Diseases Related To Cholesterol

 

Diseases Related To Cholesterol

 

Familial hypercholesterolemia

There are hereditary disorders of cholesterol metabolism (familial hypercholesterolemia), which lead to very high blood cholesterol levels regardless of food intake. In one of the known hypercholesterolemia forms, the LDL receptors are only incompletely developed or completely absent. techbizcenter

 

Heterozygous carriers of these hereditary factors are more often affected than average by heart attacks and other vascular diseases at a young age. According to a study from 1991, this no longer applies to older people. Here, the mortality drops significantly and is only 44% compared to the standard.

The most common monogenetic hypercholesterolemia, the so-called autosomal dominant familial hypercholesterolemia, is about 1: 500. However, there seems to have been significant variability in the frequency of symptoms in those affected over the past 200 years, suggesting an interaction between a changing environment (e.g., diet, lifestyle) and genotype. For more severe forms of hypercholesterolemia (such as familial hypercholesterolemia), drug therapies with statins, LDL apheresis, and sometimes surgical forms of treatment are used. technologywebdesign

 

Gallstones

Cholesterol is captivated by the body with the bile acid in the intestine. Cholesterol is blended and involved in the small intestine. The solubility of cholesterol in total bile is 0.26%. When the composition of the bile changes, cholesterol stones form. 80% of gallstones are high in cholesterol, and 50% are pure cholesterol stones. The formation of gallstones occurs not only in the gallbladder but also in the liver. marketingmediaweb

 

Other forms of the disease

Less known diseases are, for example, the cholesterol storage disease ( xanthomatosis or Hand-Schüller-Christian syndrome ), in which cholesterol is pathologically stored in the skin, among other things. answerhop

 

Smith-Lemli-Opitz syndrome (SLO) occurs with a frequency of approx. 1: 60,000 in Europe. The disease with SLO syndrome is a defect in the last enzyme in the cholesterol biosynthetic pathway, 7-dehydrocholesterol reductase. The clinical picture is characterized by mental retardation, growth problems, developmental disorders, and facial changes.

 

Furthermore, hypocholesterolemia is known in which the cholesterol level is below 130 mg/dl in the blood. This occurs primarily in liver damage such as cirrhosis of the liver, the genetic Tangier disease, and manganese deficiency. Among other things, vitamin E can no longer be transported to its respective destination. tipsfromcomputertechs

Cholesterol and coronary artery disease (CHD)

Cardiovascular diseases, especially coronary artery disease ( CHD ), replaced infectious diseases as the most common cause of death in the western industrialized nations as the standard of living rose in the 20th century. In the 1950s, the American nutritionist Ancel Keys' hypothesis received a lot of attention that this development was also favored by the fact that increasing prosperity was accompanied by a diet that was too fatty. In particular, lead a high cholesterol diet (primarily meat, chicken eggs, milk, butter, and other dairy products). The ingestion of food containing cholesterol is one of the many causes of a heart attack. Key himself relativized the importance of diet-related cholesterol intake for the cholesterol level in human blood as early as 1965: "To control the serum level, dietary cholesterol should not be completely ignored, but observing this factor alone is of little use."

 

Meaning of the hypothesis

The hypothesis that a high-cholesterol diet and a high blood cholesterol level played a causal role in the development of heart attacks has become widespread in the scientific environment and the public eye over the past decades. Today it is an essential element in preventing heart attacks in medical practice. In the USA in particular, but also in Europe, it led to the spread of artificially reduced or cholesterol-free foods ( e.g., margarine ) and the routine prescription of drugs to lower cholesterol levels.

 

Cholesterol-lowering drugs are now the pharmaceutical market segment with the highest sales worldwide. In 2004, cholesterol-lowering drugs achieved 27 billion US dollars worldwide, with a growth rate of 10.9%. The drug with the highest sales is atorvastatin (Lipitor ®, Sortis ® ) from the US manufacturer Pfizer, which achieved worldwide sales of 12.2 billion US dollars in 2005.  However, this drug no longer plays an essential role in the German market since health insurances introduced a fixed price regulation for statins.

 

Around 25 million people around the world regularly take cholesterol-lowering preparations.

 

Empirically obtained evidence

Ø  The cholesterol hypothesis is based exclusively on empirically obtained evidence. However, no biological mechanism has been demonstrated which leads to plaque formation via cholesterol or an increased cholesterol level.

 

Ø  In animal experiments, the administration of food (milk, egg yolk) with high cholesterol in rabbits and other predominantly vegetarian animals leads to arteriosclerosis development. This observation was first published in 1908 by the Russian scientist Alexander Ignatowski. However, these results' transferability to humans is controversial since their natural regulating mechanism for cholesterol level almost completely compensates for the intake of cholesterol through food. Therefore, similar studies were later carried out on pigs, which showed a 70% homology of humans and monkeys, with results identical to those of rabbits. In some of the monkey species investigated (such as pigs, mostly omnivores with a predominantly vegetarian diet), substantial individual differences were also found within a species. In some individuals, the cholesterol level can be influenced by diet ("hyper responders"); in others, not (" hypo-responders ").

Ø  Cholesterol is an integral part of arteriosclerotic plaques. This was proven in 1910 by the German chemist and later Nobel Prize winner Adolf Windaus. digitalmarketingtrick

Ø  Ancel Keys published sensational comparative studies of six (1953 ) and seven countries (1966, 1970, and 1980  ), in which he found a cross-national correlation between the CHD rate (coronary artery disease) and the Percentage of animal fats in the diet showed. Mostly in JapanThere was a low CHD rate with a low proportion of animal fats in the diet; in the USA, the opposite was found. Later, however, he was accused of having deliberately only presented those of the country data sets published at the time that seem to support the correlation he postulated. Other studies examining the CHD rate of immigrant Japanese in the United States found an alignment of the lower Japanese rate with the US CHD rate. This could speak for diet-related factors, but could also be explained by other factors related to lifestyle. Critics also question the comparability of the causes of death published by different countries, which was assumed in both cases,

Ø  In earlier men up to 45, a high total or LDL cholesterol level is associated with an increased incidence of coronary heart disease. It represents a different risk factor and the other known risk factors. This means that this correlation is not alone can be explained by the correlation of the cholesterol level with other general CHD risk factors. Further known risk factors are age, gender, positive family history (i.e., the occurrence of a heart attack in close relatives), smoking, diabetes mellitus, high blood pressure, obesity, and sedentary lifestyle. Contrary to popular belief, however, high cholesterol levels are not a risk factor for coronary heart disease for both younger and older women and older men.

Ø  Due to a hereditary genetic defect, patients with familial hypercholesterolemia have a very high cholesterol level (often 400 mg/dl and more). At a young age, the risk of CHD is many times higher than that of the average population. These patients' life expectancy could be increased by giving various lipid-lowering drugs. However, the CHD risk in these patients normalizes from around 55 years of age.

Ø  Numerous studies have demonstrated that taking drugs to lower cholesterol, especially in high-risk male CAD patients, can decrease the risk of myocardial infarction. However, this has generally been offset by an increase in other death causes. In the past few years, the statins drug group was also able to demonstrate, for the first time, a slight life-prolonging benefit of taking a cholesterol-lowering preparation in individual studies. However, this was only shown in some of the studies conducted exclusively in middle-aged male high-risk CHD patients.

Ø  People with a specific variant in the gene for the low-density lipoprotein receptor ( LDL receptor ) have lower blood cholesterol levels for life. The risk of heart attack is reduced by 23% in these people. However, the LDL receptor binds LDL and several other proteins, so that the connection has not yet been established through this fact.

Ø  A higher total cholesterol level correlates with women's higher life expectancy compared to men.  The average life expectancy for men in Germany in 1995/97 was 73.6 years, for women 80 years.

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Average Total Cholesterol In Blood

 

Average Total Cholesterol In Blood

The average total cholesterol level and the LDL and HDL levels of the healthy average population differ from country to country and are also age and gender-dependent. There is a positive correlation between blood cholesterol values ​​and the body mass index.

Total cholesterol

In general, the total cholesterol level increases significantly with age. As a rule, it is somewhat lower in young women than in young men. However, with age, this difference is evened out, and older women end up having, on average, higher cholesterol levels than older men. Pregnancy is a particular case in which the total cholesterol level usually is significantly increased.

 

The average total cholesterol level in the age group between 35 and 65 in Germany is around 236 mg/dl (corresponds to 6.1 mmol / l), the standard deviation is ± 46 mg/dl. This roughly means that about two-thirds of the German population in this age group have a total cholesterol value between 190 mg/dl and 282 mg/dl, and one-sixth of the Germans in this age group have values ​​above or below this range. In some parts of China, the average cholesterol level is 94 mg/dl with typical values ​​between 70 mg/dl and 170 mg/dl. The lower cholesterol levels correlate with a lower likelihood of heart disease and cancer.

 

LDL cholesterol levels

The LDL cholesterol level is subject to similar age and gender-dependent distribution. Here, too, the age-related increase is much more pronounced for women than men. The mean value for the age group between 35 and 65 years is 164 mg / dl (standard deviation ± 44 mg / dl) for German women and 168 mg / dl (± 43 mg / dl) for men.

HDL cholesterol levels

The average HDL level differs more between the sexes, with middle-aged women having higher HDL levels than men. The age dependency shows itself in both sexes decreased from the age of about 55 years. The average HDL level in German women in the age group between 35 and 65 is 45 mg/dl (± 12 mg/dl); in men, it is 37 mg/dl (± 11 mg/dl). tockhop

 

Quotient

Based on the parameters above, quotients are occasionally determined from these values. The mean value of the LDL and HDL levels is 3.9 (± 1.6) for German women between 35 and 65 years, and 4.9 (± 1.9) for men. The corresponding average values ​​for the total cholesterol and the HDL level are 5.7 (± 2.1) for women and 7.0 (± 2.3) for men.popbom

Measurement and laboratory reference values

 

The resolve of the concentration of cholesterol in the blood in routine medical laboratories is one of Germany's required methods. A round-robin test is the external quality control of laboratory parameters, checked and certified by the German Medical Association. Every medical laboratory in Germany must adhere to the "guidelines of the German Medical Association" (RiLiBÄK). The reference range(often misleadingly referred to as "normal value") depends on the measuring device and the method. The reference ranges have been revised several times upwards in recent years. To rule out any falsification of the results, the determination is often not carried out until 12 to 16 hours after the last meal.

 

Only total cholesterol was determined in the laboratory for a long time since the direct measurement of the various lipoproteins was not possible or very complex. That has now changed. The LDL cholesterol is not determined directly, but from the directly measured values ​​for total cholesterol, triglycerides and HDL, according to Friedewald et al., estimated as total cholesterol minus HDL cholesterol minus one-fifth of the triglyceride value (all data in mg/dl). This method cannot be used for triglyceride levels above 400 mg / dL or in the presence of chylomicronemia. Various correction factors have been proposed to increase this estimation's precision, but they have not yet entered clinical practice. The LDL cholesterol level's reference range is given for women and men between 70 and 180 mg/dl.

 

For the reliable determination of the cholesterol, after adequate sample preparation, the coupling of gas chromatography and HPLC with mass spectrometry can be used.

 

Units and conversion

In West Germany, the unit "mg/dl" ( milligrams per deciliter ) is often used to indicate cholesterol concentration in the blood. In East Germany, on the other hand, as in the Anglo-Saxon-speaking area, the unit "mmol / l" (millimole per liter, compare milli and mole ) is predominantly used. For cholesterol (but not for triglycerides or other substances), the following relationship between these units of measurement applies:

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1 mg / dl = 0.02586 mmol / l

1 mmol / l = 38.67 mg / dl

Ø  Example:

 

236 mg / dl = 236 x 0.02586 mmol / l = 6.10 mmol / l

6.10 mmol / l = 6.10 x 38.67 mg / dl = 236 mg / dl

·        The following conversion formulas apply to triglycerides:

 

1 mg / dl = 0.0113 mmol / l

1 mmol / l = 88.57 mg / dl

Cholesterol classification

 

Cholesterol  classification

Cholesterol is polycyclic alcohol. Traditionally it is counted as a steroid belonging to the sterols' group (sterols) to the lipids. However, contrary to popular confusion, it is not fat. The steroids belong to the group of isoprenoids, which, unlike the fats, are not esters of fatty acids and alcohol but can have hydrophilic poles as diverse patterns in their basic hydrophobic structure.  Globalmarketingbusiness

 

Like many substances, cholesterol is sensitive to oxidants. Autoxidation processes can lead to many reaction products. To date, more than eighty such substances are known, which often have considerable physiological effects. The oxidation products are isolated and purified by chromatographic methods. Your secure identification takes place at z. B. by spectroscopic or spectrometric techniques such as mass spectrometry. A comprehensive description of these cholesterol oxidation products is given in Leland L. Smith's work: Cholesterol Autoxidation. Nanobiztech

Physiology

Cholesterol is a zoosterol that is essential for humans and animals. In humans, cholesterol is mostly (90%) produced ( synthesized ) in the body, in adults in an amount of 1 to 2 g per day, and only a small part of it can be ingested with food. The cholesterol absorption is on average 0.1 to 0.3 g per day and maybe at most 0.5 g to be increased per day. Techcrunchblog

 

All animals synthesize cholesterol. Starting from "activated acetic acid," acetyl-CoA, isopentenyl diphosphate is produced in four steps via mevalonic acid. Another three reaction steps lead to squalene. After the ring closure to lanosterol, around a dozen enzymatic reactions follow, running in parallel until cholesterol is finally formed. This last section is not known in full, but the enzymes involved have been identified. Divinebeautytips

 

Cholesterol is excreted in the liver by being secreted into the intestines in the form of bile acids via the biliary tract (around 500 mg per day). Bile acids are necessary to absorb water-insoluble food components, including cholesterol. Cholesterol is emulsified by bile acids and interested in the small intestine. Since around 90% of the bile acids are reabsorbed, cholesterol's excretion is correspondingly ineffective. Through drugs like colestyramine, which binds bile acids and makes their re-absorption more difficult, cholesterol excretion can be increased. However, the lowering of the cholesterol level is compensated for by an increase in the density of LDL receptors on liver cells and the increased absorption of cholesterol from the blood into the liver, partly also by increased new synthesis.

 

Biosynthesis

The biosynthesis of cholesterol, which was elucidated in particular by Konrad Bloch's work, Feodor Lynen, George Joseph Popják, and John W. Cornforth, starts the end products of the mevalonate biosynthetic pathway, from dimethylallyl pyrophosphate and isopentenyl pyrophosphate, and requires 13 further reactions. In humans, the liver and the intestinal lining are the main cholesterol synthesis sites.

 

Regulation

The balance between required, self-produced, and cholesterol ingested through food is maintained through various mechanisms. The inhibition of HMG-CoA reductase, the most critical enzyme in cholesterol biosynthesis, by cholesterol (HMG-CoA reductase is even more strongly inhibited by lanosterol, a precursor of cholesterol) can be considered necessary. This metabolic pathway (cholesterol synthesis) inhibits "their" enzyme; this is a typical example of negative feedback. Also, HMG-CoA reductase's half-life is significantly shortened when the lanosterol level is increased. It then increasingly binds to the proteins Insig-1 and Insig-2binds, leading to their breakdown in the proteasome.  There are many other, less direct regulatory mechanisms that operate at the transcriptional level. The proteins SCAP, Insig-1, and Insig-2, are essential here. In the presence of cholesterol, for which they have a binding site, they regulate the activity of a large number of genes via the proteolytic activation of SREBPs. Also, insulin plays a role here, as it u. A. increases the transcription of SREBP1c. Marketingmediaweb

 

HMG-CoA reductase, the key enzyme in cholesterol biosynthesis, can be precisely and effectively inhibited by various substances (for example, statins, which, as HMG-CoA reductase inhibitors, represent a particular class of drugs). Uptake into the cell is activated via the LDL receptor.

 

The cholesterol level depends primarily on the body's production and only secondarily on food intake. There are also a large number of genetic hypercholesterolemia. The cholesterol level can also be increased due to other diseases (for example, due to hypothyroidism, renal insufficiency, or metabolic syndrome ).

 

 

Cholesterol

 

Cholesterol

The cholesterol, also more accurate cholesterol ( Greek χολή cholé, Galle ' and στερεός stereos, reliable, rigid, hardened' ), is an occurring in all animal cells crystalline, fat-like natural substance. The name, coined in 1824 by the chemist Michael Eugène Chevreul, is derived from the fact that cholesterol was found in gallstones as early as the 18th century was found. Aside from bile, the liver's cholesterol is also abundant in the brain, nerves, and blood. Cholesterol plays a role in the steadying of cell membranes and nerve occupation, is essential for the production of sex hormones and other processes.

 

Cholesterol was also found in small amounts in plant cells ( potato tops, pollen, isolated chloroplasts ) and bacteria. A particularly cholesterol vegetable oils were corn oil (55 mg per kg), rapeseed oil (53 mg per kg), and cottonseed oil (45 mg per kg) identified. Typical sources of cholesterol of animal origin contain many times this level.  For example, butter has a cholesterol content of 2340 mg per kg.

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Function

Cholesterol is a vital sterol and an essential part of the cell membrane. It raises the membrane's stability and, together with proteins, helps smuggle signal substances into and out of the cell membrane. The human body covers about 140 g of cholesterol; over 95% of the cholesterol is within the cells and cell membranes. To source the cells with cholesterol, which is lipophilic (fat-soluble) and hydrophobic (water-repellent when wetted), it is used to transport it via the blood lipoproteins bound. These can be of different densities and are divided into chylomicrons, VLDL, IDL, LDL, HDL, and lipoprotein according to their behavior during centrifugation or electrophoresis.

 

 

The numbering of carbon atoms and the designation of the rings in the steroid structure is also the basis for cholesterol.

In the body, cholesterol serves, among other things, as a precursor for steroid hormones and bile acids. The cholesterol side chain separating enzyme converts cholesterol to pregnenolone for the formation of hormones. This is the starting compound from which the body builds the sex hormones testosterone, estradiol and progesterone, and adrenal hormones ( corticoids ) such as cortisol and aldosterone. Bile acids such as cholic acid and glycolic acid are also based on the starting substance cholesterol.

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An intermediate product of cholesterol biosynthesis, 7-dehydrocholesterol, is the provitamin for vitamin D formation through UV light.

 

New research also shows that the body uses cholesterol for cardiac glycosides' biosynthesis. The significance of these endogenously synthesized glycosides is still mostly unknown.

 

Based on sediment finds with chemical cholesterol relatives ( sterols ), some researchers assume that the cholesterol molecule, if it never appeared otherwise than in living matter, must be ancient in evolutionary history.  However, the biosynthesis of the molecule can only function since oxygen has been present in the atmosphere. For this reason, hardly any cholesterol is found in bacteria and the membranes of mitochondria; Plants and mushrooms also contain no cholesterol but other, structurally similar sterols.

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Uses Of Fats

 

Uses Of Fats

The use of fats and fatty oils (the latter are usually colloquially referred to as oils for short) as food and food preparation and preservation is widespread. Significant quantities of vegetable oils (rapeseed oil, palm oil) have recently been chemically converted into biodiesel. For this purpose, the oils are subjected to transesterification with methanol in the presence of acidic heterogeneous catalysts. The produces fatty acid methyl esters (FAME) and glycerine. Fatty acid methyl esters are sold directly as biodiesel, but much larger quantities are already mixed with conventional diesel fuel in the mineral oil industry's refineries. The legislator has issued regulations for this. An admixture of up to 5% by volume of fatty acid methyl ester is permitted without labeling the fuel and is also widely practiced. The fatty acid methyl ester must meet specific, well-defined quality parameters in the standard DIN defined EN 14,214th

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The direct combustion of melted fats and oils in truck diesel engines is ordinary. However, the vehicles must be specially converted beforehand.

 

By saponification (ester splitting with alkali hydroxides), soaps, the alkali salts of fatty acids, are made from fats or fatty oils. This also produces glycerine.

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Analytics

The fat content of foods is usually determined by extraction with lipophilic solvents. The FDA defines fat as the saponifiable portion of food. This means that non-triacylglycerides, such as sterols or phosphatides, do not fall under the FDA's definition of fat.

 

For fat characterization, titration- analytical indicators such as iodine number, Reichert-Meißl number, saponification number, peroxide number, or acid number are determined. For the qualitative and quantitative determination of individual fat components, chromatographic methods are preferred. The fatty acid distribution can be determined using gas chromatography. Accompanying fat substances such as zoo or phytosterols or lipophilic vitamins are also determined by gas chromatography or HPLCcertainly.  For the reliable identification of the fats' components, mass spectrometry is mostly used in combination with gas chromatography or HPLC.  The German Society for Fat Science has already defined more than 400 analytical methods, including methods for identifying virgin olive oil's authenticity or determining degradation products in used deep-fryer fats.

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Fat accompanying substances

The accompanying fat substances include:

 

·        Phosphatides

·        Sphingolipids

·        Lipochromes

·        Waxes

·        cholesterol

·        Fat spoilage

Fats are perishable; they can change chemically, primarily through light, higher temperatures, atmospheric oxygen, water, and microbes. As a rule, the double bonds or the ester bonds are affected when spoilage occurs, making them rancid and possibly harmful to health.  It is advantageous to protect fats by storing them in a cool, dry place inaccessible to air.

 

Fresh fats usually contain few free, unesterified acids. Fats saponify over time due to moisture and exposure to light and microorganisms. You get pissed off and rancid. An indication for this is the acid number SZ (or neutralization number NZ), which indicates how many milligrams of potassium hydroxide is required to neutralize the free acids contained in one gram of fat.

 

Related topics

Oil paints

 

In art history, oils play a critical role as binders. Mixed with color pigments, these oil colors were crucial for the development of painting (see also: Oil painting ). Vegetable fats are also used as a varnish (protective coating after picture).

 

Fat in art

 

Fatwas a material used more frequently by the artist Joseph Beuys to symbolize the energy stored within an art object or a room installation. The most famous items are the fat corner and the fat stool.

 

Grease trap

 

Typically, fat separators are used in butcher shops, slaughterhouses, deep-frying, and large kitchens. They are always used when fats and oils of organic origin are retained from the wastewater. The dirty water is led into the grease separator via an integrated baffle plate, which leads to a reduction in the flow speed and uniform flow distribution. The separation of the separable light-matter (fat) and suspended matter (sludge) from dirty water is achieved solely by the effect of gravity. A coalescence separator can also separate more finely divided oils and fats.

 

Fatty acid composition of nearly fats and oils

 

Fatty acid composition of nearly fats and oils

Fatty acids are chemically bound in triglycerides in almost all natural (vegetable and animal) oils and fats. Contrary to popular belief, natural fats and oils do not contain any free (chemically unbound) fatty acids but glycerol esters of the fatty acids.

physiology

Fats and oils are essential human nutrients. Among other things, they are needed in the human body as

·        Energy supplier (so-called reserve material ),

·        Insulators against cold,

·        Solvent for only fat-soluble substances such as some vitamins,

·        Protective padding for internal organs and the nervous system,

·        Part of the cell membrane.

Fats as energy stores

Besides carbohydrates ( sugar, starch, and glycogen ), fats are the most important energy stores in cells. The physiological calorific value of 37 kJ / g fat is more than twice as high as that of carbohydrates and proteins (17 kJ / g). [1]

 

The depot fat as an energy store in the human body comes from the fat contained in food or other macronutrients (carbohydrates, proteins), which can ultimately be converted into fat over several intermediate stages of energy. It is controversial to what extent the conversion of the macronutrient fat, carbohydrates and proteins directly contribute to adipose tissue formation. Such a connection is established, especially from the point of view of calorie theory. Other mammals can easily make depot fats from an excess of energy in their food.

 

The density of human adipose tissue is 0.94 kg / l, the physiological calorific value (energy content) is around 29,000  kJ / kg (7,000 kcal / kg). The difference to 37,000 kJ / kg of fat results from the fact that the fatty tissue does not consist of pure fat. In the blood of people who Gesamttriglyceride is determined and are, as such, in addition to the blood fats' cholesterol level. The normal level of triglycerides in the blood is 70 to 170 mg/dl.

 

According to the German Nutrition Society (DGE), a fat intake of 60 to 80 g per day is sufficient for an adult, which corresponds to 25 percent of the energy consumed from food. There may well be small excesses, provided that the fat intake is balanced out in the following days. Women should consume a maximum of approx. 420 g and men approx. 560 g of fat per week. This calculation is based on an assumed energy requirement of approx. 10 to 13.4 MJ per day (= 2,400 to 3,200 kcal / d). For example, this would correspond to a 40-year-old office worker with bodyweight between 80 kg and 107 kg who does not participate in regular sports. Only determining the actual resting metabolic rate and the individual physical activity allows an exact determination of needs. Concomitant diseases must also be taken into account.

 

Trans fatty acids can stress the body and lead to vascular damage.

 

Biosynthesis of fats

The triacylglycerols are built up from the components glycerol and fatty acids in several reaction steps.

 

First, the fatty acid is activated using one of several fatty acid CoA ligases and glycerol using one of the glycerol kinases. The end products acyl-CoA and glycerine-3-phosphate react to form lysophosphatidic acid, catalyzed by the enzyme glycerine phosphate O- acyltransferase. Another fatty acid molecule is transferred by the acylglycerol-3-phosphate- O- acyltransferase, resulting in phosphatidic acid. One of the phosphatidate phosphatases splits off phosphate, whereby diacylglycerol remains. Finally, the diacylglycerol- O- acyltransferase transfers a third fatty acid molecule to the triacylglycerol. [8th]

 

Breakdown of fats

In fat cells, triacylglycerols are surrounded by a shell made from the protein complex Perilipin: CGI-58, which, depending on the degree of phosphorylation, prevents the breakdown of fats through hydrolysis. The enzyme hormone-sensitive lipase (HSL) is responsible for starting the analysis and is subject to both positive ( catecholamines, ACTH, glucagon ) and negative regulation ( insulin ).

 

The triacylglycerols are broken down into twelve steps: after phosphorylation of the HSL and its dimerization, the protein layer around the lipids is broken up with catecholamines or glucagon, perilipin separates from CGI-58 and is phosphorylated by protein kinase A and later recycled with protein phosphatase 1. HSL gets close to the lipids; their hydrolysis activity is enhanced by complexation with FAB4. This is how cholesterol esters are made fatty acids and cholesterol and from triacylglycerol glycerol and three fatty acid molecules. Dephosphorylation of HSL terminates the process; the phosphatase's identity that catalyzes this reaction is unknown. The course of the entire metabolic

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Fats

 

Fats

Fats and fatty oils ( neutral fats ) are esters of the trihydric alcohol glycerine (propane-1,2,3-triol) with three, mostly different, predominantly even, and unbranched aliphatic monocarboxylic acids, the fatty acids. Compounds of this type are also called triglycerides, but the IUPAC recommends triacylglyceride as a name.

 

Whether a fat is solid or liquid at room temperature, it is called fat or a fatty oil. Best-known fats are the eponymous mixtures of different fatty acid triglycerides obtained from animals; the expression of fatty oil is adjacent to the liquid (thin) fats from other groups of oils from (general nonspecific diverse groups of liquid organic compounds).

 

As natural substances, fats are assigned to lipids and soluble in lipophilic organic solvents such as petroleum ether and benzene. With an energy density of 37  kJ / g (9 kcal / g), fats are the most critical energy stores for humans, animals, and some plants. In plants, fats are mainly found in seeds or germs, in animal organisms in adipose tissue. Fats and fatty oils are used as food ( edible fats and oils).

Etymology

The word fat is a noun of the originally Nieder. Adjective end. Vet ( Robert . : feist ), which in turn is the 2nd participle of the im Nhd. she submerged verb MHD. veiȥen “make fat.” It is based on an extension of the Indo-European. Root PE [i] - "are full, fat be".

Extraction

Fats are obtained from animal products or plants ( useful plants ) and sometimes in the chemical industry. Animal fats are either melted directly from fatty tissue ( lard, oil, sebum ) or obtained from milk ( butter ). The vegetal oils and fats used for food are obtained from oil plants or oilseeds by pressing or extraction with steam or solvents. Refining and thus removal of unwanted ingredients makes the fats usable for humans. Margarine was original of animal origin but is nowadays obtained by hydrogenation ( fat hardening ) of the C = C double bond (s) in the fatty acid residues of vegetable oils (sunflower oil, rapeseed oil). Trans fatty acids can also be formed, which is undesirable.

 

In 2006 53 companies in Germany were involved in fat extraction and refining. With 3,445 employees, a total turnover of 131 million euros was achieved. The refining of fats is an essential industry with 82.7 million euros.

 

In 2007, 2.4 million tons of rapeseed oil, 685,300 tons of soybean oil, 47,700 tons of sunflower oil, and 1,961 tons of linseed oil were produced in Germany. The main refined products in 2007 were rapeseed oil (1.55 million tons), sunflower oil (195,000 tons), soybean oil (510,600 tons), and palm oil (504,000 tons). Most of the products are planned for export. The production of margarine (2007: 430,000 tons) and butter (2007: 1.35 million tons) is also essential.

 tockhop

Classification of diabetes mellitus

 

Classification of diabetes mellitus

In 1965, the WHO published a distinction between different types of diabetes in its "Recommendations for Classification and Diagnostics."

 

In 1997 the American Diabetes Society (ADA) changed the criteria for classification and diagnosis adopted by the WHO in 1998 and the German Diabetes Society (DDG) in 2000. The model no longer differentiated between insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM). This classification only relates to the treatment and not its cause. Since 2009, the definition no longer distinguishes between subgroups a and b. The ranking of diabetes types from A to H was also abandoned.

 KEYWORD

Classification until 1997

Up to this date, diabetes mellitus was divided into four groups according to the type of treatment, the fifth indicating that the disease is absent:

 

·        NIR : (non-insulin-requiring) treatment without external insulin supply, e.g., B. only with diet and oral antidiabetic drugs.

·        IRC : (insulin-requiring for control) In addition to the body's insulin, external insulin is also required to lower elevated blood sugar levels.

·        IRS : (insulin-requiring for survival) External insulin supply is required for survival. According to the new classification, type 1 diabetes and order two diabetes significantly reduced or discontinued own insulin production.

·        IGT : (impaired glucose tolerance) impaired glucose tolerance.

·        ND : (nondiabetic) Not suffering from diabetes.

Types of diabetes since 1998

As of that date, all organizations have divided the disease into four types based on its cause:

 

Diabetes mellitus type 1: T-cell- mediated autoimmune disease with destruction especially of the beta cells of the islets of Langerhans in the pancreas; this usually leads to an absolute insulin deficiency

Diabetes mellitus type 2: different combinations of insulin resistance, hyperinsulinism, relative insulin deficiency, secretion disorders

·        Type 2a: without obesity (obesity)

·        Type 2b: with obesity

Other specific types of diabetes

Ø  A: genetic defects in the beta cells of the islets of Langerhans (impaired insulin secretion)

Ø  B: rare genetic defects in the action of insulin

Ø  C: Diseased or destroyed pancreas

Ø  D: diabetes due to hormonal disorders (endocrinopathies)

Ø  E: diabetes from drugs or chemicals (drugs, poisons)

Ø  Q: Diabetes mellitus due to infections

Ø  G: unusual forms of immune-mediated diabetes

Ø  H: other genetic syndromes associated with diabetes

·        Gestational diabetes (gestational diabetes)

Diabetes types according to the guidelines of the DDG 2009

Based on the report of the WHO commission from 1999, classification is made according to the guidelines of the DDG 2009 [8] using the following criteria:

 

·        Type 1 diabetes mellitus: Destruction of the beta cells in Langerhans' islets in the pancreas leads to an absolute insulin deficiency.

·        Type 2 diabetes mellitus: Can range from (genetically determined) insulin resistance with a relative insulin deficiency to an absolute insulin deficiency in the later course of the disease. It is often associated with other metabolic syndrome problems.

·        Other specific types of diabetes

·        Exocrine pancreatic disorders (e.g., pancreatitis, cystic fibrosis, hemochromatosis )

·        Endocrinopathies (e.g., Cushing's syndrome, acromegaly, pheochromocytoma )

·        Drug-chemically induced (e.g., glucocorticoids, neuroleptics, alpha interferon, pentamidine )

·        Genetic defects in β-cell function (e.g., MODY forms)

·        Genetic defects in the action of insulin

·        Other genetic syndromes that may be associated with diabetes

·        Rare forms of autoimmune-mediated diabetes.

·        Gestational diabetes: Glucose tolerance disorder appeared or was first diagnosed during pregnancy. This includes:

·        The initial manifestation of type 1 diabetes

·        The first manifestation of type 2 diabetes

·        The initial onset of other specific types of diabetes

·        Preconceptionally manifest but undiagnosed diabetes mellitus (type 2), especially in glucose tolerance disorders, as early as the 1st trimester.

This classification was confirmed in 2011 as part of an update of the guidelines by the DDG. [8th]

 

More terms

·        Adolescent diabetes (English: juvenile diabetes mellitus ) or "juvenile diabetes mellitus" is the outdated term for type 1 diabetes.

·        Age diabetes (English: Adult-Onset Diabetes mellitus ) or "adult diabetes" used to be called type 2 diabetes. Both terms are still widely used but do not correspond to state of the art and are therefore no longer included in the current classifications.

·        LADA: LADA ( latent autoimmune diabetes with onset in adults ) also belongs to type 1 diabetes mellitus. This form affects autoimmune diabetes, which develops in later adulthood, which no longer reacts to oral medication and requires insulin after a relatively short time. The detection of the GAD (= glutamate decarboxylase ) antibody is typical.

·        MODY: MODY ( maturity-onset diabetes of the young ) corresponds to the course of type 2 diabetes, but without the occurrence of obesity and insulin resistance; it already occurs in children and adolescents.

·        IDDM: Abbreviation for insulin-dependent diabetes mellitus. Traditional but still widespread classification according to the type of therapy required.

·        NIDDM: Abbreviation for noninsulin-dependent diabetes mellitus. Traditional but still widespread classification according to the type of therapy required.

Diabetes

 

Diabetes

Compared to the over-all population, people with diabetes mellitus have a higher risk of developing cardiovascular diseases. Heart attacks are more common and less favorable in diabetics than in people without diabetes. In many cases, the additional diabetic damage to the autonomic nervous system can lead to disturbances in the conduction of pain and to cardiac arrhythmias. In type 2 diabetes in particular, in addition to increased blood sugar levels, there are often disorders that have a negative effect on blood vessels. Increased blood pressure ( hypertension ) and dyslipidemia also damage the vessel walls and cause constrictions ( stenoses) and blockages ( thromboses ) of the arteries. Dyslipidemia can also occur in type 1 diabetes mellitus.

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The diabetes mellitus (honey-sweet flow ', Honigharnruhr'; from ancient Greek διαβήτης diabetes [to διαβαίνειν diabainein , pass' , flow through '] and Latin mellitus , honeyed' ), commonly known as just diabetes , German diabetes (formerly Zuckerharnruhr ) computersmarketing or, more rarely, blood sugar disease , describes a group of metabolic disorders of the carbohydrate metabolism, which are based on an (absolute or relative) lack of insulin hollyhealthfitness and become chronic Cause hypoglycaemia . The hallmarks webtechgalaxy of this complex disorder include hyperglycemia , glucosuria , acidosis, and ketosis .

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The word  describes their main symptom , the excessive healthbeautystudio  excretion of sugar with the urine . Thomas Willis diagnosed the disease in 1675, as did doctors of antiquity in India, Alexandria and Rome, on the basis of a taste test of the urine, because the urine of people with diabetes has a sweet taste when the blood sugar level is elevated .

 

Mechanisms that lead to excess sugar in the blood (hyperglycemia), set mainly on insulin, the main control hormone of glucose metabolism in the human body, to: absolute insulin deficiency, relative insulin deficiency due to a weakened effectiveness of insulin ( insulin resistance ) or both. The main consequences of diabetes mellitus are changes in the nervous system and the blood vessel system, including diabetic foot syndrome .

Physiological foundations

The digestive system breaks down the carbohydrates ingested with food (from fruits, grain products, potatoes, corn, rice) into glucose (grape sugar), which is then captivated into the blood through the intestinal wall and spread throughout the physique.

 

The pancreas products the hormone insulin in the β cells of the islets of Langerhans . As a messenger substance , insulin brings about the transport of glucose into the cell interior, where the glucose is then used to generate energy ( glycolysis ). In addition, insulin also causes the storage of glucose in the form of glycogen in the liver and in the muscle cells, which means that the blood sugar level after eating is within narrow limits (approx. 80–120 mg / dl or 4.5–6.7 mmol / l ) is kept constant.

 

Even with long periods of sobriety, the blood sugar level remains at a normal level, which in turn is mainly provided by the liver , on the one hand by the fact that the previously formed glycogen is split back into glucose and released back into the blood, on the other hand by the fact that the liver is biochemical constantly produces new glucose ( gluconeogenesis ).

 

If the insulin-producing β-cells no longer produce enough or no insulin at all or e.g. B. due to inflammation or surgery are no longer available, so both the glucose uptake in the body cells and the inhibition of glucose formation in the liver (which can produce up to 500 grams of glucose daily in humans) are missing. This new formation explains the rise in blood sugar levels in diabetics. B. in the early morning in the sober state (see also dawn phenomenon ).

In diabetes mellitus, the glucose ingested remains in the blood, or the body's own formation of new glucose in the liver continues unchecked and constantly supplies glucose, which offsets or even exceeds the continuous consumption and, as a result, causes the blood sugar to rise. It is a very complex and dynamic organic process in which inflows, outflows, new formation and degradation of glucose have to be constantly balanced, i.e. offset. In order to understand these relationships - and thus the disease and how to deal with the disease - affected patients must be carefully informed and advised and, if necessary, trained, for example in drawing up suitable nutrition plans.

 

Insulin also has another, third effect. It is the only hormone in the human body that builds up body fat and also ensures that this fat remains in the depots (so-called adipogenic effect).

 

An essential characteristic of the severe, persistent insulin deficiency is therefore also an extreme weight loss due to the loss of the adipogenic effect, in particular through the breakdown of body fat and (muscle) protein for energy production.

 

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general health

 The position of interdental cleaning for oral fitness, fashionable fitness, and great of lifestyles

Recent studies suggests oral health is essential for humans’s well-being and high-quality of life. To reap the worldwide dreams for oral fitness, the dental career has a splendid duty to paintings with a preventive and fitness-promoting approach. lifebloombeauty

According to the World Dental Federation (FDI), the definition of oral health is “multifaceted and consists of the ability to talk, smile, scent, flavor, contact, chew, swallow, and produce a selection of feelings via facial expressions with self assurance and without ache, pain, and ailment of the craniofacial complex.”1 With this definition in thoughts, oral fitness is an plain part of stylish fitness and nicely-being. futuretechexpert

The massive results of oral ailment 

Periodontal sickness is common worldwide. It affects about 50% of the individual population, and excessive periodontitis occurrence varies from 10% to fifteen%. Prevalence figures are undoubtedly associated with increasing age.2-four Given the large results of the disorder, it becomes clean that it want to be a rely of world concern.  naturalbeautytrends

First, there is developing scientific assist for a link among periodontal disease and numerous widespread illnesses—e.G., cardiovascular sickness, diabetes, and weight troubles. Thus, oral diseases aren't taken into consideration neighborhood problems affecting simply the oral cavity, however, rather, systemic ailments with outcomes for average fitness.Five 

Research has additionally shown a considerable association among periodontal disorder and oral health-related incredible of life—independent of things which consist of age, gender, and one-of-a-kind dental problems.6 The ailment can make a contribution to tension, low vanity, and feelings of disgrace and vulnerability.7  smarttechpros

Oral diseases even have a extremely good impact from a economic perspective. In 2015, on a worldwide foundation, the general price became shown to be $544.41 billion, wherein direct fees (measured as dental expenses expenses) accounted for $356.Eighty billion and oblique expenses (measured as productivity losses) for $187.Sixty one billion. Among oral diseases, periodontitis modified into the second biggest motive for international productivity prices.8 Severe periodontitis money owed for $fifty four billion each year because of oblique costs. techsmartinfo

Causes and prevention

Dental specialists have a essential function in preventing illness through a health-selling approach primarily based totally on technology and set up medical enjoy. Evaluating individual desires and situations and weighing them together with clinical guide should form the idea for affected person instructions and recommendations, consequently growing the pleasant feasible foundation for affected man or woman compliance and lengthy-lasting oral fitness.

There are several chance elements for the development of periodontitis. Most crucial is the buildup of a plaque biofilm along and beneath the gingival margin. Control and removal of this biofilm are of intense importance to maintain oral fitness. The significance of top oral hygiene in order to prevent oral sickness is, consequently, indisputable.

Toothbrushing and interdental cleansing are cornerstones to achieve exquisite oral hygiene. Interdental cleansing is associated with lower tiers of periodontal ailment, and periodontal health increases as the usage of interdental cleansing devices turns into greater frequent.10 The recommendation of an interdental cleaning tool wishes to be tailored mainly for every affected individual, but an interdental brush is desired for most people of the individual populace.

A meta-examine concluded that there can be steady proof for interdental brushes being the handiest devices for interdental plaque elimination.11 This is also said within the document from the eleventh European Workshop in Periodontology at the primary prevention of periodontitis.2 According to the walking organization, interdental brushes are the desired preference for interdental cleansing, at the identical time as floss is an possibility best at the same time as web websites are too slender for the interdental brush and show gingival and periodontal fitness. These results had been confirmed in a network meta-assessment in which interdental brushes displayed the great result regarding gingival irritation, plaque cut price, and pocket discount.12

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