg cytP450) → unmask conjugation sites o Phase 2: Conjugation to ↑solubility for excretion Blood reservoir: 450ml in liver at resting state o Can ↑ to 1500ml in fluid overload o ↓intravascular vol → able to mobilise 350ml By Amanda Diaz