Endocrine Disorders

Harliansyah,Ph.D
Dept Biochemistry, FK-UY
Abnormalities of endocrine glands generally
fall into one of the several categories;
1. Hypersecretion
- Excess activity of a specific hormone
- May be due to overproduction of a hormone due to abnormal
glandular function, glandular hypertrophy/ hyperplasia or the
presence of tumors that secrete hormone.

2. Hyposecretion
- Reduced activity of a specific hormone
- May be due to atrophy of glandular tissue or damage from
autoimmune attack, infection or neeoplasia.
3. Altered responsiveness of a tissue to a specific hormone

-. Tissue no longer responds to a specific hormone
-. May involve down regulation of receptors or altered receptor/
secondary messenger function
-. Circulating levels of hormone may be normal or even elevated
( Type II DM)
Metabolic syndrome
The metabolic syndrome is identified by the
presence of three or more of these components:
Central obesity as measured by waist circumference:
Men Greater than 40 inches (102 cm)
Women Greater than 35 inches (88 cm)
Fasting blood triglycerides greater than or equal to 1.7
mmol/L
Blood HDL cholesterol:
Men Less than 1.03 mmol/L
Women Less than 1.2 mmol/L
Blood pressure greater than or equal to 130/85 mmHg
Fasting glucose greater than or equal to 6.1 mmol/L

The Metabolic Syndrome:
Significance
Body Size
BMI
Central Adiposity
Glucose
Metabolism
Uric Acid
Metabolism
Dyslipidemia Hemodynamic
Novel Risk
Factors
CORONARY HEART DISEASE
Insulin Resistance
Hyperinsulinemia
+
TG
PP lipemia
HDL-C

Small, dense LDL
Glucose
intolerance
Uric acid
Urinary uric
acid clearance
SNS activity
Na retention
Hypertension
CRP
PAI-1
Fibrinogen
There are three types of hormonal control pathways
Pathway Example
Stimulus
Low blood
glucose
Receptor
protein
Pancreas
secretes
glucagon ( )
Endocrine
cell
Blood
vessel
Liver
Target
effectors
Response
Pathway Example
Stimulus Suckling
Sensory
neuron
Hypothalamus/
posterior pituitary
Neurosecretory
cell
Blood
vessel
Posterior pituitary
secretes oxytocin
( )
Target
effectors
Smooth muscle
in breast
Response Milk release
Pathway Example
Stimulus
Hypothalamic
neurohormone
released in
response to
neural and
hormonal
signals
Sensory
neuron
Hypothalamus
secretes prolactin-
releasing
hormone ( )
Neurosecretory
cell
Blood
vessel
Anterior
pituitary
secretes
prolactin ( )
Endocrine
cell
Blood
vessel
Target
effectors
Response
Mammary glands
Milk production
(c) Simple neuroendocrine pathway
(b) Simple neurohormone pathway
(a) Simple endocrine pathway
Hypothalamus
Glycogen
breakdown,
glucose release
into blood
TG
Normal Insulin Function
Insulin Insulin
Insulin
Insulin Insulin
Insulin
Normal Insulin Action
Increase in glucose uptake by muscle, liver,
and fat
Decrease glucose output by the liver
Increase TG storage, decreased TG
breakdown
Net Result:
Insulin Resistance
Increased insulin production to force glucose
uptake
Decreased inhibition of glucose rate of
appearance from the liver
Decreased inhibition of TG breakdown
FFA in blood.
Net Result:
TG
Cholesterol
LDL
HDL
Insulin (hyperinsulinemia)
Post-prandial glucose

Consequences of Prolonged
Hyperinsulinemia
Consequences of Prolonged
Hyperinsulinemia.
Prolonged high levels of insulin:
glucose continues to enter cells, but stored in liver
and fat cells and less glucose for immediate fuel
hunger returns quickly and eating increases
resulting in weight gain

Thanks you