00:01
Let's look at the fourth one.
00:02
Again, this picture
really helps me
because it's showing you
the effect of adipose tissue.
00:07
So the fourth factor
or the hormones and cytokines
that are produced by
adipose tissue,
I've got a really cool picture
of the skin there for you.
00:16
Look you've got the epidermis.
00:17
So I'm starting out this level.
00:19
You've got the epidermis.
00:21
Then the next layer
is the dermis,
and then you've got
the adipose tissue.
00:25
It's this kind of
loose connective tissue
composed of adipocytes,
that's what the individual cells
are called.
00:32
Now its main role is to store energy
in the form of fat,
but it also cushions
and insulates the body.
00:38
It's primarily located
beneath the skin,
but it's also found around
the internal organs.
00:43
And remember, we just talked about
fatty liver.
00:46
So the right amount
of adipose tissues
supposed to store energy
in the form of fat,
and it's going to
cushion and insulate the body
as appropriate.
00:54
When that gets out of balance
and out of whack
and a patient has
excess adipose tissue,
that's when the balance
gets all off.
01:02
Because this is
killer factor 4 of 4.
01:05
The adipocytes
of the adipose cells.
01:08
You end up with this tissue,
releasing these adipokines
like adiponectin and leptin.
01:13
Now stay with me.
01:14
I don't think you like,
"Good night, what is this?"
Well, I want you to have
a crystal clear understanding
of the damage that adipose tissue
can do in our bodies
when it's out of balance.
01:27
So we know this tissue
makes the adipokines.
01:30
Two examples of adipokines
are adiponectin and leptin.
01:36
So okay, now this is getting
real fancy here, right?
It's really not that bad.
Stick with me.
01:42
On the left, there's a picture
of obese adipocytes.
01:47
Now move to the right.
01:48
Three substances:
adipokines, chemokines,
and cytokines.
01:53
Still with me?
Okay, those are just categories.
01:56
So we're talking about
obese adipocytes.
02:00
We've got,
they put out
adipokines, chemokines,
and cytokines.
02:04
Now, there's a lot of names
right there.
02:07
There's a lot of names right there.
02:09
I'm not looking for you
to memorize those.
02:11
I'm going to walk you through
the key points.
02:13
Just add this to your notes.
02:15
So see under the adipokines,
we've got
leptin, adipoconectin,
resistin, apelin,visfatin.
02:19
Okay?
Again, not asking you
to rememorize those names.
02:25
What I want you to zero in on
is know that
these are all secreted
by adipose tissue.
02:30
Now they play a role
in glucose and fat metabolism.
02:34
Ding, ding, ding, ding, ding.
02:36
This is the important part.
02:37
Not that you memorize
all these names,
especially look at those
chemokines.
02:41
Those are some weird names
that will never stick in your mind
at this point in your career.
02:46
But I want you to know
these are secreted by
adipose tissue three types:
adipokines, chemokines,
and cytokines.
02:54
They play a role in
glucose and fat metabolism,
and they can cause
chronic inflammation.
03:01
Now you have our attention.
Right?
Because we know inflammation.
03:04
If it's used for healing,
that's a good thing.
03:06
But if it's chronic inflammation,
now we've got some real issues.
03:12
See, when this is out of whack,
see all the arrows extra leptin
extra, extra, extra,
extra, extra extra.
03:17
Now we've got a problem
because excess of these substances
leads to an increased risk
of type 2 diabetes.
03:25
We know that a lot of this
also leads to
increased insulin resistance,
which the next stop,
is risk of type 2 diabetes.
03:35
So what's the takeaway point?
Don't get frustrated,
you can totally do this.
03:39
We've got obese adipocytes,
they put out adipokines,
chemokines, and cytokines
you can do that,
you got it.
03:47
We know that these play a role
in glucose and fat metabolism,
and they cause
chronic inflammation.
03:54
Both of these challenges
are going to lead us to
an increased risk
of type 2 diabetes.
04:00
So this chronic inflammation
is a really serious concept
because we believe
to be a significant factor
in insulin resistance,
type 2 diabetes,
and cardiovascular disease.
04:12
Hey, why do you keep
bringing this up?
Because it matters.
04:16
We want to understand
how the impact of these adipocytes
are on the average body.
04:21
So we can help patients understand
the impact on their bodies.
04:25
So it's so important,
I'm asking you just,
will you write those three things
in your notes
by inflammation?
So next inflammation,
will you write
insulin resistance, type 2 diabetes,
and cardiovascular disease.
04:39
So the next time
someone asks you about
why it's a challenge
to be overweight?
Not that you're going to be
asked that.
04:45
But what the impact
is on your body
don't talk about body image
as much as,
"Hey, there's some real
chemical reactions
that happen in our body."
So every step that you make
towards health
is going to help resolve
some of these reactions
and the risks for inflammation,
for cardiovascular disease,
for type 2,
and insulin resistance.
05:07
See put a positive spin on it.
05:09
Don't make someone feel guilty for
not making the absolute
healthiest choices
or having extra weight,
help them see small steps
toward a healthier lifestyle
is going to make a
phenomenal difference
in their body
on a chemical level.
05:23
That's what you do.
05:25
because this
adiponectin and leptin,
let's talk, just a little
more about it, I promise.
05:29
I just want to hit
a couple more concepts home.
05:32
These are protein hormones.
They modulate metabolic processes.
05:37
So these two little fellers
right here that you see
at the bottom of your screen
are the two main adipokines
that affect insulin sensitivity.
05:45
So underneath these little fellers,
I want you to write in
insulin sensitivity
in your notes.