CHM333 LECTURE 34 - 36: 4/19 – 22/7/13 SPRING 2013 Professor Christine Hrycyna

Lipid Metabolism

β-OXIDATION
FA ! Acetyl-CoA

• Triacylglycerols (TAGs) and glycogen are the two major forms of stored energy in vertebrates
• Glycogen can supply ATP for muscle contraction for less than an hour
• Glycogen stores depleted 12-15 h after eating and shorter if exercising
• Fats are the most highly concentrated form of stored biological energy
• Long-term
storage solution!
• Important for
migratory birds
who fly
incredibly long
distances
• Ruby-throated
hummingbird
winters in
Central America
and nests in
southern Canada – often flies non-stop! Store large amounts of TAGs
% dry-weight body fat = 70% when migration begins; 30% or less for non-migratory birds
• Sustained work is fueled by metabolism of TAGs which are very efficient energy stores
because:
(1) They are stored in an anhydrous form (no water present)
(2) Their fatty acids are more reduced than monosaccharides. Must go through many more
oxidation steps than carbohydrates before completely broken down to CO2
* Fats have 9 calories/g whereas carbohydrates have 4 calories/g (alcohol = 7 cal/g)

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• Long chain fatty acids are the ideal storage fuel: hold more calories, and body has a virtually
unlimited capacity to store fat; 70 kg man with 11% body fat has over 100,000 kcal stored as fat
in abdominal cavity; only about 600 kcal in glycogen
•Fats can support body for long time: 60-90 days; obese people can survive for over a year
without food.
How is this stored energy used?
- Fatty acids released from TAGs, transported to cytoplasm and then mitochondria of
peripheral tissues (muscle cells) for degradation
- Catabolized by process called
β−oxidation
• 4 step process
• Yields Acetyl-CoA
units that feed into the
TCA cycle
- When too much fuel is around,
fatty acids are made, linked to
glycerol (TAGs are made) and
stored in adipocytes.
•LOCALIZATION OF PROCESSES:
- Degradation = mitochondrial
matrix
- Synthesis = cytosol
METABOLISM OF FATS: Adsorption and
Mobilization of Fatty Acids

§ Fatty acids need to be delivered to cells for

β−oxidation to occur – how?
- Two major sources for fatty acids (FA) and glycerol
for metabolic fuels are obtained from triacylglycerols:
(1) In the diet
(2) Stored in adipocytes (fat storage cells)
Free fatty acids occur only in trace amounts in cells
Storage and Mobilization of Fatty Acids in Fat Cells
§ TAGs are stored in adipocytes, and fatty acids are
released to supply energy demands
§ Liberation of fatty acids from TAGs in adipose tissue
is regulated by hormones
o Epinephrine
o Glucagon
o Released into blood stream when there are low
glucose levels in blood

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§ At low carbohydrate and insulin concentrations, TAG hydrolysis is stimulated by increased

epinephrine (binds to β-adrenergic receptors, and activates cAMP-dependent protein kinases)
• Hormones bind to receptors on adipocyte cell surface
• Binding starts a process that generates cAMP (a nucleotide derivative)
• cAMP acts as an intracellular messenger that activates hormone-sensitive triacylglycerol lipase
• Lipase catalyzes hydrolysis of stored TAGs to free fatty acids and glycerol
• FAs exported from the cell into the blood stream (either by transporter or diffusion)
Bind to blood protein = serum albumin and transported to muscle cells via capillaries, enter
cells, get transported into the mitochondrial matrix and undergo β-oxidation.
Glycerol is gluconeogenic
Absorption of Dietary Lipids
• On average, fat makes up 37% of calories in American diet
• Most diet lipids of mammals are TAGs
• 90% of the fat we eat is TAG; rest: cholesterol esters, phospholipids, essential unsaturated fatty
acids (Linoleic acid (LA) (omega-6) 18:2 9,12 and linolenic acid (omega-3) 18:3 9,12,15), and fat
Δ Δ

soluble vitamins A, D, E, and K

• In normal individuals, 95% of fat consumed is absorbed and most transported to adipose for storage.
• General principle of dietary lipid assimilation is to hydrolyze large non-absorbable molecules into
smaller units.

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1. Emulsification starts in the stomach and continues in the lumen of the small
intestine
• Starts as a big glob of hydrophobic fat – has limited surface area to attack
• In the stomach the fat is heated to liquify, peristaltic movements help emulsify (like a
washing machine) (mixer making mayonaise)
2. In the small intestine, fat particles are coated with bile salts and digested by
pancreatic lipases

Bile salts: Biological Detergents

Bile salts are amphipathic: synthesized in liver, stored and secreted by gall bladder to intestine. Made
from cholesterol: retain the ring structure but have more hydroxyl groups and a polar side chain – can
act as DETERGENTS - Serve to convert water-insoluble lipids to dispersible micellar aggregates
• They emulsify fat globules into smaller micelles, increasing the surface area accessible to lipid-
hydrolyzing enzymes. Aid in lipid digestion and are essential for the absorption of lipid
digestion products
• Also required for efficient intestinal absorption of lipid-soluble vitamins A, D, E, and K
• Taurocholate and glycocholate (cholesterol derivatives) are the most abundant bile salts
Amphipathic: hydrophilic (blue), hydrophobic (black)

• Form MICELLES
• Hydrophobic portions interact with lipids while the hydrophilic groups remain exposed to water
• Disc-like shapes - free fatty acids and bile
• Recycled through hepatic portal vein from intestine back to liver
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LIPASES: Action of pancreatic lipase

§ Duct at the junction of pancrease and duodenum enters
pancreatic juice – contains lipases (among other things, including
colipase: small protein that the lipase needs around to keep it
active with all the bile salts around.
§ Lipases degrade TAGs to free fatty acids (FA) and a 2-
monoacylglycerol (MAG) by hydrolysis at the C-1 and C-3
positions
§ Dietary phospholipids are degraded by phospholipases
Dietary cholesterol
§ Most dietary cholesterol is unesterified
§ Any Cholesteryl esters are hydrolyzed by an intestinal
esterase to yield free
§ Free cholesterol is solublized by bile-salt micelles for
absorption

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3. Free FA and cholesterol from bile

salt mixed micelles are taken up
through the intestinal wall
Micelle = free fatty acids and bile
Micelle can interact with brush border and is
the form in which lipids are absorbed
4. Once inside intestinal cells,
cholesteryl acyl-CoA esters are
formed and FA are resynthesized
into triacylglycerols (TAGs)

5. TAGs, cholesterol and apoproteins

are packaged into a chylomicron
(lipoprotein) and exported into blood
for use
• TAGs, cholesterol and cholesterol
esters are insoluble in water and
cannot be transported in blood or
lymph as free molecules
• These lipids assemble with
phospholipids and apoproteins
(apolipoproteins) to form spherical
particles called lipoproteins with:
Hydrophobic cores: TAGs,
cholesteryl esters
Hydrophilic surfaces: cholesterol,
phospholipids, apolipoproteins
• Chylomicrons are the largest
lipoproteins
• Make fats SOLUBLE
• They deliver TAGs from the
intestine (via lymph and blood) to
tissues (muscle for energy, adipose
for storage)
• They are present in blood only after feeding
• Cholesterol-rich chylomicron remnants deliver cholesterol to the liver
6. Lipoprotein lipase on cells lining capillary wall adjacent to ADIPOSE and MUSCLE tissue
promotes release of fatty acids; The chylomicrons dock with lipoprotein lipases

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7. Fatty acids are taken up and degraded by β-oxidation in mitochondrial matrix

CHYLOMICRONS
lymphatic system
thoracic duct
subclavian vein
heart
circulation

liver adipocytes muscle

Fatty Acid Oxidation

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• The β-oxidation pathway degrades fatty acids two carbons at a time

• Skeletal muscle, liver, kidney, heart can use FA directly
• Three stages:
(1) Activation of fatty acids in the
cytosol
(2) Transport into the
mitochondria
(3) Degradation to two-carbon
fragments
(as acetyl CoA) in the
mitochondrial matrix

Activation of Fatty Acids

• Fatty acids in the cytosol are activated by conversion to CoA thioesters by acyl-CoA
synthetase (ATP dependent)
• Fatty acid attached to CoA-SH
• The PPi released is hydrolyzed by a pyrophosphatase to 2 Pi
• Net of two ATP equivalents are
consumed to activate one fatty acid to a thioester

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2. Transport of Fatty Acyl CoA into Mitochondria

• Activated acyl-CoA freely
diffuses through OMM into
intermembrane space,
however cannot pass IMM to
be brought into mitochondrial
matrix
• The carnitine shuttle system
transfers fatty acyl CoA from
the cytosol into the
mitochondria
• Fatty acyl CoA is first
converted to acylcarnitine
(which can enter the
mitochondria) and then back
to fatty acyl CoA
• The β-oxidation cycle
enzymes (mitochondrial) can
then degrade the fatty acyl
CoA
Sequence of Events:
1. At IMM, acyl group transferred to carnitine, a small organic molecule that carries the fatty acyl
group into the mitochondrial matrix. Used as a SHUTTLE for fatty acyl groups.
Compound = acylcarnitine
Enzyme = carnitine acyltransferase I
2. Acylcarnitine is transported across IMM via protein translocase
3. Once in the matrix, acyl group is transferred back to CoA-SH by carnitine acyltransferase II
4. Carnitine transported back to intermembrane space via translocase to get another molecule of acyl
5. Keep pools of CoA-SH separate
• Cytosolic CoA-SH used for synthesis
• Mitochondrial CoA-SH used for degradation

ANIMATION:
http://www.brookscole.com/chemistry_d/templates/student_resources/shared_resources/animations/carnitine/carnitine1.html

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CARNITINE:
- Diet: red meat, dairy, poultry, fish
- Body: made in liver and kidneys
- Enters cells by specific transporter
- Carnitine deficiencies:
§ Symptoms:
• Poor muscle tone
• Muscle weakness
• Brain dysfunction
• Heart dysfunction
§ Primary Deficiency: Rare disorder due to faulty transporter that allows carnitine into
cells
§ Secondary Deficiency: Poor dietary intake or metabolic diseases that deplete or limit
stores
§ Treatment: Pharmaceutical administration of carnitine to supplemental stores in the
body; Can flood system and enough carnitine can enter if due to a faulty transporter
- NOTE: NO evidence exists that if normal, taking more supplements of carnitine does
anything. Not bad – excess carnitine is not harmful but not necessarily beneficial.

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The Reactions of β-oxidation

• One round of β-oxidation: 4 enzyme steps produce acetyl CoA from fatty acyl CoA
• Each round generates one molecule each of:
1 FADH2 – oxidative phosphorylation
1 NADH – oxidataive phosphorylation
1 Acetyl CoA – enters TCA cycle
Fatty acyl CoA (2 carbons shorter each round)
Process continues until acyl-CoA is completely broken down to Acetyl-CoA groups
o Cleavage occurs between the α and β carbons of the acyl-CoA (between 1st and 2nd C next to
carbonyl)
o # of acetyl-CoA made = ½ the number of Carbons in the original fatty acid
o # of cycles of β-oxidation = # of acetyl-CoAs made minus 1
o Example:
§ Palmitic acid = 16:0
• 8 moles of acetyl-CoA (enter TCA cycle)
• 7 rounds of β-oxidation

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β-OXIDATION, A SPIRAL PATHWAY:

Reaction 1: Oxidation-reduction reaction catalyzed by Acyl-CoA Dehydrogenase

- Generates FADH2
- Produces a double bond between carbon atoms 2 and 3

Reaction 2: Hydration reaction catalyzed by Enoyl-CoA Hydrase

- Catalyzes stereospecific hydration of the trans double bond produced in the 1st step of the
pathway
- Forms 3-L-Hydroxyacyl-CoA

Reaction 3: Oxidation-reduction reaction catalyzed by 3-L-Hydroxyacyl-CoA Dehydrogenase

- Generates NADH
- Oxidation of the hydroxyl in the β position (C3) to a ketone

Reaction 4: Bond cleavage reaction catalyzed by Thiolase

- Requires CoA-SH (Coenzyme A)
- Releases Acetyl-CoA – which enters the TCA cycle
- Acyl-CoA (2 carbons shorter) re-enters β−oxidation

ANIMATION: http://www.wiley.com/college/fob/anim/
Fig. 19-9 -- The Oxidation Pathway of Fatty Acyl-CoA

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SUMMARY OF THE
PRODUCTS OF EACH
CYCLE:
- Acyl-CoA which re-
enters β−oxidation
- 1 Acetyl-CoA which
enters TCA
- 1 FADH2
- 1 NADH

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ATP Generation from Fatty Acid Oxidation

- Three things to keep in mind as sources of ATP
• NADH and FADH2 produced by β-oxidation cycles
• Processing of Acetyl-CoA generated in β-oxidation cycles through TCA cycle and ox phos
• How much ATP was USED in activating the FA for degradation
o Remember – 2 ATP equivalents are used per mole of fatty acid; 1 ATP but 2 high
energy bonds

The balanced equation for oxidizing one palmitoyl CoA by seven cycles of β−oxidation Net yield of
ATP per palmitate oxidized to 16 CO2

Palmitoyl CoA + 7 HS-CoA + 7 FAD + 7 NAD+ + 7 H2O

8 Acetyl CoA + 7 FADH2 + 7 NADH + 7 H+

Each acetyl-CoA that enters TCA:

- 1 mole GTP
- 3 moles NADH
- 1 mole FADH2

Therefore for palmitate: 80 ATP

- 8 GTP = 8 ATP
- 24 NADH = 60 ATP
- 8 FADH2 = 12

ATP generated
8 acetyl CoA 80
7 FADH2 10.5
7 NADH 17.5
108 ATP
ATP expended to activate palmitate -2
Net yield: 106 ATP

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MUCH BETTER THAN GLUCOSE:

o Even for 3 glucose molecules, only get 96 ATP (18 carbons),
o Palmitate (16:0) gives 106!
o Fats are better energy stores that sugars/carbs!

- An important source of metabolic water for some animals:

- Water is ultimately formed through the process of electron transport & oxidative phosphorylation
• Gerbils, Killer Whales (do NOT drink sea water)
• Camel – hump is essentially a large deposit of fat
• Fatty acid metabolism from fat store provides metabolic energy as well as needed water
during periods when food and drinking water is not available!!
• It has been found for every half pound of fat metabolized, a pint of water is produced!
• Water also stored in specialized places near the stomach.

Kangaroo rats Oxidation water

Water formed
• exhibit many of the most common desert Type of food
animal specializations (g H 20/g food)
• speciose and abundant - very successful
• do not use evaporative cooling, so water starch*
budgets can be easily calculated 0.56
(carbohydrate)
• small, easily studied in the lab
• pioneering studies of Knut Schmidt-Nielsen at
Duke University fat 1.07
• drink no water

protein 0.39

*e.g. C 6H12 O6 + 6 O 2 to 6 CO 2 + 6 H 20

Water budget for a kangaroo rat

Water losses ml Water gains ml

Urine 13.5 Oxidation 54.0

Feces 2.6 Absorbed water 6.0
Evaporation 43.9

Total 60.0 ml Total 60.0 ml

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β Oxidation of Unsaturated Fatty Acids

• Unsaturated FA are common in nature
• Degradation requires two other enzymes in addition to the β-oxidation pathway enzymes:
(1) Enoyl-CoA isomerase
(2) 2,4-Dienoyl-CoA-reductase

Ketone Bodies Are Fuel That Are Synthesized in the Liver

• Unbalanced metabolism of fats and carbohydrates changes the flow of nutrients in pathways
• Common factors in abnormal metabolic conditions
• Lack of carbohydrates
• Impaired use of carbohydrates
• Fasting
• Starvation
• Untreated diabetes
• Atkins’ Diet

Response to a Fast and Starvation

The natural response to glucose and energy deficiency is involves two metabolic processes. Firstly the
adrenal cortex secretes glucocorticoids to stimulate gluconeogenesis. Secondly growth hormone is
secreted to accelerate lipolysis in adipose tissue to provide fatty acids for oxidation.

• Liver glycogen stores are depleted

• Fatty acids can be used by heart, kidney,
skeletal muscle and liver
• Fatty acids are not used as fuel by the
brain because they do not cross the blood-
brain barrier
• Survival during starvation is mainly
determined by the size of the stored
triacylglycerol pool
• After several days of starvation, acetyl-
CoA is made in abnormally high amounts:
• Due to excessive fatty acid breakdown since glucose/glycogen is not available
• Glucose is the primary source of fuel for the human brain, therefore the rate of
gluconeogenesis has to increase
• During fasting or carbohydrate starvation, oxaloacetate in liver is depleted from the TCA
cycle because it is used for gluconeogenesis (making glucose for the brain)
• Impedes entry of acetyl-CoA into the TCA cycle.

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• Excessive Acetyl-CoA is converted in liver mitochondria to ketone bodies

• Ketone bodies can be thought of as “soluble fats” – exported to cells that need it
They are transportable forms of fatty acids!
• There is a limited amount of mitochondrial CoA-SH so need to regenerate it for
further fatty acid catabolism

• Ketone Bodies:
• β-Hydroxybutyrate
• Acetoacetate
• Acetone – expelled in breath
• Ketone bodies are acids – can cause lowering of
blood pH leading to acidosis (ketosis); untreated
can lead to coma and death

• Ketone bodies can fuel brain cells during starvation

• Use of ketone bodies
minimizes protein
breakdown
• Able to cross blood-brain
barrier
• Major energy source for
brain during starvation
• β-Hydroxybutyrate and
acetoacetate used as fuel
• Acetone – expelled in
breath

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from liver

from liver

FORMATION OF KETONE BODIES:

1. β-Ketothiolase. The final step of the β-oxidation pathway runs backwards, condensing 2 acetyl-
CoA to produce acetoacetyl-CoA, with release of one CoA.
2. HMG-CoA Synthase catalyzes condensation of a third acetate moiety (from acetyl-CoA) with
acetoacetyl-CoA to form hydroxymethylglutaryl-CoA (HMG-CoA).
3. HMG-CoA Lyase cleaves HMG-CoA to yield acetoacetate plus acetyl-CoA.
4. β-Hydroxybutyrate Dehydrogenase catalyzes inter-conversion of the ketone bodies
acetoacetate and β-hydroxybutyrate.
Ketone Bodies Are Oxidized in Mitochondria of many tissues OTHER than liver

- Liver cannot use ketone bodies because the activating

enzyme required for ketone body utilization is absent
in the liver.
- Acetyl-CoA regenerated and enter TCA cycle to
make energy

DIABETES:
"Starvation of cells in the midst of plenty"
• Third leading cause of death in the U.S.
– Two types: Type 1 and Type 2
• For glucose to get into cells, insulin must be present
• Causes of diabetes – Insufficient insulin is secreted or
insulin does not stimulate its target cells
• Glucose builds up in the blood, overflows into urine,
and passes out of body.
• Body loses main fuel source even though blood full of
glucose
• Consequences:
– Blood and urine [glucose] is elevated
– Glucose is abundant in blood, but uptake by
cells in muscle, liver, and adipose cells is low

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– Cells, metabolically starved, turn to gluconeogenesis and fat/protein catabolism

• Processes of TAG hydrolysis, fatty acid oxidation, gluconeogenesis accelerated
• OAA is low, due to excess gluconeogenesis, so Acetyl-CoA from fat/protein
catabolism does not go to TCA, but rather to ketone body production
– Blood levels of ketone bodies are elevated
• Lowered pH of blood
• Increased elimination of water and electrolytes, causing dehydration and lowered
blood volume
• Acetone can be detected on breath
ATKINS DIET
- High protein/High Fat/Low to no carbohydrate
diets
- In a carbohydrate free diet, newly ingested
fatty acids are immediately oxidized by all
tissues except brain
- When diet contains carbohydrates, ingested
fatty acids are transported to fat cells for
storage (Insulin signals fat storage)
- Effective because body fat is metabolized for
energy
- Also effective because lots of water is lost
(excessive urination)
- BUT: No idea of what long term effects of being in constant ketosis are or other side-effects
- Potentially Problematic Side Effects:
v Dehydration – caused by excessive urination to rid body of acids
v Electrolyte Imbalance – Loss of Na+ and K+ in urine
v Difficulty in Concentration – Low fuel availability to brain
v GI Problems – No fiber
v Bad Breath – Acetone expulsion
v Heartbeat Irregularities
v Kidney Stress or Damage
§ Excessive urination to flush out toxins created by ketosis
§ Processes by-products of protein breakdown
v Excessive proteins can cause Ca+2 loss from bones which can lead to
osteoporosis – esp. bad for women
v Acidosis and Death
v Depression – Lack of carbohydrates can result in lowered serotonin production –
a mood stabilizing compound in the brain
v Workouts suffer – due to depleted energy stores

- Hard to stick with this diet – weight gain common afterwards

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- If on this type of diet, be sure to drink lots of water and supplement with vitamins and salt
- BE BALANCED! Weight loss = Eat fewer calories and increase exercise
- 1 pound of fat = 3500 calories
o Cut 500 calories/day and lose 1 pound per week
o Safe weight loss that will last = 2 pounds per week
- EVERYTHING IN MODERATION to keep body in balance – eat all food groups

Integration of Metabolic Pathways:

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EXTRA INFORMATION

DIABETES
Insulin-dependent diabetes Non-insulin dependent diabetes
mellitus mellitus
Synonym Type I Type II
Age of onset During childhood or puberty After age 35
Nutrition status at time of
Frequently undernourished Obesity
onset
Prevalence 10-20% of diagnosed diabetics 80-90% of diagnosed diabetics
Genetic predisposition Moderate Very strong
Insulin resistance; not enough Beta
Defect or deficiency Beta cells are destroyed
cells
Ketosis Common Rare
Plasma insulin Low to absent Normal to high
Acute complications Ketoacidosis Hyperosmolar coma
Oral hypoglycemia drugs Unresponsive Responsive
Treatment with insulin Always Usually not required

Type I (Insulin-Dependent) Diabetes (10% of cases)

• Formerly called juvenile diabetes
• Caused by slow autoimmune destruction of insulin-secreting pancreatic β-cells
• Patients require insulin to live
• Life spans reduced due to complications resulting from the crude metabolic control provided by
insulin injections
• Hyperglycemia leads to blindness
– Degeneration of the retina
– Cataract formation due to protein glucosylation

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Type II
• Comprises > 90% of the diagnosed cases
• Affects almost 20% of individuals over age 65
• Characterized by an insensitivity to insulin (impaired recognition of insulin)
• Insulin levels are elevated, but affected individuals have low numbers of or defects in insulin
receptors
• Transport of glucose into muscle, live and adipose tissue resudes significantly and despite
abundant glucose , cells metabolically starved
• Respond by increased gluconeogenesis and catabolism of fat and protein

• Causes of Insulin Resistance in type II Diabetics:

1. Defects in signal transduction
2. Abnormal insulin or insulin receptors
3. Defects in glucose transporters
4. It is also thought that insulin resistance is caused by obesity as insulin response in
type II diabetics dramatically improves with weight reduction.
5. Postulated that in obese individuals there is a constant elevated level of insulin
because of high carbohydrate intake.
§ Thought to cause beta cell destruction
§ Decrease the sensitivity of insulin receptors in the target organs
§ Increased insulin production resulting from overeating may suppress insulin
receptor synthesis

Insulin Resistance
Ë Complication of obesity and type 2 diabetes
¯ Mildly increased plasma glucose
¯ Normal or increased plasma insulin
° Tissue insensitivity to insulin
Ë Several levels of defects
¯ Pre-receptor: rare
° Defect: insulin receptor antibodies, abnormal molecule
¯ Receptor:
° Decreased number or affinity of insulin receptors
¯ Post-receptor : Most probable site of insulin resistance in diabetes
° Defects in intracellular signal transduction, decreased activity of key enzymes
such as pyruvate dehydrogenase or glycogen synthase
¯ Glucose transport: To be established
° Deficient or defective glucose transporters

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• The primary treatment is exercise and diet.

• The main goal with type II diabetes treatment is to keep the glucose concentration within
the normal limits. In order to do this, the patient is asked to maintain a strict diet which
is low in carbohydrates and weight reduction is encouraged by the doctor.

• Prevention:
• Maintaining ideal body weight (weight management) and an active lifestyle may prevent
the onset of type II diabetes in people at risk for the disease.

Drug Treatment:
1. Sulfonylurea drugs – enhance insulin secretion (e.g. glyburide)
2. α-glucosidase inhibitors: inhibits the digestion of ingested carbohydrates, thereby resulting in
a smaller rise in blood glucose concentration following meals. Results in delayed glucose
absorption Effect is additive to that of sulfonylureas when used in combination.

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