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Chapter 9 The Endocrine System Lecture Presentation by Patty Bostwick-Taylor Florence-Darlington Technical College © 2015 Pearson Education, Inc. The Endocrine System  Second controlling system of the body  Nervous system is the fast-control system  Uses chemical messengers (hormones) that are released into the blood  Hormones control several major processes:  Reproduction  Growth and development  Mobilization of body defenses  Maintenance of much of homeostasis  Regulation of metabolism © 2015 Pearson Education, Inc. Hormone Overview  Hormones are produced by specialized cells  Cells secrete hormones into extracellular fluids  Blood transfers hormones to target sites  These hormones regulate the activity of other cells  Endocrinology is the scientific study of hormones and endocrine organs © 2015 Pearson Education, Inc. The Chemistry of Hormones  Hormones are classified chemically as  Amino acid–based, which includes:  Proteins  Peptides  Amines  Steroids—made from cholesterol  Prostaglandins—made from highly active lipids that act as local hormones © 2015 Pearson Education, Inc. Hormone Action  Hormones affect only certain tissues or organs (target cells or target organs)  Target cells must have specific protein receptors  Hormone binding alters cellular activity © 2015 Pearson Education, Inc. Hormone Action Hormones arouse cells, or alter cellular activity. Typically, one or more of the following occurs: 1. Changes in plasma membrane permeability or electrical state 2. Synthesis of proteins, such as enzymes 3. Activation or inactivation of enzymes 4. Stimulation of mitosis 5. Promotion of secretory activity © 2015 Pearson Education, Inc. The Chemistry of Hormones  Hormones act by two mechanisms: 1. Direct gene activation 2. Second-messenger system © 2015 Pearson Education, Inc. Direct Gene Activation (Steroid Hormone Action) 1. Steroid hormones diffuse through the plasma membrane of target cells 2. Steroid hormones enter the nucleus 3. Steroid hormones bind to a specific protein within the nucleus 4. Hormone-receptor complex binds to specific sites on the cell’s DNA 5. Certain genes are activated that result in… 6. Synthesis of new proteins © 2015 Pearson Education, Inc. Figure 9.1a Mechanisms of hormone action. Steroid hormone Slide 1 Nucleus Cytoplasm 1 Receptor protein 2 3 Hormone-receptor complex 4 DNA 5 mRNA New protein Plasma membrane of target cell (a) Steroid hormone action © 2015 Pearson Education, Inc. 6 Second-Messenger System (Nonsteroid Hormone Action) 1. Hormone (first messenger) binds to a membrane receptor 2. Activated receptor sets off a series of reactions that activates an enzyme 3. Enzyme catalyzes a reaction that produces a second-messenger molecule (such as cyclic AMP, or cAMP) 4. Oversees additional intracellular changes to promote a specific response in the target cell © 2015 Pearson Education, Inc. Figure 9.1b Mechanisms of hormone action. Slide 1 Nonsteroid hormone (first messenger) Cytoplasm Enzyme ATP 1 2 Receptor protein Plasma membrane of target cell 3 Second cAMP messenger 4 Effect on cellular function, such as glycogen breakdown (b) Nonsteroid hormone action © 2015 Pearson Education, Inc. Control of Hormone Release  Hormone levels in the blood are maintained mostly by negative feedback  A stimulus or low hormone levels in the blood triggers the release of more hormone  Hormone release stops once an appropriate level in the blood is reached © 2015 Pearson Education, Inc. Endocrine Gland Stimuli  The stimuli that activate endocrine glands fall into three major categories: 1. Hormonal 2. Humoral 3. Neural © 2015 Pearson Education, Inc. Hormonal Stimuli of Endocrine Glands  Most common stimulus  Endocrine organs are activated by other hormones  Example:  Anterior pituitary hormones travel to target glands, such as the thyroid gland, to prompt the release of a particular hormone, such as thyroid hormone © 2015 Pearson Education, Inc. Figure 9.2a Endocrine gland stimuli. (a) Hormonal stimulus 1 The hypothalamus secretes hormones that… Hypothalamus 2 …stimulate the anterior pituitary gland to secrete hormones that… Thyroid gland Anterior pituitary gland Adrenal Gonad cortex (testis) 3 …stimulate other endocrine glands to secrete hormones © 2015 Pearson Education, Inc. Humoral Stimuli of Endocrine Glands  Changing blood levels of certain ions and nutrients stimulate hormone release  Humoral indicates various body fluids, such as blood and bile  Examples:  Parathyroid hormone and calcitonin are produced in response to changing levels of blood calcium levels  Insulin is produced in response to changing levels of blood glucose levels © 2015 Pearson Education, Inc. Figure 9.2b Endocrine gland stimuli. (b) Humoral stimulus 1 Capillary blood contains low concentration of Ca2+, which stimulates… Capillary (low Ca2+ in blood) Thyroid gland (posterior view) Parathyroid glands Parathyroid glands PTH 2 …secretion of parathyroid hormone (PTH) by parathyroid glands) © 2015 Pearson Education, Inc. Neural Stimuli of Endocrine Glands  Nerve impulses stimulate hormone release  Most are under the control of the sympathetic nervous system  Examples:  The release of norepinephrine and epinephrine by the adrenal medulla © 2015 Pearson Education, Inc. Figure 9.2c Endocrine gland stimuli. (c) Neural stimulus 1 Preganglionic sympathetic fiber stimulates adrenal medulla cells… CNS (spinal cord) Preganglionic sympathetic fibers Medulla of adrenal gland Capillary 2 …to secrete catecholamines (epinephrine and norepinephrine) © 2015 Pearson Education, Inc. Major Endocrine Organs  Pituitary gland  Thyroid gland  Parathyroid glands  Adrenal glands  Pineal gland  Thymus gland  Pancreas  Gonads (ovaries and testes)  Hypothalamus © 2015 Pearson Education, Inc. Figure 9.3 Location of the major endocrine organs of the body. Pineal gland Hypothalamus Pituitary gland Thyroid gland Parathyroid glands Thymus Adrenal glands Pancreas Ovary (female) Testis (male) © 2015 Pearson Education, Inc. Major Endocrine Organs  Some glands are purely endocrine  Anterior pituitary, thyroid, adrenals, parathyroids  Endocrine glands are ductless glands  Hormones are released directly into blood or lymph  Other glands are mixed glands, with both endocrine and exocrine functions (pancreas, gonads) © 2015 Pearson Education, Inc. Pituitary Gland and Hypothalamus  Pituitary gland is the size of a pea  Hangs by a stalk from the hypothalamus in the brain  Protected by the sphenoid bone  Has two functional lobes  Anterior pituitary—glandular tissue  Posterior pituitary—nervous tissue  Often called the “master endocrine gland” © 2015 Pearson Education, Inc. Pituitary Gland and Hypothalamus  Hypothalamus produces releasing and inhibiting hormones  These hormones are released into portal circulation, which connects hypothalamus to anterior pituitary  Hypothalamus also makes two hormones: oxytocin and antidiuretic hormone  Carried to posterior pituitary via neurosecretory cells for storage © 2015 Pearson Education, Inc. Figure 9.4 Hormones released by the posterior lobe of the pituitary and their target organs. Optic chiasma Axon terminals Hypothalamic neurosecretory cells Hypothalamus Arterial blood supply Posterior lobe Capillary bed Venous drainage Anterior lobe of the pituitary © 2015 Pearson Education, Inc. ADH Oxytocin Kidney tubules Mammary glands Uterine muscles Posterior Pituitary and Hypothalamic Hormones  Oxytocin  Stimulates contractions of the uterus during labor, sexual relations, and breastfeeding  Causes milk ejection (let-down reflex) in a breastfeeding woman © 2015 Pearson Education, Inc. Posterior Pituitary and Hypothalamic Hormones  Antidiuretic hormone (ADH)  Inhibits urine production (diuresis) by promoting water reabsorption by the kidneys  In large amounts, causes vasoconstriction of arterioles, leading to increased blood pressure (the reason why ADH is known as vasopressin)  Alcohol inhibits ADH secretion  Diabetes insipidus results from ADH hyposecretion © 2015 Pearson Education, Inc. Hormones of the Anterior Pituitary  Six anterior pituitary hormones  Two affect nonendocrine targets: 1. Growth hormone 2. Prolactin © 2015 Pearson Education, Inc. Hormones of the Anterior Pituitary  Four stimulate other endocrine glands to release hormones (tropic hormones): 1. 2. 3. 4. Thyroid-stimulating hormone (thyrotropic hormone) Adrenocorticotropic hormone Follicle-stimulating hormone Luteinizing hormone © 2015 Pearson Education, Inc. Hormones of the Anterior Pituitary  Characteristics of all anterior pituitary hormones  Protein (or peptides) structure  Act through second-messenger systems  Regulated by hormonal stimuli  Regulated mostly by negative feedback © 2015 Pearson Education, Inc. Figure 9.5 Hormones of the anterior pituitary and their major target organs. Releasing hormones secreted into portal circulation Hypothalamus Anterior pituitary Posterior pituitary Hypophyseal portal system Adrenocorticotropic hormone (ACTH) Growth hormone (GH) Bones and muscles Prolactin (PRL) Follicle-stimulating hormone (FSH) and luteinizing Mammary hormone (LH) glands Testes or ovaries © 2015 Pearson Education, Inc. Thyrotropic hormone (TH) Thyroid Adrenal cortex Hormones of the Anterior Pituitary  Growth hormone (GH)  General metabolic hormone  Major effects are directed to growth of skeletal muscles and long bones  Plays a role in determining final body size  Causes amino acids to be built into proteins  Causes fats to be broken down for a source of energy © 2015 Pearson Education, Inc. Hormones of the Anterior Pituitary  Growth hormone (GH) disorders  Pituitary dwarfism results from hyposecretion of GH during childhood  Gigantism results from hypersecretion of GH during childhood  Acromegaly results from hypersecretion of GH during adulthood © 2015 Pearson Education, Inc. Figure 9.6 Disorders of pituitary growth hormone. © 2015 Pearson Education, Inc. This individual exhibiting gigantism (right) stands 8 feet, 1 inch tall. The pituitary dwarf (left) is 2 feet, 5.37 inches tall. Hormones of the Anterior Pituitary  Prolactin (PRL)  Stimulates and maintains milk production following childbirth  Function in males is unknown  Adrenocorticotropic hormone (ACTH)  Regulates endocrine activity of the adrenal cortex © 2015 Pearson Education, Inc. Hormones of the Anterior Pituitary  Thyrotropic hormone (TH), also called thyroidstimulating hormone (TSH)  Influences growth and activity of the thyroid gland © 2015 Pearson Education, Inc. Hormones of the Anterior Pituitary  Gonadotropic hormones  Regulate hormonal activity of the gonads  Follicle-stimulating hormone (FSH)  Stimulates follicle development in ovaries  Stimulates sperm development in testes  Luteinizing hormone (LH)  Triggers ovulation of an egg in females  Stimulates testosterone production in males © 2015 Pearson Education, Inc. Thyroid Gland  Found at the base of the throat  Consists of two lobes and a connecting isthmus  Produces two hormones: 1. Thyroid hormone 2. Calcitonin © 2015 Pearson Education, Inc. Figure 9.7a The thyroid gland. Thyroid cartilage Epiglottis Common carotid artery Isthmus of thyroid gland Trachea Brachiocephalic artery Left subclavian artery Left lobe of thyroid gland Aorta (a) Gross anatomy of the thyroid gland, anterior view © 2015 Pearson Education, Inc. Thyroid Gland  Thyroid hormone  Major metabolic hormone  Controls rate of oxidation of glucose to supply body heat and chemical energy  Needed for tissue growth and development  Composed of two active iodine-containing hormones  Thyroxine (T4)—secreted by thyroid follicles  Triiodothyronine (T3)—conversion of T4 at target tissues © 2015 Pearson Education, Inc. Figure 9.7b The thyroid gland. Colloid-filled Follicle cells follicles Parafollicular cells (b) Photomicrograph of thyroid gland follicles (380×) © 2015 Pearson Education, Inc. Thyroid Gland  Thyroid hormone disorders  Goiters  Thyroid gland enlarges because of lack of iodine  Salt is iodized to prevent goiters  Cretinism  Caused by hyposecretion of thyroxine  Results in dwarfism during childhood © 2015 Pearson Education, Inc. Figure 9.8 Woman with an enlarged thyroid (goiter). © 2015 Pearson Education, Inc. Thyroid Gland  Thyroid hormone disorders (continued)  Myxedema  Caused by hypothyroidism in adults  Results in physical and mental sluggishness  Graves’ disease  Caused by hyperthyroidism  Results in increased metabolism, heat intolerance, rapid heartbeat, weight loss, and exophthalmos © 2015 Pearson Education, Inc. Figure 9.9 The exophthalmos of Graves’ disease. © 2015 Pearson Education, Inc. Thyroid Gland  Calcitonin  Decreases blood calcium levels by causing calcium deposition on bone  Antagonistic to parathyroid hormone  Produced by parafollicular cells found between the follicles © 2015 Pearson Education, Inc. Figure 9.7b The thyroid gland. Colloid-filled Follicle cells follicles Parafollicular cells (b) Photomicrograph of thyroid gland follicles (380×) © 2015 Pearson Education, Inc. Parathyroid Glands  Tiny masses on the posterior of the thyroid  Secrete parathyroid hormone (PTH)  Stimulates osteoclasts to remove calcium from bone  Hypercalcemic hormone (increases blood calcium levels)  Stimulates the kidneys and intestine to absorb more calcium © 2015 Pearson Education, Inc. Figure 9.10 Hormonal controls of ionic calcium levels in the blood. Calcitonin Calcitonin stimulates calcium salt deposit in bone. Thyroid gland releases calcitonin. Stimulus Rising blood Ca2+ levels BALANCE Calcium homeostasis of blood: 9–11 mg/100 ml BALANCE Stimulus Falling blood Ca2+ levels Thyroid gland Osteoclasts degrade bone matrix and release Ca2+ into blood. Parathyroid glands PTH © 2015 Pearson Education, Inc. Parathyroid glands release parathyroid hormone (PTH). Adrenal Glands  Sit on top of the kidneys  Two regions: 1. Adrenal cortex—outer glandular region has three layers that produce corticosteroids  Mineralocorticoids are secreted by outermost layer  Glucocorticoids are secreted by middle layer  Sex hormones are secreted by innermost layer 2. Adrenal medulla—inner neural tissue region © 2015 Pearson Education, Inc. Figure 9.11 Microscopic structure of the adrenal gland. Adrenal gland Capsule Mineralocorticoidsecreting area Adrenal gland • Medulla • Cortex Cortex Kidney Adrenal cortex Sex hormone– secreting area Medulla Kidney © 2015 Pearson Education, Inc. Glucocorticoidsecreting area Adrenal medulla Hormones of the Adrenal Cortex  Mineralocorticoids (mainly aldosterone)  Produced in outer adrenal cortex  Regulate mineral content in blood, particularly sodium and potassium ions  Regulate water and electrolyte balance  Target organ is the kidney © 2015 Pearson Education, Inc. Hormones of the Adrenal Cortex  Release of aldosterone is stimulated by:  Humoral factors (fewer sodium ions or too many potassium ions in the blood)  Hormonal stimulation (ACTH)  Renin and angiotensin II in response to a drop in blood pressure  Aldosterone production is inhibited by atrial natriuretic peptide (ANP), a hormone produced by the heart when blood pressure is too high © 2015 Pearson Education, Inc. Figure 9.12 Major mechanisms controlling aldosterone release from the adrenal cortex. Decreased Na+ or increased K+ in blood Stress Hypothalamus Decreased blood volume and/or blood pressure Corticotropinreleasing hormone Anterior pituitary ACTH Kidney Renin Indirect stimulating effect via angiotensin Increased blood pressure or blood volume Heart Atrial natriuretic peptide (ANP) Angiotensin II Direct stimulating effect Inhibitory effect Mineralocorticoidproducing part of adrenal cortex Enhanced secretion of aldosterone targets kidney tubules Increased absorption of Na+ and water; increased K+ excretion © 2015 Pearson Education, Inc. Increased blood volume and blood pressure Hormones of the Adrenal Cortex  Glucocorticoids (including cortisone and cortisol)  Produced by middle layer of adrenal cortex  Promote normal cell metabolism  Help resist long-term stressors by increasing blood glucose levels (hyperglycemic hormone)  Anti-inflammatory properties  Released in response to increased blood levels of ACTH © 2015 Pearson Education, Inc. Hormones of the Adrenal Cortex  Sex hormones  Produced in the inner layer of the adrenal cortex  Small amounts are made throughout life  Mostly androgens (male sex hormones) are made, but some estrogens (female sex hormones) are also formed © 2015 Pearson Education, Inc. Adrenal Glands  Adrenal cortex disorders  Addison’s disease  Results from hyposecretion of all adrenal cortex hormones  Bronze skin tone, muscle weakness, burnout, susceptibility to infection  Hyperaldosteronism  May result from an ACTH-releasing tumor  Excess water and sodium are retained, leading to high blood pressure and edema © 2015 Pearson Education, Inc. Adrenal Glands  Adrenal cortex disorders (continued)  Cushing’s syndrome  Results from a tumor in the middle cortical area of the adrenal cortex  “Moon face,” “buffalo hump” on the upper back, high blood pressure, hyperglycemia, weakening of bones, depression  Masculinization  Results from hypersecretion of sex hormones  Beard and male distribution of hair growth © 2015 Pearson Education, Inc. Hormones of the Adrenal Medulla  Produces two similar hormones: (catecholamines) 1. Epinephrine (adrenaline) 2. Norepinephrine (noradrenaline)  These hormones prepare the body to deal with short-term stress (“fight or flight”) by:  Increasing heart rate, blood pressure, blood glucose levels  Dilating small passageways of lungs © 2015 Pearson Education, Inc. Figure 9.11 Microscopic structure of the adrenal gland. Adrenal gland Capsule Mineralocorticoidsecreting area Adrenal gland • Medulla • Cortex Cortex Kidney Adrenal cortex Sex hormone– secreting area Medulla Kidney © 2015 Pearson Education, Inc. Glucocorticoidsecreting area Adrenal medulla Figure 9.13 Roles of the hypothalamus, adrenal medulla, and adrenal cortex in the stress response. Short term Stress More prolonged Hypothalamus Releasing hormones Nerve impulses Spinal cord Corticotropic cells of anterior pituitary Preganglionic sympathetic Adrenal fibers medulla ACTH Adrenal cortex Mineralocorticoids Glucocorticoids Short-term stress response 1. Increased heart rate Catecholamines 2. Increased blood pressure (epinephrine and 3. Liver converts glycogen norepinephrine) to glucose and releases glucose to blood 4. Dilation of bronchioles 5. Changes in blood flow patterns, leading to increased alertness and decreased digestive and kidney activity 6. Increased metabolic rate © 2015 Pearson Education, Inc. Long-term stress response 1. Retention of sodium 1. Proteins and fats and water by kidneys converted to 2. Increased blood glucose or broken volume and blood down for energy pressure 2. Increased blood sugar 3. Suppression of immune system Pancreatic Islets  Pancreas  Located in the abdomen, close to stomach  Mixed gland, with both endocrine and exocrine functions  The pancreatic islets produce hormones  Insulin—produced by beta cells  Glucagon—produced by alpha cells  These hormones are antagonists that maintain blood sugar homeostasis © 2015 Pearson Education, Inc. Figure 9.14a Pancreatic tissue. Stomach Pancreas (a) © 2015 Pearson Education, Inc. Figure 9.14b Pancreatic tissue. Exocrine cells of pancreas (b) © 2015 Pearson Education, Inc. Pancreatic islets Figure 9.14c Pancreatic tissue. Exocrine cells of pancreas Alpha (𝛂) cells Capillaries (c) © 2015 Pearson Education, Inc. Cord of beta (𝛃) cells secreting insulin into capillaries Pancreatic Islets  Insulin  Released when blood glucose levels are high  Increases the rate of glucose uptake and metabolism by body cells  Glucagon  Released when blood glucose levels are low  Stimulates the liver to release glucose to blood, thus increasing blood glucose levels © 2015 Pearson Education, Inc. Homeostatic Imbalance  Diabetes mellitus  Occurs in the absence of insulin  Blood sugar levels increase dramatically  Blood glucose is lost in the urine; water follows  Three cardinal signs: 1. Polyuria 2. Polydipsia 3. Polyphagia © 2015 Pearson Education, Inc. Figure 9.15 Regulation of blood glucose levels by a negative feedback mechanism involving pancreatic hormones. Uptake of glucose from blood is enhanced in most body cells Insulin-secreting cells of the pancreas activated; release insulin into the blood Pancreas Insulin Tissue cells Glucose Glycogen Elevated blood sugar level Liver takes up glucose and stores as glycogen Stimulus Blood glucose level (e.g., after eating four jelly doughnuts) Stimulus Blood glucose level (e.g., after skipping a meal) Blood glucose rises to homeostatic set point; stimulus for glucagon release diminishes Liver breaks down glycogen stores and releases glucose to the blood © 2015 Pearson Education, Inc. Blood glucose falls to homeostatic set point; stimulus for insulin release diminishes Low blood sugar level Glucagon-releasing cells of pancreas activated; release glucagon into blood Glucose Glycogen Liver Glucagon Pineal Gland  Located posterior to the third ventricle of the brain  Secretes melatonin  Helps establish the body’s sleep/wake cycles as well as biological rhythms  Believed to coordinate the hormones of fertility in humans © 2015 Pearson Education, Inc. Figure 9.3 Location of the major endocrine organs of the body. Pineal gland Hypothalamus Pituitary gland Thyroid gland Parathyroid glands Thymus Adrenal glands Pancreas Ovary (female) Testis (male) © 2015 Pearson Education, Inc. Thymus Gland  Located posterior to the sternum  Largest in infants and children  Produces thymosin  Matures some types of white blood cells  Important in developing the immune system © 2015 Pearson Education, Inc. Gonads  Ovaries  Produce eggs  Produce two groups of steroid hormones: 1. Estrogens 2. Progesterone  Testes  Produce sperm  Produce androgens, such as testosterone © 2015 Pearson Education, Inc. Figure 9.3 Location of the major endocrine organs of the body. Pineal gland Hypothalamus Pituitary gland Thyroid gland Parathyroid glands Thymus Adrenal glands Pancreas Ovary (female) Testis (male) © 2015 Pearson Education, Inc. Hormones of the Ovaries  Estrogens  Stimulate the development of secondary female characteristics  Mature female reproductive organs  With progesterone, estrogens also  Promote breast development  Regulate menstrual cycle © 2015 Pearson Education, Inc. Hormones of the Ovaries  Progesterone  Acts with estrogen to bring about the menstrual cycle  Helps in the implantation of an embryo in the uterus  Helps prepare breasts for lactation © 2015 Pearson Education, Inc. Hormones of the Testes  Produce several androgens  Testosterone is the most important androgen  Responsible for adult male secondary sex characteristics  Promotes growth and maturation of male reproductive system  Required for sperm cell production © 2015 Pearson Education, Inc. Table 9.1 Major Endocrine Glands and Some of Their Hormones (1 of 5). © 2015 Pearson Education, Inc. Table 9.1 Major Endocrine Glands and Some of Their Hormones (2 of 5). © 2015 Pearson Education, Inc. Table 9.1 Major Endocrine Glands and Some of Their Hormones (3 of 5). © 2015 Pearson Education, Inc. Table 9.1 Major Endocrine Glands and Some of Their Hormones (4 of 5). © 2015 Pearson Education, Inc. Table 9.1 Major Endocrine Glands and Some of Their Hormones (5 of 5). © 2015 Pearson Education, Inc. Other Hormone-Producing Tissues and Organs  Parts of the small intestine  Parts of the stomach  Kidneys  Heart  Many other areas have scattered endocrine cells © 2015 Pearson Education, Inc. Placenta  Produces hormones that maintain pregnancy  Some hormones play a part in the delivery of the baby  Produces human chorionic gonadotropin (hCG) in addition to estrogen, progesterone, and other hormones © 2015 Pearson Education, Inc. Table 9.2 Hormones Produced by Organs Other Than the Major Endocrine Organs (1 of 3). © 2015 Pearson Education, Inc. Table 9.2 Hormones Produced by Organs Other Than the Major Endocrine Organs (2 of 3). © 2015 Pearson Education, Inc. Table 9.2 Hormones Produced by Organs Other Than the Major Endocrine Organs (3 of 3). © 2015 Pearson Education, Inc. Developmental Aspects of the Endocrine System  In the absence of disease, efficiency of the endocrine system remains high until old age  Decreasing function of female ovaries at menopause leads to such symptoms as osteoporosis, increased chance of heart disease, and possible mood changes © 2015 Pearson Education, Inc. Developmental Aspects of the Endocrine System  Efficiency of all endocrine glands gradually decreases with aging, which leads to a generalized increase in incidence of:  Diabetes mellitus  Immune system depression  Lower metabolic rate  Cancer rates in some areas © 2015 Pearson Education, Inc.
 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                            