Metabolic Disorders and Shen in Integrative Cardiovascular Chinese Medicine

Volume 7

Anika Niambi Al-Shura

• Publisher: Academic Press
• Year: 2020
• Print ISBN: 9780128189221
• eBook ISBN: 9780128189238
• Topic: Biological Sciences
• Subtopic: Biology
• Index: Biological Sciences

Metabolic Disorders and Shen in Integrative Cardiovascular Medicine, volume seven in the Integrative Cardiovascular Chinese Medicine series, presents the connection between metabolic diseases that affect the cardiovascular system and mental health through both Chinese and Western medicine explanations. Sections discuss the etiology of metabolic disorders of blood sugar disorders, lipid disorders, inflammatory disorders and shen, the clinical significance and differentiations in both Western and Chinese medicine, and prescriptions and the medicated diet, including main acupoints, remedies and medicines used in Western and Chinese medicine and the combination of medicinal herbs and food for Chinese diet therapy.This important reference will aid cardiovascular researchers in the study of integrative Chinese and Western medicine with its clear, structured base that not only guides clinical practice, but also encourages collaboration between Chinese and Western medicine practitioners.- Gives basic medical science and TCM theory background on lipids, blood sugar, inflammation and shen with clinical significance and diagnosis- Provides treatment methods and advice, including nutritional therapy and the Chinese medicine dietary plan- Prepares readers for advanced study within Integrative Cardiovascular Chinese Medicine

Part I

Etiology of metabolic disorders

Outline

1. 1. Etiology of lipid disorders
2. 2. Etiology of blood sugar disorders
3. 3. Etiology of inflammatory disorders
4. 4. Etiology of shen disorders

1: Etiology of lipid disorders

Abstract

In integrative cardiovascular Chinese medicine, the etiology of lipid disorders includes recognizing the different types of lipids, understanding lipid metabolism, the pathology directly associated with lipid excess and the genetic involvement.

Keywords

Genetics; Integrative cardiovascular Chinese medicine; Lipids; Pathology

Chapter objectives

The objectives of this chapter are:

• 1. To discuss the etiology of lipid disorders
• 2. To describe the different lipids and lipid metabolism
• 3. To discuss pathology of lipid disorders and genetic involvement

Overview of lipid metabolism and circulation

Lipids are hydrophobic macromolecules that are obtained through bile and pancreatic enzyme breakdown of food; synthesized by Acyl-CoA: cholesterol acyltransferase (ACAT1 found in endoplasmic reticulum (ER) of all cells and ACAT 2 found in the ER of intestinal and liver cells); processed, distributed, and utilized by the liver with the presence of ACAT1.

Cholesterol is processed, circulated, absorbed, excreted, and reabsorbed between the intestines, lymphatic system, and liver.

Cholesterol specifically binds to lipoproteins for transport through water-based fluids of the body. Lipoproteins are ligands and cofactors in enzyme processing. They bind to receptors on various cell surfaces of hepatocytes and enterocytes. Niemann-Pick C1 Like 1 (NPC1L1) is a specific protein receptor that is crucial for passage of cholesterol across cell membranes and into the ER. Within the ER, ACAT2 is present and catalyzes cholesterol into an ester for utilization in protein synthesis. From the cells of the enterocytes, cholesterol that has not been esterized is reabsorbed through the intestinal lumen and moved in two directions: the blood capillaries to the hepatic portal vein and the lymphatic system to circulate through the peripheral body. From peripheral tissues, the lymphatic vessels empty fluid and cholesterol into blood circulation, which flows back to the liver. Within the liver, a process called reverse cholesterol transport (RCT) receives the cholesterol that was sent out, returns, and then processes the cholesterol into bile acid for excretion.

Intermediate density lipoproteins
Lipoprotein lipase (LPL)	Derived from diet, uptake by macrophages that form foam cells and contribute to atherosclerosis
High-density lipoproteins (HDL)	Lipoproteins without cholesterol that help scavenge the body and return cholesterol-laden proteins to the liver
Low-density lipoproteins (LDL)	Derived from diet, uptake by macrophages that form foam cells and contribute to atherosclerosis
Very low-density lipoproteins (VLDL)	Derived from diet, the result of excess liver synthesis and circulation in diabetes mellitus
Chylomicrons	A lipoprotein that transports lipids from the microvilli of the small intestines through blood and lymph vessels to the liver and peripheral adipose

The liver generates hydrolyzed VLDL, which are triglycerides that form LDLs. LDLs bind to and transport cholesterol to participate in various physiological functioning throughout the body. Cholesterol is utilized by the liver as cholesterol 7-alpha hydroxylase (CYP7A1), the enzyme that synthesizes bile acids.

Low-density lipoprotein receptors (LDLR) are located mainly on the surface of hepatic cells and found throughout the body. These allow LDL to bind and allow for cholesterol to pass through cell membranes and hydrolyze for use in plasma membrane formation, synthesizing of hormones, bile acids, and elimination as waste. Lipoprotein lipase (LPL) is responsible for the transport and metabolism of various LDL and VLDL including triglycerides and cholesterol for storage regulation to attempt to maintain body-wide lipid balance.

Proprotein convertase subtilisin kexin 9 (PCSK9) circulates and regulates functioning of LDLR by degradation in lysosomes, which reduces the number for LDL binding, thus increasing blood plasma levels of LDL with vessel build-up contributing to vascular factors of heart disease.

Hepatic-derived LPL that travel in lymph and blood vessels become pa...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• In Memory
• Dedication
• Preface
• Dr. Al-Shura biography
• Part I. Etiology of metabolic disorders
• Part II. Clinical presentations
• Part III. Prescriptions and the medicated diet
• Index