Continuation of Lipids to Lipid Digestion (copy)

Chapter 1: Introduction

  • Discussion on protein metabolism and urea cycle

  • Urea cycle is the end product of protein metabolism

  • Urea cycle is also known as Krebs Hensulate Urea Cycle or Ornithine Cycle

  • Urea cycle involves two nitrogen atoms: ammonia and aspartic seeds

  • Urea cycle is closely linked to the citric acid cycle

Chapter 2: Urea Cycle Steps

  • Formation of carbamoyl phosphate from ammonia and carbon dioxide

  • Conversion of carbamoyl phosphate to citrulline

  • Conversion of citrulline to argininosuccinate

  • Conversion of argininosuccinate to arginine

  • Conversion of arginine to ornithine with the help of urea

Chapter 3: Hyperammonemia and Enzyme Deficiencies

  • Hyperammonemia is a condition characterized by high levels of ammonia in the blood

  • Different diseases associated with urea cycle enzyme deficiencies: pachyhyperammonemia type 1, hyperammonemia type 2, hyperornithinemia, citrullinemia, argininosuccinic aciduria, hyperarginemia

  • Each disease is associated with a specific enzyme deficiency and has characteristic features and inheritance patterns

Chapter 4: Treatment and Metabolic Defects

  • Treatment for argininosuccinate deficiency involves providing excess arginine in the diet and restricting total protein intake

  • Metabolic defects in amino acid metabolism, such as phenylketonuria (PKU), can result in mental retardation and other developmental abnormalities

  • PKU is caused by a deficiency of phenylalanine hydroxylase and is the most common clinical inborn error of amino acid metabolism

  • Newborn screening tests, including PKU screening, are done to prevent mental retardation

Chapter 1: Phenylketonuria (PKU)

  • Elevated levels of phenylketones in urine can be detected using ferric chloride test

  • Positive test indicated by transient blue-green color in urine

  • Early detection is important for treatment

  • Treatment involves a diet low in phenylalanine, such as tapioca cassava

  • After 5 years, patient can have a normal diet

Chapter 2: Maple Syrup Urine Disease (MSUD)

  • MSUD is a branched chain ketoaciduria

  • Symptoms include poor feeding, lack of energy, seizures, mental and physical retardation

  • Diagnosis is done using mass spectrometry

  • Treatment involves a restricted diet, frequent testing, and IV fluids

  • sugars are avoided in patients

Chapter 3: Albinism

  • Albinism is a group of conditions with a defect in tyrosine metabolism

  • Results in deficiency in production of melanin

  • Different types include oculocutaneous albinism, ocular albinism, Hermansky-Pudlak syndrome, Chediak-Higashi syndrome, and Griscelli syndrome

  • Symptoms include vision problems, sensitivity to light, impaired vision, and blindness

  • Diagnosis is done through genetic testing or family history

  • Treatment involves managing symptoms, such as wearing sunglasses and protective clothing

Chapter 4: Homocystinuria

  • Homocystinuria is a defect in homocysteine metabolism

  • Symptoms include intellectual disability, failure to grow, seizures, and megaloblastic anemia

  • Treatment involves vitamin B6 supplements and avoiding high protein foods

Chapter 5: Alkaptonuria

  • Alkaptonuria is a defect in phenylalanine and tyrosine degradation

  • Characterized by black urine

  • Diagnosis is done through ferric chloride and Benedict's tests

  • Other genetic disorders affecting amino acid catabolism are listed in a table

Chapter 6: Glycinuria

  • Glycinuria is a rare disorder characterized by high excretion of glycine in urine

  • Increased tendency for formation of oxalate renal stones

  • Urinary oxalate level is normal in patients with glycinuria

Chapter 1: Primary Hyperoxaluria and Tyrosinemia

  • Primary hyperoxaluria is a disorder characterized by increased urinary oxalate and deposition of oxalate in various tissues.

    • Urinary oxalate is endogenous in origin, not due to dietary consumption of oxalate.

    • Primary hyperoxaluria is caused by a defect in glycine transaminase and impairment in glyoxylate oxidation.

  • Tyrosinemia type 2, also known as Richter Hanhardt syndrome, is a defect in the enzyme tyrosine transaminase.

    • Results in blockade in the degradation pathway of tyrosine and accumulation of tyrosine and its metabolites.

    • Symptoms include dermatitis, eyelashes, mental retardation, and disturbed self-coordination.

  • Neonatal tyrosinemia is a temporary condition caused by the absence of the enzyme pyruvate dioxygenase.

    • Responds to ascorbic acid, which overcomes the substrate strict inhibition of the enzyme.

Chapter 2: Parkinson's Disease

  • Parkinson's disease is a common disorder characterized by muscular rigidity, tremors, expressionless face, lethargy, and involuntary movement.

  • Linked with decreased production of dopamine, a neurotransmitter associated with happiness.

  • Treatment includes dopa or levodopa, which helps increase dopamine levels.

Chapter 3: Hartnup's Disease

  • Hartnup's disease is a hereditary disorder of tryptophan metabolism.

  • Symptoms include dermatitis, ataxia, mental retardation, and low plasma levels of tryptophan.

  • Increased urinary output of indole acetic acid and indolepyruvic acid.

  • Impairment in absorption and transport of tryptophan and other neutral amino acids.

Chapter 4: Cystinuria

  • Cystinuria is a common inherited disease characterized by increased excretion of cysteine.

  • Defective carrier system leads to exclusion of cysteine and other amino acids in urine.

  • 1 in 7,000 people are affected by cystinuria.

Chapter 5: Amino Acid Metabolism Disorders

  • Table of inborn errors of amino acid metabolism includes phenylketonuria, tyrosinemia, cystinuria, cystinosis, homocystinuria, and more.

Chapter 6: Amino Acids as Neurotransmitters

  • Glycine is an inhibitory neurotransmitter in the spinal cord.

  • Dopamine and serotonin are neurotransmitters associated with happiness and regulation of cerebral activity and behavior.

  • Phenylalanine is involved in the synthesis of norepinephrine and epinephrine.

Chapter 7: Protein Sources and Allergies

  • Nuts are an excellent source of protein and consuming them regularly reduces the risk of heart attacks and heart diseases.

  • Other protein sources include meats, seafood, poultry, eggs, dairy products, soy, quinoa, and buckwheat.

  • Allergies to nuts and seafood can be managed by consuming alternative protein sources.

Chapter 8: Introduction to Lipids

  • Lipids are organic substances made of fatty acids and their derivatives.

  • They are insoluble in water and considered hydrophobic.

  • Lipids are important dietary constituents due to their high energy value, fat-soluble vitamins, and essential fatty acids.

  • They serve as a long-term energy source, thermal insulator, and component of cell membranes.

Chapter 9: Functions and Classification of Lipids

  • Triglycerides are a secondary energy source, thermal insulator, and protect tissues from physical trauma.

  • Cholesterol is a precursor of biological hormones, source of bile acids, and component of cell membranes.

  • Phospholipids are components of cell membranes and associated with vital life processes.

  • Lipids are classified into simple lipids, compound lipids, and derived lipids.

Chapter 10: Simple Lipids

  • Simple lipids include neutral fats (triglycerides) and waxes.

  • Neutral fats are composed of glycerol and fatty acids.

  • Waxes are esters of higher alcohols and have various functions.

Chapter 11: Fat-Soluble Vitamins

  • Fat-soluble vitamins include vitamin A, D, E, and K.

  • Vitamin A is responsible for vision and immune system function.

  • Sources of vitamin A include carrots, sweet potatoes, spinach, and cantaloupe.

  • Vitamin D has various functions and can be obtained from sunlight exposure and certain foods.

Bone Development, Immune System, and Moods

  • Fatty fish, beef liver, eggs, and mushrooms are rich in vitamins for bone development, immune system, and moods.

  • Sunflower seeds are a good source of vitamins for skin health, antioxidant properties, and fat digestion.

Vitamin K and its Sources

  • Vitamin K is essential for blood clotting, bone and tissue development.

  • Leafy greens, broccoli, Brussels sprouts, asparagus, and cauliflower are good sources of vitamin K.

Compound or Complex Lipids

  • Compound or complex lipids consist of glycerol, fatty acids, nitrogenous base, and phosphoric acid.

  • Phospholipids contain phosphate and phosphoric acid, with three types: gensilecithin, c cephaline, and liposetal.

  • Gensilecithin is also known as phosphatidylcholine, which contains choline as a nitrogenous base.

  • Cephaline is also known as phosphatidyl ethanolamine.

  • Lipositol is also known as inositol.

  • Phosphatidylserine contains serine as a nitrogenous base.

Types of Phospholipids

  • Plasma lecithin resembles leucine and cephalicine in structure.

  • Sphingomyelin contains sphingosine and choline as nitrogenous base.

  • Glycolipids are fatty acids that contain carbohydrates and nitrogenous base.

Derived Lipids

  • Derived lipids are the products of hydrolysis of simple and compound lipids.

  • They include saturated and unsaturated fatty acids, monoglycerides, glycerides, squalene, carotenoids, and vitamins D, E, and K.

  • Cholesterol is a major component of cell membranes and is involved in the synthesis of steroids, bile acids, and vitamins.

  • Intake of cholesterol should not exceed 300 milligrams per day.

  • LDL is the bad cholesterol, while HDL is the good cholesterol.

Good and Bad Fats

  • Monounsaturated and polyunsaturated fats are considered good fats.

  • Olive oil, nuts, oily fish, and avocado are examples of good fats.

  • Saturated and trans fats are considered bad fats.

  • Butter, cheese, creams, cakes, and fried foods are sources of bad fats.

Types of Fatty Acids

  • Saturated fats have all carbon atoms bonded to hydrogen atoms and raise blood cholesterol.

  • Unsaturated fats, such as monounsaturated and polyunsaturated fats, lower bad cholesterol.

  • Omega-3 and omega-6 fatty acids reduce the risk of heart diseases and lower LDL cholesterol.

  • Trans fats are unsaturated fats created through hydrogenation and increase bad cholesterol while lowering good cholesterol.

Sources of Trans Fats

  • Trans fats can be found in fast foods, packaged foods, baked goods, frozen foods, and chips.

Benefits of Reading Food Labels

  • Reading food labels helps in selecting foods low in trans fats and saturated fats.

  • Avoid products that contain hydrogenated, fractionally hydrogenated, or partially hydrogenated oils.

Esters and Fats

  • Esters are fatty acids combined with glycerol to form fats.

  • Simple glycerides have the same fatty acid chain, while mixed glycerides have different fatty acid chains.

  • Animal fats, butter fat, and human fat have different fatty acid compositions.

Chemical Properties of Lipids

  • Lipids have various chemical properties that contribute to their functions in the body.

Hydrogenation

  • Hydrogenation converts carbon double bonds to single bonds in unsaturated fats

  • Hydrogen gas is bubbled through heated oil in the presence of nickel

  • Oxidation of double bonds occurs in the presence of oxygen and microorganisms

  • Products of hydrogenation are short chain fatty acids and aldehydes with disagreeable odors

Saponification

  • Saponification is the hydrolysis of fats by an alkali to form soaps

  • Fats are hydrophobic and resist water, while soaps are hydrophilic and water-loving

  • Fats have a long chain hydrocarbon tail and a hydrophilic head

  • Saponification involves the formation of carboxylic acid group fatty acids

Digestion of Fats

  • Complete hydrolysis of fats occurs through the action of bile and lipases

  • Bile emulsifies and solubilizes fats for digestion

  • Incomplete digestion of fats can still occur with the help of lipases

  • Fatty acid esters are resistant to hydrolysis and can be absorbed and deposited in fat tissue

  • Unabsorbed fats or fatty acid esters are excreted in feces

Intestinal Absorption of Fats

  • 40% of ingested triglycerides are hydrolyzed to fatty acids and glycerol

  • 3 to 10% of triglycerides are absorbed as 3-glycerides

  • The rest are partially hydrolyzed to become beta monoglycerides

  • Glycerol is water-soluble and absorbed via the portal route

  • Fatty acids are water-insoluble and predominantly absorbed via the intestinal lymph

Lipid Metabolism

  • Lipolysis is the breakdown of lipids

  • Lipolysis will be discussed in the next meeting

  • Lipid metabolism will be the topic of the next discussion