What is Madelung’s disease?
Madelung’s disease is a rare disorder of fat metabolism that results in an unusually high accumulation of subcutaneous fat deposits.
Where are the fat deposits located in Madelung’s disease?
The deposits occur directly under the skin around the neck, shoulders, trunk, hips, upper arms, and thighs.
Why is Madelung’s disease often mistaken for obesity?
Because of the totally symmetrical deposition of fat.
What functional symptoms can patients with Madelung’s disease experience?
Although painless, the fatty tumors can compromise function of other structures in the affected area, resulting in difficulty swallowing, speaking, and breathing.
How does Madelung’s disease affect quality of life?
It can very much limit the quality of life of these patients due to the functional compromise of affected areas.
Which demographic is most often affected by Madelung’s disease?
Adult males between ages 30 to 70 with a history of excessive drinking (chronic alcoholism).
Can women or non-drinkers get Madelung’s disease?
Yes, women and those who do not drink alcohol can also get Madelung’s disease.
In which populations is Madelung’s disease more common?
It is more common in Mediterranean and European populations.
In which populations is Madelung’s disease less frequent?
It is less frequent in Asian populations.
What is known about the underlying causes and treatment of Madelung’s disease?
The underlying causes aren’t fully understood, which can lead to limitations in treatment options.
Why do adult humans generally have little need for fatty acid synthesis?
Because our diet meets our physiological needs for fats and lipids.
In which tissues does de novo fatty acid synthesis primarily occur in adults?
Primarily in the liver and lactating mammary glands and, to a lesser extent, in adipose tissue.
When is fatty acid synthesis physiologically required?
Under certain physiological conditions, such as embryonic development and lactation.
What can result from too much fatty acid synthesis?
It can lead to pathological conditions and diseases such as fatty liver diseases (alcoholic and non-alcoholic).
What distinguishes Alcoholic from Non-alcoholic fatty liver disease?
Alcoholic liver disease is due to high alcohol consumption. Non-alcoholic is most often due to metabolic disease, including obesity and type two diabetes.
What happens to the liver’s appearance in fatty liver disease?
Fatty deposits result in a discoloration of the liver lobes, giving it a more pale-like color (compared to the healthy maroon color).
What are the potential progressions of fatty liver disease?
It can give rise to inflammation and hepatitis, as well as progress to overt liver cirrhosis and liver failure.
What is the first biochemical hurdle in fatty acid synthesis?
Synthesis takes place in the cytoplasm, but acetyl CoA (the raw material) is formed in the mitochondria, which are not permeable to acetyl CoA.
How does the cell solve the Acetyl-CoA mitochondrial permeability problem?
Citrate, synthesized in the mitochondria, is transported to the cytoplasm and cleaved by ATP-citrate lyase to generate acetyl CoA.
What does Citrate carry across the mitochondrial membrane?
It carries acetyl groups.
What is the reaction catalyzed by ATP-citrate lyase?
Citrate + ATP + Coenzyme A + Water ? Acetyl CoA + ADP + Phosphate + Oxaloacetate.
Is the ATP-citrate lyase reaction energy consuming?
Yes, it is an ATP consuming reaction.
What metabolic pathway does Citrate inhibit?
Citrate inhibits phosphofructokinase, thus shutting down glycolysis.
What does Citrate accumulation signal?
It is considered a signal of an energy-rich status of the cell.