AKF Carbohydrat Lipid

8/14/2019 AKF Carbohydrat Lipid

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Carbohydrates are compounds containing C, Hand O. Carbohydrate is one of the majorcompound as source of energy and also theprimary source of brain, erythrocytes andretinal cell. Carbohydrates are stored primarily

as liver and muscle glycogen.The classification of carbohydrate is based onfour different properties


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The size of the base carbon chainThe location of the CO function groupThe number of sugar unit

The stereochemistry of the compoundThe nervous system including brain totallydepends on glucose from surroundingextra cellular fluid (ECF) for energy


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The liver, pancreas, and other endocrineglands are all involved in the controlling theblood glucose concentration within a narrowrange. During a brief fast, glucose is supplied

to the ECF from liver through glycogenolysis.Control of blood glucose is under two majorhormones : insulin and glucagons bothproduced by pancreas. Their action appose

each other.


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Insulin is the primary hormones

responsible for the entry of glucose into

cell. It is synthesized by the -cell of

islets of Langerhans in the pancreas.When these cell detect an increase in

body glucose, they release insulin and

causes an increased movement of glucose

into the cells and increasesd glucosemetabolism.


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Insulin is normally released when glucose

levels are high and is not released when

glucose levels are decreased. It decreasedplasma glucose levels by increasing the

transport entry of glucose in muscle and

adipose tissue by way of non specific

receptor.


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Glucagon is the primary hormone responsiblefor increasing glucose levels. It is synthesizedby the -cells of islet of Langerhans in thepancreas and is released during stress and

fasting states. When these cells detect adecrease in body glucose, they releaseglucacon. Glucagon acts by increasing plasmaglucose levels by glycogenolysis in the liver

and an increase in gluconeogenesis. It can bereferred to as a hyperglycemic agent.


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Hyperglycemiais an increase in plasmais an increase in plasma

glucose levels caused by an imbalance ofglucose levels caused by an imbalance of

hormones. This condition known ashormones. This condition known asdiabetes mellitus.diabetes mellitus.

Diabetes Mellitus is actually a group ofDiabetes Mellitus is actually a group of

metabolic diseases characterized bymetabolic diseases characterized byhyperglycemia resulting from defect inhyperglycemia resulting from defect in

insulin secretion, insulin action or both.insulin secretion, insulin action or both.


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Classification of diabetes Mellitus :1. Diabetes type 1, is characterized byinappropriate hyperglycemia primarily due topancreatic islet -cell destruction and proneness

to ketoacidosis caused an absolute deficiency.This case constitutes only 10%-20% of all diabetesand commonly occurs in childhood andadolescence2. Diabetes type 2, is characterized by

hyperglycemia due to an individual's resistanceto insulin with an insulin secretory defect. Thisresistance result in a relative, not an absoluteinsulin deficiency. This type is the majority ofdiabetes case.Most patient in this type are obese or have

abdominal fat


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Laboratory Finding in HyperglycemiaIncreased glucose in plasma and urineIncreased urine specific gravity (Density)

Increased serum and urine osmolalityKetones in serum and urineDecreased blood and urine pHElectrolytes imbalance


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The major lipids of the body triglycerides,cholesterol, phospholipids and glycolipidsplay a variety of biologic roles. Lipoproteinare complex particles that interact withmany other metabolic pathway of the body.

Cholesterol is an unsaturated steroid alcoholof high molecular weigh consisting of aperhydrocyclopenthanthro-line ring and aside chain of eight carbon atoms.


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Characteristics of human lipoprotein :Chylomicron :diameter 80-1200 nm, density


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Arteriosclerosis caused by cholesterols in the

wall of arteries. This lipid deposition startswith thin layers called fatty streaks. Thefatty streaks develop over time into plaqueswhich partially block blood flow.

When plaques develop in legs or arm calledPeripheral Vascular disease (PVD), in heartcalled Coronary Artery disease (CAD), invessel brain called Cerebrovascular disease

(CVD) associated with Stroke


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Hyperlipoproteinemia are disease associatedwith elevated lipoprotein levels whileHypolipoproteinemia are disease associatedwith decreased lipoprotein level. Devided into

low LDL and low HDL caused by physiologystress, acute infection, surgical procedure

Hyperlipoproteinemia includinghypercholesterolemia, hypertriglyceridemia

and combined hyperlipidemia. All associatedwith heart disease


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Lipid Measurement used isolation/extraction

from samples and use some enzymes toconvert into substance to be measured.Total lipid measurement used gravimetricmethod but other substance like cholesterolneed spectrophotometric method like massspectrometry. Now, bioassay such as EnzymeLike Immunobsorbent assay (ELISA), radioimmunodetection (RID) and radioimmunoassay (RIA) prefer and more available.


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VLDL, IDL, LDL and HDL characterized by

separation centrifugal method. The

supernatant analized by enzyme assay.

Fatty acid analysis is less used commonlyin routine clinical test. Usually use Gas

chromatography.

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AKF Carbohydrat Lipid