Clinical Importance of Relevant Lipids

in Human System
Dr.J.Vigneshwaran
Dept. of General Medicine
 Definitions
 What’s the medical meaning of Fat?
 Triglyceride
 What’s a Triglyceride made of ?
 Glycerol + 3 Fatty acids

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Definitions
 What’s a Saturated Fat & Unsaturated Fat?
 Are they also Triglycerides ?

Naturally occurring fatty acids

have even Carbon atoms
 Why do You need TGL?

What’s the major source of TGL?

• Fat
• Carbohydrate
• Protein

From Carbohydrate – Glycolysis –

Pyruvate – Acetyl CoA

Acetyl Co A – fatty acid Synthase Complex

Definitions
 In Energy surplus state
 Triglyceride thus formed is stored in Adipose tissue
 In Energy Deficient stage
 Triglycerides are acted on by Lipase and Free Fatty acids are released
 Free Fatty acids undergo Beta Oxidation and lot of ATP is produced
 Free Fatty acids can be converted also to Glucose
 Types of Lipids Cholesterol
• Lipoproteins
Fatty Acids • Steroid Hormones
• Triglycerides Signaling
• Glycerol + Fatty acids Fat Soluble Vitamins
• 3 Carbon structure + 3 Fatty acids

• Saturated Fats
• Unsaturated Fats
• MUFA
• PUFA Phospholipids & Glycolipids
• Eicosanoids • 3 Carbon structure + 2 fatty acid chain
• Prostaglandins + 1 phosphate
• Thromboxane • Amphipathic – (Hydrophobic &
• Leukotrienes Hydrophilic )
• Cell membrane

• Sphingomyelin - nerves
Insulin Resistance
 Abdominal Obesity leads to increased fat in Abdominal
Viscera
 Liver more fat
 Skeletal muscle also has increased fat

 Fat accumulation leads to inflammatory response

 This leads to Insulin Resistance

Problems because of Insulin Resistance
 Type 2 DM

 Dyslipidemia and Atherosclerosis

 Coronary Artery Disease
 Stroke
 Peripheral Artery Disease

 Fatty Liver and Cirrhosis

 PCOS
 Menstrual irregularity, anovulatory cycles – Infertility, features of
androgen excess – acne, Hirsutism, frontal balding
Metabolic Syndrome
Thank You
LIPIDS OF CLINICAL
IMPORTANCE
DR. VINU , DEPARTMENT OF GENERAL MEDICINE
 Lipids are efficient source of energy and important
storage forms of energy.

 They form the important constituent of membranes.

 Membran
e lipids

Phospholi Glycolipi
pid ds
PHOSPHOLIPID
Phosphatidyl
choline
Diphosphatidyl
glycerol
Phospholipid (cardiolipin)
Phosphatidyl
ethanolamine
Phosphatidyl
serine

Sphingomyelin
Phosphatidyl choline
 Synthesized from choline.

 Major component of pulmonary surfactant.

 Pulmonary surfactant thus greatly reduces surface

tension, increasing compliance allowing the lung to
inflate much more easily, thereby reducing the
work of breathing.
RESPITATORY DISTRESS
SYNDROME
Phosphatidyl ethanolamine @ Cephalin

 Synthesized from ethanolamine.

 Found in biological membranes- inner cytoplasmic

layer.

 Thromboplastin which is needed for the clotting

process is composed of mainly cephalin.
PHOSPHATIDYL SERINE
Diphosphatidyl glycerol (cardiolipin)

 Important constituent of mitochondrial membranes.

Sphingomyelin
 Important constituent of myelin sheath.

 Myelin surrounds nerve cell axons to insulate

them and increase the rate at which information
(encoded as electrical impulses) is passed along the
axon.

 The discontinuous structure of the myelin sheath

results in saltatory conduction whereby the action
potential "jumps" from one node of Ranvier to
another.
GLYCOLIPIDS
 Glycolipids are components of cellular membranes.
 Glycolipids are found on the outer leaflet of cellular
membranes where it plays not only a structural role to
maintain membrane stability but also facilitates cell-cell
communication.

 Cerebroside = ceramide + sugar

(galactose)
 Ganglioside = ceramide+ sugar +
NANA
CEREBROSIDE
 They occur in myelin sheath of nerves
and white matter of brain tissues and
cellular membrane.
 They are important for nerve
conduction.
GANGLIOSIDE
 They are composed of ceramide and NANA.
 They are present in the cell membranes of RBC,
ganglionic cells and grey matter of brain.
 As components of membrane – modulate signal
transduction events.
 They also act as cell membrane receptors.
 They can be receptors of proteins, viruses and
bacteria (GM1 is a receptor of Cholera toxin).
Lipids( continued)
Dr V.S. Gaurav Narayan
Lipoproteins
• Lipids are not water soluble
• Combined with apolipoprotein for transport
• 7 different types
Uses of lipoproteins
• Transportation of lipids to tissues

• HDL has additional anti oxidant, anti-inflammatory

properties
Clinical significance
• LDL, VLDL, IDL, chylomicrons are atherogenic,
leading to cardiovascular disease

• HDL causes reverse cholesterol transport,

cardioprotective effect

• Statins act against HMG Coa reductase activity

Steroid hormones
• These are hormones synthesized from cholesterol

• There are 2 types- corticosteroids and sex steroids

• Corticosteriods are produced in the adrenal glands

along with adrenal androgens( DHEA)

• Other sex steroids are secreted from the gonads

Androgens in women
• Normal muscle mass
• Bone mass
• Libido
• Mood balance
Prostaglandins
• Important cytokines involved in various body
functions
• Produced by the metabolism of arachidonic acid
• PGE2 causes vasodilation and plays an important
role in uterine contraction

• PGI2 protects the gastric mucosa. Also maintains

the ductus arteriosus

• PGI2 analogues also used for treatment of

pulmonary hypertension
Thank you!