Case Study:

Scene 1:
Kenshin Mochi Tumaba, a 21 y/o, male medical student, is a diagnosed case of Metabolic
syndrome (increased blood glucose levels and dyslipidemia (increased TAGs and LDL-C,
decreased HDL) BP=140/90 and BMI=30 came for consult at your clinic. He admits to unlimited
food ingestion (pizza, buffalo wings, baby back ribs, potato wedges, ice cream & fruit juice) with
very limited physical exercise. Family history: positive for DM type 2 diabetes.

1.Describe the effects of insulin on acetyl CoA carboxylase and HMGR, as to feedback inhibition,
allosteric stimulation and inhibition, covalent modification and transcriptional regulation.

Scene 2:
What happens to these enzymes (ACC and HMGR) if he decides to go on intermittent fasting
and restricted calorie diet?

Scene 3:
What would happen to his lipid profile and blood sugar if he indulges in alcohol ingestion?

Scene 4.
What would be the effect of lifestyle modification (non-pharmacologic and pharmacologic
intervention) on Kenshin Mochi’s lipid profile?