Integration of metabolism


Published on

Integration of Metabolism for nutrition science

  • thank you
    Are you sure you want to  Yes  No
    Your message goes here
  • Njce! Thanks for sharing.
    Are you sure you want to  Yes  No
    Your message goes here
  • This is real take it serious, who will believe that a herb can cure herpes, i navel believe that this will work i have spend a lot when getting drugs from the hospital to keep me healthy, what i was waiting for is death because i was broke, one day i hard about this great man who is well know of HIV and cancer cure, i decided to email him, unknowingly to me that this will be the end of the herpes in my body, he prepare the herb for me, and give me instruction on how to take it, at the end of the one month, he told me to go to the hospital for a check up, and i went, surprisingly after the test the doctor confirm me negative, i thought it was a joke, i went to other hospital was also negative, then i took my friend who was also herpes positive to the Dr Agumagu, after the treatment she was also confirm negative . He also have the herb to cure cancer. please i want every one with this virus to be free, that is why am dropping his email address, or do email him he is a great man. the government is also interested in this DR, thank you for saving my life, and I promise I will always testify for your good his number +233200116937..
    Are you sure you want to  Yes  No
    Your message goes here
  • thanks
    Are you sure you want to  Yes  No
    Your message goes here
  • very good work i like so nice and very good to read
    thanks precise work
    Are you sure you want to  Yes  No
    Your message goes here
No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Integration of metabolism

  1. 1. Integration of Metabolism By: Mohammed S. El-Lulu Master of Clinical Nutrition Palestine - GAZA 1
  2. 2. Macronutrients Organic compounds that yield Energy Classified as : - Carbohydrates (limited capacity for store) - Fats/Lipids (Unlimited capacity for store) - Proteins (used for building and No capacity for store) 2
  3. 3. Major Metabolic Pathways 1. Glycolysis 2. Gluconeogenesis 3. Glycogen Metabolism 4. Fatty Acid Metabolism 5. Citric Acid Cycle 6. Oxidative Phosphorylation 7. Amino Acid Metabolism Only the liver can carry out all of the reaction the major pathways. 3
  4. 4. The key junction points The key junction points are:-1- Glucose- 6- phosphate,2- Pyruvate and3- Acetyl CoA. 4
  5. 5. Position of metabolic pathways 5
  6. 6. Metabolic Fate of Glucose Glucose: The intracellular form of glucose is glucose-6- phosphate. Only liver cells have the enzyme glucose-6-phosphatase that dephosphorylates G-6-P and releases glucose into the blood for use by other tissues G-6-P can be oxidized for energy in the form of ATP and NADH G-6-P can be converted to acetyl CoA and then fat. Excess G-6-P is stored away as glycogen. G-6-P can be shunted into the pentose phosphate pathway to generate NADPH and ribose-5-phosphate. 6
  7. 7. Metabolic Fate of Fatty Acids Fatty acids are oxidized to acetyl CoA for energy production in the form of NADH. Fatty acids can be converted to ketone bodies. KB can be used as fuel in extrahepatic tissues. Fatty acids are used for the biosynthesis of bioactive molecules such as arachidonic acid and eicosanoids. Cholesterol, steroids and steroid hormones are all derived from fatty acids. Excess fatty acids are stored away as triglycerides in adipose tissue. 7
  8. 8. Metabolic Fate of Amino Acids Amino acids are used for the synthesis of enzymes, transporters and other physiologically significant proteins. Amino acid N is required for synthesis of the cell’s genetic information (synthesis of nitrogenous bases). Several biologically active molecules such as neurotransmitters. Amino acids are precursors of several hormones (peptide hormones like insulin and glucagon and Amine hormones such as catecholamines). Aminoacids can be catabolized to acetyl CoA, pyruvate or intermediates of the TCA cycle for complete oxidation. 8
  9. 9. Central Themes of Metabolic Pathways Acetyl CoA is a common intermediate of all metabolic pathways. It interconnects glucose, fatty acid and amino acid metabolism. Oxidation of dietary fuel leads to the capture of energy in the form of ATP and NADH / FADH2. NADH / FADH2 transfer their electrons to O2 via the electron transport chain. The energy released is used to synthesize ATP. Biosynthetic and degradative pathways are distinct and coordinately regulated. 9
  10. 10. Endocrine Regulation of Metabolism Metabolic processes are tightly regulated by the concerted actions of hormones. Hormones regulate enzyme primarily by covalent phosphorylation The three main endocrine signals that regulate metabolism are epinephrine, glucagon and insulin. Epinephrine is responsible for the mobilization of glucose (glycogenolysis) and an inhibition of enzyme activities of fuel storage pathways. 10
  11. 11. Endocrine Regulation of Metabolism. Cont. Glucagon also increases breakdown of glycogen, but in addition, it promotes gluconeogenesis in the liver. Insulin opposes the functions of both glucagon and epinephrine. It stimulates the uptake of glucose from the blood, stimulates glycogen and FA biosynthesis and inhibits FA oxidation 11
  12. 12. Glycolysis Glycolysis oxidizes one molecule of glucose to 2 molecules of pyruvate. NAD+ is generated. Under anaerobic conditions, pyruvate is reduced to lactate for the regeneration of NAD+. Phosphofructokinase is the key regulatory enzyme. It catalyzes the committed step of glycolysis: conversion of F-6-P to F-1,6-BP. It is activated by F-2,6-BP and inhibited by citrate. 12
  13. 13. 13
  14. 14. The First Stage of GlycolysisGlucose (6C) is broken down into 2 PGALs(Phosphoglyceraldehyde – 3Carbon molecules)This requires two ATPs 14
  15. 15. The Second Stage of Glycolysis2 PGALs (3C) are converted to 2 pyruvatesThis creates 4 ATPs and 2 NADHsThe net ATP production of Glycolysis is 2 ATPs 15
  16. 16. Gluconeogenesis This pathway is most active in the liver. Glucose is synthesized from non-carbohydrate presursors such as lactate, pyruvate, oxaloacetate, glycerol and amino acids. Glycolysis and gluconeogenesis are reciprocally regulated. When one is highly active the other is minimally active. The key regulatory enzyme is fructose-1,6- bisphosphatase. This enzyme is activated by citrate and inactivated by F-2,6-BP. 16
  17. 17. The TCA cycle and Oxidative phosphorylation These are common pathways for the oxidation of carbohydrates, fats and amino acids. There is a tight coupling of the TCA cycle to the ETC. The electrons captured in NADH / FADH2 via the TCA cycle are immediately transported along the ETC for reduction of O2 to H2O and synthesis of ATP. Since the availability of O2 depends on respiration, the activity of the TCA cycle depends on the rate of respiration. Two key regulatory enzymes of the TCA cycle are isocitrate dehydrogenase and α-ketoglutarate dehydrogenase. Major allosteric inhibitors are ATP and NADH. 17
  18. 18. Results of Kreb’s cycle6 NADHs are generated (3 per Acetyl CoA that enters)2 FADH2 is generated (1 per Acetyl CoA that enters)2 ATP are generated (1 per Acetyl CoA that enters)4 CO2s are released (2 per Acetyl CoA that enters) Net Result: (8 NADH, 2 FADH2, 2 ATP, 6 CO2) 18
  19. 19. 19
  20. 20. Electron Transport Phosphorylation Goal: to break down NADH and FADH2, pumping H+ into the outer compartment of the mitochondria In this reaction, the ETS creates a gradient which is used to produce ATP, quite like in the chloroplast Electron Transport Phosphorylation typically produces 32 ATPs ATP is generated as H+ moves down its concentration gradient through a special enzyme called ATP synthase 20
  21. 21. 21
  22. 22. Fatty acid β-oxidation Fatty acids are oxidized to acetyl CoA in the mitochondria The fatty acids have to be activated to acyl CoA and then transported to the mitochondria prior to oxidation Tranportation requires that the acyl group be transferred from CoA to carnitine by the enzyme carnitine acyltransferase I. The transport of acyl CoA to the mitochondria is the committed step (and key regulatory step) of FA oxidation Carnitine acyltransferase I is inhibited by malonyl CoA, a committed intermediate of the FA biosynthesis pathway. 22
  23. 23. Fatty acid biosynthesis fatty acids are synthesized in the cytosol from acetyl CoA as feed back inhibition of krebs cycle due to increased percent of ATP/ADP. Malonyl CoA is an activated intermediate; its formation is the committed step in FA biosynthesis. It is catalyzed by acetyl CoA carboxylase The transport of acetyl CoA to the cytosol is facilitated by the citrate shuttle. Both the citrate shuttle and acetyl CoA carboxylase are inhibited by palmitoyl CoA, the end product of FA biosynthesis. 23
  24. 24. Cholesterolbiosynthesis1- Hydroxy Methyl Glutaryl-CoAIs formed from 3 Acetyl CoA.2- The step of HMG-CoA reductaseIs committed step in cholesterol formation.3- HMG CoA & Mevalonate is the precursorFor Cholesterol while HMG CoA forKetone bodies.4- cholesterol is important for cellMembrane synthesis and formationOf bile salts. 24
  25. 25. Metabolic Profiles: Brain The brain accounts for 20 % of the energy requirements of the body, mostly to maintain membrane potential required for transmission of nerve impulses. Normally, glucose is the sole preferred fuel of the brain. The brain’s consumption of glucose and oxygen are constant regardless of resting/ sleeping or active/ waking state. 25
  26. 26. Metabolic Profiles: Brain The brain cannot store glycogen, it must receive a constant supply of glucose through the blood. Brain cells have a glucose transporter, GLUT3, with a low Km for glucose. In the event of starvation or disease, the brain cells adapt quickly and utilize ketone bodies that are made in the liver. 26
  27. 27. Skeletal Muscle Skeletal muscle metabolism is different from that of brain in three main ways:1- Muscle fuel needs are dependent on activity level.2- Muscle can store glycogen. If glucose is not available, glycogen stores are hydrolyzed by the active muscle. Muscle cells lack the enzyme glucose-6-phosphatase, thus, muscle glycogen cannot supply glucose to the circulation and other tissues.3- Muscle can use both glucose and fatty acids and occasionally even amino acids as fuel. 27
  28. 28. Skeletal Muscle Cont. The resting muscle prefers fatty acids as fuel. The active muscle undergoing rapid contraction prefers glucose. During high activity, anaerobic respiration ensues and glucose metabolism produces high levels of lactate which is transported to the liver (Cori cycle). During high activity, a large amount of alanine is formed by transamination of pyruvate. This is also sent to the liver (alanine) for disposal of N as urea. 28
  29. 29. Cardiac Muscle Heart metabolism is different from skeletal muscle in 3 ways.1- Heart muscle can function only under aerobic conditions. Heart muscle cells are rich in mitochondria facilitating aerobic respiration.2- Heart muscle is not able to store glycogen. 29
  30. 30. Cardiac Muscle Fatty acids are the preferred fuel of the heart. Glucose is the least favored fuel.3- Ketone bodies and lactate are used under stress when the energy demand is high. 30
  31. 31. Kidney The major task of the kidney is excretion. Water-soluble metabolic waste products are excreted in the urine. Excess water is removed and the osmolarity of body fluids is maintained. The final composition of urine is determined after several cycles of filtration and reabsorbtion to avoid loss of useful biomolecules. 31
  32. 32. Kidney The energy required by the kidneys for this function is supplied by glucose and fatty acids. The kidneys are a minor site of gluconeogenesis (liver is the major site). During starvation, the kidneys can contribute significant amounts of blood glucose 32
  33. 33. Liver The liver supplies metabolites and fuel molecules to all peripheral organs. The liver cannot efficiently use glucose or ketone bodies as fuel. It prefers fatty acids and α-keto acids as a source of energy for its activities. After absorption by the intestine, dietary fuel’s first destination is the liver. The liver is able to gauge fuel availability and adjust its metabolism to regulate the level of various metabolites in the blood. 33
  34. 34. Liver Hepatic lipid metabolism:When fatty acids are in excess, they are exported to the adipose tissue for storage as TG. TG are transported as VLDL particles assembled from newly synthesized or dietary fatty acids. In the fasting state, liver converts fatty acids into ketone bodies. 34
  35. 35. Liver 35
  36. 36. Carbohydrate metabolism in liver The liver removes 2/3 of glucose from the circulation. This is phosphorylated to G-6-P by glucokinase and meets different metabolic fates. Very little is oxidized for supplying energy to the liver. The liver converts excess G-6-P to acetyl CoA for the synthesis of fatty acids, cholesterol and bile salts. The liver has an active pentose phosphate shunt. This supplies NADPH for reductive biosynthesis. 36
  37. 37. Carbohydrate metabolism in liver When glucose levels are low, liver stores of glycogen can be shared with other organs because of the presence of the enzyme glucose-6-phosphatase. The liver is responsible for gluconeogenesis. The substrates for gluconeogenesis are lactate and alanine from the muscle, glycerol from adipose tissue and glucogenic aa from the diet. 37
  38. 38. Amino acid metabolism in liver The liver absorbs most of the dietary amino acids from the blood. Amino acid are preferentially diverted to protein synthesis rather than catabolism. This is possible because the Km for aminoacyl tRNA synthetase is lower than that for catabolic enzymes. AA catabolism takes place when the anobolic pathways are saturated. 38
  39. 39. Amino acid metabolism in liver Liver is the only organ capable of sequestering N as urea for disposal. The α-keto acids derived from aa enter the gluconeogenesis pathway. They serve as a primary source of energy for the liver. 39
  40. 40. Oxidative de-amination in liver 40
  41. 41. Urea Cycle 41
  42. 42. Tissue-Specific Metabolism during the Fed-Fast Cycle Stages of fed-fast cycle – Fed state - lasts 3 hours after meal ingestion – Postabsorptive/early fasting state - 3 to 12-18 hours after meal – Fasting state - 18 hours to 2 days after meal when nothing else eaten – Starvation/long-term fast - fully adapted to deprivation (weeks) 42
  43. 43. Carbohydrate & Lipid Metabolism The fed state – Glucose  glycogen & fatty acids – Glucose used by nervous tissues, RBCs, adipose & muscle tissues The postabsorptive or early fasting state – Glycogenolysis – Gluconeogenesis 43
  44. 44. Carbohydrate & Lipid Metabolism The fasting state – Amino acids (primarily), glycerol, lactate used for gluconeogenesis – Ketone formation The starvation state – Fatty acids used to greater extent – Glycerol major glucose source – Ketosis after oxaloacetate depletion 44
  45. 45. Amino Acid Metabolism Fed state - used for proteins or degraded Fasting – Catabolism for energy produces quantities of N Excreted in urea – Gluconeogensis in liver & kidneys 45
  46. 46. System Integration & Homeostasis Major regulatory systems – Nervous system – Endocrine system – Vascular system Endocrine function in fed state – CCK, gastrin, secretin – Insulin 46
  47. 47. System Integration & Homeostasis Endocrine function in postabsorptive or fasting state – Glucagon – Epinephrine & norepinephrine – Low levels of insulin 47
  48. 48. Energy Sources during Exercise The ATP-CP (phosphagen) system – Muscles use high-energy creatine phosphate with ATP The lactic acid system – Anaerobic glycolysis The aerobic system – TCA cycle 48
  49. 49. Energy Sources during Exercise Fuel sources during exercise – Muscle glycogen – Plasma glucose – Plasma fatty acids – Intramuscular triacylglycerols 49
  50. 50. Energy Sources during Exercise Exercise intensity & duration – Low intensity - plasma fatty acids – Moderate intensity - increased fatty acid oxidation (due to muscle TG) – High intensity - CHO oxidation & lactate production increase 50
  51. 51. Energy Sources during Exercise Level of exercise training – Training increases muscle glycogen & TG stores Initial muscle glycogen levels 51
  52. 52. Metabolism during Diabetes Type I or Insulin-dependent diabetes (IDDM): These individuals suffer from an inability to synthesize insulin because of autoimmune destruction of β-cells of pancreas. Glucose entry into cells is impaired due to lack of insulin. 52
  53. 53. Metabolism during Diabetes Type II or Non-insulin depedent diabetes (NIDDM): This is due to a developed resistance to insulin. The cells are unable to respond to insulin and glucose entry into cells is impaired. In both forms of diabetes, cells are starved of glucose. The levels of glucogon are high and metabolic activity is similar to that in starvation. 53
  54. 54. Metabolic Patterns in Diabetes Diabetic subjects are constantly relying on protein and fat for fuel. Proteins are degraded for gluconeogenesis. Glycolysis is inhibited and gluconeogenesis is stimulated. This exaggerates hyperglycemia; glucose (and water) are removed in urine. The diabetic subject suffer from acute hunger and thirst. 54
  55. 55. Metabolic Patterns in Diabetes A lack of insulin action leads to mobilization of fat from adipose tissue, β- oxidation and formation of ketone bodies. In general metabolism shift from carbohydrate usage to fat usage. Excessive buildup of ketone bodies leads to lowering of the pH. When the kidneys can’t keep up with acid-base homeostasis, ketoacidosis can be fatal. 55
  56. 56. Obesity In most cases obesity is a direct result of overeating and a sedentary life-style. Biochemically, appetite and caloric expenditure are controlled by a complex process involving the brain and adipose tissue. Leptin is a protein synthesized by the adipose tissue; it is called as the satiety factor. Leptin’s target organ is the hypothalamus. This is the part of the brain that controls food intake. 56
  57. 57. Obesity Leptin secretion is directly related to adipose mass. In the presence of leptin, the hypothalamus tells the body to stop food intake. In other words, there is satiety or a loss of appetite. When adipose stores are being depleted leptin synthesis declines and appetite returns. Genetic obesity may be due to impairment of leptin action. The defect may be in the leptin protein itself, or its signaling pathway 57
  58. 58. Transport of oxygen in the blood  Hb + 4O2 Hb.4O2 58
  59. 59. Fat Soluble Vitamins Stored in liver and adipose tissue Body can’t remove until they are used Toxicity: take years to appear but very harmful Is important for Growth and development They are: A, D, E, K 59
  60. 60. Water Soluble Vitamins Is not Harmful with excess dose. Will be removed by urine. Composed of B-Vitamins and Vit-C. Important for metabolic pathways. B1 (thiamin) precursor for thiamin pyrophosphate B2 (falvin) precursor for FAD B3 (niacin) precursor for NAD B5 (Pantothenate) precursor for Co-A B7 (Biotin) All of them are Co-Enzymes for processing of Macronutrients. 60
  61. 61. Thank you for paying attention 61