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CONTROL OF INTERMEDIARY METABOLISM D. C. MIKULECKY Dept. Physiology ENERGY IS CAPTURED BY PLANTS CO2 + H2O + RADIANT (SOLAR ) ENERGY --> (CH20)n + O2 ANAEROBIC METABOLISM SUGAR CAN BE BURNED WITHOUT OXYGEN - ANAEROBICALLY FAR MORE ENERGY RELEASED FROM BURNING SUGAR AEROBICALLY GLYCOLYSIS IS ANAEROBIC-CARRIED OUT IN CYTOSOL GLUCOSE ----> 3 CARBON FRAGMENTS PLUS 2 ATP AEROBIC METABOLISM PYRUVIC ACID (3 C FRAGMENT) ENTERS MITOCHONDRIA COMBINES WITH COENZYME A LOOSING A CO2 AND BECOMING ACETYL COENZYME A (2 C FRAGMENT) THIS FRAGMENT ENTERS A CYCLIC REACTION SCHEME, THE CITRIC ACID CYCLE, ATP IS PRODUCED PRODUCTS OF THE CITRIC ACID CYCLE ENTER THE ELECTRON TRANSPORT CHAIN, MORE ATP IS PRODUCED BY OXIDATIVE PHOSPHORYLATION ULTIMATELY, 34 MORE ATP’S ARE PRODUCED MITOCHONDRIA Extract Energy from Food Fuels Energy is stored in ATP Aerobic Metabolism OVERVIEW OF CATABOLISM DIETARY PROTEIN DIETARY CARBOHYDRATES DIETARY FATS AMINO ACIDS GLUCOSE FATTY ACIDS MITOCHONDRIA ACETYLCOA CAC ELECTRON TRANSPRT CHAIN ATP OVERALL REGULATION OF BLOOD GLUCOSE (+) RELEASE FROM LIVER - ( ) BLOOD GLUCOSE INSULIN (+) EPINEPHRINE AND NOREPINEPHRIN (+) GLUCAGON (+) GLUCOCORTICOIDS - ( ) - ( ) CONSUMPTION BY MUSCLE AND FAT CELLS GH SYNERGISTIC EFFECTS OF CORTISOL, GLUCAGON, AND EPINEPHRINE ON BLOOD GLUCOSE WHEN ALL THREE ARE PRESENT THE EFFECT IS FAR MORE THAN ADDITIVE COUNTERREGULATORY HORMONES ALSO GH AND T3 HYPOGLYCEMIA (LOW BLOOD SUGAR) HYPOPITUITARYISM ADRENAL CORTICAL FAILURE (ADDISON’S DISEASE) SEVERE HEPATIC DAMAGE METABOLIC ACTIONS OF GROWTH HORMONE MOBILIZES TRIGLYCERIDE FAT STORED IN ADIPOSE TISSUE CONSERVES GLUCOSE FOR BRAIN THYROID HORMONE’S EFFECTS METABOLIC RATE: INCREASED BMR CALOROGENIC: INCREASED HEAT PRODUCTION SYMPATHOMIMETIC: FLIGHT OR FIGHT CARDIOVASCULAR:INCREASES RESPONSIVENESS OF HEART GROWTH: ESSENTIAL FOR NORMAL GROWTH NERVOUS SYSTEM:DEVELOPMENT AND ADULT ACTIVITY ACTIONS OF EPINEPHRINE MIMICS SYMPATHETIC NS MOBILIZES STORED FAT AND CARBOHYDRATE HEART AND BLOOD VESSELS GENERAL ADAPTATION SYNDROME FLIGHT OR FIGHT EPINEPHRINE CRH-ACTH-CORTISOL RENIN-ANGIOTENSIN-ALDOSTERONE VASOPRESSIN COORDINATED BY HYPOTHALAMUS CAN BE INDUCED PSYCHOSOCIALLY FEEDING : INSULIN CEPHALIC PHASE: INSULIN FOOD IN SMALL INTESTINE: GIP - A SECRETAGOUGE FOR INSULIN INCREASED GLUCOSE AND AA IN BLOOD STIMULATE INSULIN SECRETION BLOOD INSULIN MAY SWING AS MUCH AS FROM 10 TO 50 MICROUNITS/ML MOVES ABSORBED SUGAR AND FAT TO STORES SEVERAL HOURS AFTER EATING ABSORPTION FROM S. I. COMPLETE INSULIN SECRETION RETURNS TO LOW BASAL RATES BEGIN TO DRAW UPON STORES OF FUEL BLOOD GLUCOSE RETURNS TO ABOUT 5 MMOL/L. GLUCAGON, GH, ADRENAL HORMONES ALSO SECRETED AT LOW BASAL RATES ABOUT 75% GLUCOSE CONSUMED BY BRAIN, BLOOD CELLS, OTHER TISSUES NOT DEPENDENT ON INSULIN, THE OTHER 25% BY MUSCLE AND ADIPOSE TISSUE. MAY BEGIN SOME GLUCONEOGENESIS IN LIVER FASTING AFTER 24 HOURS WITHOUT FOOD FASTING BEGINS INSULIN DECREASES FURTHER, GLUCAGON AND GH INCREASE, CORTISOL FOLLOWS ITS USUAL DIURNAL RHYTHM FATTY ACID MOBILIZATION IS SPED UP TURNOVER OF SUBSTRATES DURING FAST: FUEL RESERVES MUSCLE: PROTEIN 75 g ADIPOSE TISSUE : FA + GLYCEROL LIVER: GLYCOGEN 160 g + 16 g 180 g TURNOVER OF SUBSTRATES DURING FAST: CONSUMPTION NERVE 144 g RBC, WBC, ETC. 36 G HEART, KIDNEY, MUSCLE, ETC. 180 g PROLONGED FASTING (3 DAYS OR MORE) KETONE BODIES REACH 2 TO 3 MMOL/L BECOME SIGNIFICANT PART OF BRAIN’S FUEL ALONG WITH GLUCOSE INHIBIT PROTEIN BREAKDOWN IN MUSCLE URINARY NITROGEN EXCRETION DECREASES (ONLY ENOUGH GLUCONEOGENESIS FOR THE BRAIN) STARVATION URINARY NITROGEN AGAIN INCREASES ONCE FAT AND/OR TRIGLYCERIDE RESERVES ARE DEPLEATED FASTING BLOOD LEVELS SAMPLING TIME GLUCOSE Mg/dL POSTPRANDIAL INSULIN Mu/mL GLUCAGON pg/Ml CORTISOL ng/mL GH ng/mL T3 ng/mL 150 50 120 <1 1.2 POSTABSORPTIVE 90 15 100 120 2 1.15 DAY 1 80 10-12 120 120 2 1.15 DAY 2 70 8 150 110 6 0.70 DAY 3 70 7 150 110 10 0.60