NLEGIDE INSULIN: AKARA NA ỌGWỤGWỌ. NRI MAKA IGUZOGIDE INSULIN

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Nlegide insulin bu nzaghagharia ihe ndu ndu nke aru n’ahu na ihe oru insulin. Ọ baghị uru ebe insulin sitere, site na pancreas (endogenous) ma ọ bụ site na injections (exogenous).

Nchịkwa insulin na-abawanye ohere nke ọ bụghị naanị ọrịa shuga 2, kamakwa atherosclerosis, nkụchi obi, na ọnwụ mberede n'ihi arịa.

Ihe insulin na-eme bụ ịchịkwa metabolism (ọ bụghị naanị carbohydrates, kamakwa abụba na protein), yana usoro mitogenic - nke a bụ uto, ịmụpụta mkpụrụ ndụ, njikọ DNA, njikọ mkpụrụ ndụ.

Echiche ọgbara ọhụrụ nke nguzogide insulin anaghị ejedebe n’ọrịa metabolism na nsogbu dị n’arụ ọrịa shuga nke 2. Ọ na - agụnye mgbanwe na metabolism nke abụba, protein, gene igosipụta. Karịsịa, nguzogide insulin na-eduga ná nsogbu nke mkpụrụ ndụ endothelial, nke na-ekpuchi mgbidi nke arịa ọbara site n'ime. N'ihi nke a, oghere nke arịa ahụ na atherosclerosis na-aga n'ihu.

Ihe mgbaàmà nke nguzogide insulin na nchọpụta ọrịa

Enwere ike inyo gị enyo na ị nwere ọgwụ insulin ma ọ bụrụ na akara ngosi na / ma ọ bụ nyocha gosipụtara na ị nwere ọrịa metabolic syndrome. Ọ gụnyere:

oke ibu n’úkwù (n’ime afọ);
ọbara mgbali elu (ọbara mgbali elu);
nnwale ọbara na-adịghị mma maka cholesterol na triglycerides;
ịchọpụta protein n’ime mmamịrị.

Oké ibu n’afọ bụ isi ihe na-egosi. N’ebe nke abụọ bụ ọbara mgbali elu (ọbara mgbali elu). Obere oge, mmadụ anaghị enwe oke ibu na ọbara mgbali elu, mana nyocha ọbara maka kọlestrọl na abụba adịchaala njọ.

Testschọta nguzogide insulin site na iji ule bu nsogbu. N'ihi na itinye uche nke insulin na plasma ọbara nwere ike ịdị iche iche nke ukwuu, nke a bụkwa ihe dị mma. Mgbe ị na-enyocha insulin plasma na-ebu ọnụ, ụkpụrụ dị site na 3 ruo 28 mcU / ml. Ọ bụrụ na insulin dị ala karịa n'ọbara ibu ọnụ, ọ pụtara na onye ọrịa ahụ nwere hyperinsulinism.

Mmụba insulin dị n'ọbara na-eme mgbe pancreas rụpụtara ya nke ukwuu iji kwụọ ụgwọ nguzogide insulin na anụ ahụ. Nsonaazụ nyocha a na-egosi na onye ọrịa nwere nnukwu ihe ọghọm ụdị ọrịa shuga 2 na / ma ọ bụ ọrịa obi.

A na-akpọ usoro a ga-esi mee nyocha insulin iguzogide insulin na hyperinsulinemic insulin clamp. Ọ gụnyere nchịkwa ọbara ọbara nke insulin na glucose na-aga n'ihu ruo awa 4-6. Nke a bụ usoro na-agwụ ike, yabụ ọ na-adịkarịghị eji ya eme ihe. O bukwara ibu ọnụ nke insulin plasma ọbara na-ebu ọnụ

Nnyocha e mere egosiwo na achọpụtara insulin na-eguzogide:

10% nke mmadụ niile na-enweghị nsogbu metabolic;
n'ime 58% ndị ọrịa nwere ọbara mgbali elu (ọbara mgbali elu karịa 160/95 mm RT. Art.);
n'ime 63% nke ndị nwere hyperuricemia (serum uric acid karịrị 416 mmol / l n'ime ụmụ nwoke na karịa 387 mmol / l n'ime ụmụ nwanyị);
n’ime 84% ndị nwere abụba ọbara (triglycerides karịrị 2.85 mmol / l);
88% nke ndị nwere oke cholesterol dị mma (dị n'okpuru 0.9 mmol / L n'ime ụmụ nwoke na n'okpuru 1.0 mmol / L n'ime ụmụ nwanyị);
na 84% nke ndị ọrịa nwere ụdị shuga 2;
66% nke ndị mmadụ nwere nsogbu glucose na-emetụta ya.

I mee ule ọbara maka cholesterol - achọla cholesterol zuru ezu, mana iche “dị mma” na “jọrọ njọ”.

Otu insulin si achịkwa metabolism

Dị ka ọ na-adịkarị, mole insulin na-ekekọta ndị na-anabata ya n’elu mkpụrụ ndụ n’arụ, abụba, ma ọ bụ akwara umeji. Mgbe nke a gasịrị, autophosphorylation nke nnabata insulin na ntinye nke tyrosine kinase yana njikọ ya na ntinye nke insulin receptor 1 ma ọ bụ 2 (IRS-1 na 2).

Ihe ụmụ irighiri IRS, n’aka nke ya, na-arụ ọrụ phosphatidylinositol-3-kinase, nke na-akpali ntụgharị nke GLUT-4. Ọ bụ a na - ebu glucose n’ime sel n’agha. Usoro dị otú a na-enye nkwado nke metabolic (ntụgharị glucose, njikọ glycogen) na mitogenic (njikọta DNA) nke insulin.

Insulin na-akpali:

Ihe ndị na-akpali glucose site na mkpụrụ ndụ akwara, imeju na akwara adipose;
Nmekorita nke glycogen na imeju (nchekwa nke “ngwa ngwa” glucose na idobere);
Nchịkwa amino acid site na mkpụrụ ndụ;
Ngwakọta DNA;
Ntinye protein;
Ngwakọta mmanu acid;
Igafe Ion.

Insulin na - egbochi:

Lipolysis (mbibi nke anụ ahụ adipose na ntinye nke ọdụdụ abuba n'ime ọbara);
Gluconeogenesis (mgbanwe nke glycogen na imeju na glucose n'ime ọbara);
Apoptosis (mbibi nke mkpụrụ ndụ).

Mara na insulin na-egbochi ndakpọ nke anụ ahụ adipose. Ọ bụ ya mere, ọ bụrụ na ọkwa nke insulin na ọbara dị elu (hyperinsulinism bụ ihe na-eme ugboro ugboro na insulin na-eguzogide), mgbe ahụ ịtalata oke bụ ihe siri ike, ọ fọrọ nke nta ka ọ ghara ikwe omume.

Mkpụrụ ndụ ihe nketa na-akpata nguzogide insulin

Nmegide insulin bu nsogbu nke otutu mmadu. A kwenyere na ọ bụ mkpụrụ ndụ ihe nketa kpatara ya bụ mmalite nke mmalite. N'afọ 1962, a chọpụtara na ọ bụ usoro nchekwa ndụ n'oge agụụ. Maka na ọ na - eme ka abụba dị n’ahụ n’ahụ n’oge nri hiri nne.

Ndị ọkà mmụta sayensị agụụ ụmụ oke na-ata ụta ogologo oge. Ndị mmadụ lanarịrịnụ bụ ndị a chọpụtara na ha nwere ọgwụ mgbochi insulin. Ọ bụ ihe nwute, na ọnọdụ nke oge a, otu usoro ahụ “na-arụ ọrụ” maka mmepe nke oke ibu, ọbara mgbali elu, yana ụdị shuga 2.

Nnyocha e mere egosiwo na ndị ọrịa nwere ọrịa shuga nke 2 nwere ntụpọ mkpụrụ ndụ ihe nketa na mbufe ozi mgbe njikọ insulin na onye na-anabata ha. Nke a ka a na-akpọ ntụpọ postreceptor. Nke mbu, imeghari onye na - ebu glucose GLUT-4 na - akpaghasị.

N'ime ndị ọrịa nwere ụdị ọrịa shuga 2, a chọtara ngosipụta nke ụdị mkpụrụ ndụ ndị ọzọ na-enye metabolism nke glucose na lipids (abụba). Ndị a bụ mkpụrụ ndụ ihe nketa maka glucose-6-phosphate dehydrogenase, glucokinase, lipoprotein lipase, fatty acid synthase na ndị ọzọ.

Ọ bụrụ na mmadụ nwere ihe pụrụ ime ka mmadụ mata ọrịa shuga, ọ ga-amata ma ọ bụ ghara ịkpata ọrịa metabolic na ọrịa shuga. Ọ dabere na ụdị ibi ndụ. Ihe ndị kachasị n’ihe ndị dị ize ndụ bụ ihe oriri na-edozi ahụ, karịchaa oriri nke carbohydrates nụchara anụcha (sugar na ntụ ọka), yana mmega ahụ dị ala.

Kedu ihe bụ uche nke insulin na anụ ahụ dị iche iche

Maka ọgwụgwọ nke ọrịa, nnabata insulin nke akwara na anụ ahụ adipose, yana mkpụrụ ndụ imeju, bụ ihe kachasị mkpa. Ma ogo insulin iguzogide anụ ahụ ndị a bụ otu? Na 1999, nnwale gosiri na ọ dịghị.

Nọmalị, iji belata 50% nke lipolysis (nkwụsị abụba) na anụ ahụ adipose, ị nweta insulin na ọbara erughị 10 mcED / ml zuru ezu. Maka nnabata 50% maka ịhapụ glucose n'ime ọbara site na imeju, ihe dị ka 30 mcED / ml nke insulin n'ime ọbara ahụ ka achọrọ. Na iji bulie ume ume mmebi site na anụ ahụ akwara site na 50%, a chọrọ insulin insulin nke 100 mcED / ml ma dị elu.

Anyị na-echetara gị na lipolysis bụ mmebi nke anụ ahụ adipose. Ọrụ insulin na-egbochi ya, dịkwa ka imeju nke imeju si mepụta glucose. Na -emeju glucose umeji n’ọkpụkpụ site na insulin, n’aka nke ya, na-aba ụba. Biko rịba ama na n'ụdị ọrịa shuga abụọ nke ọrịa mellitus, ụkpụrụ egosipụtara maka insulin insulin n'ọbara ka agafere n'aka nri, yabụ,, iji mee ka mmụba nke insulin dị. Usoro a na-amalite ogologo oge tupu ọrịa shuga egosipụta onwe ya.

Mmetụta anụ ahụ anụ ahụ na insulin na-ebelata n'ihi na mkpụrụ ndụ ihe nketa, yana nke kachasị - n'ihi ụdị ndụ na-adịghị mma. Na njedebe, mgbe ọtụtụ afọ gasịrị, akwara kwụsịrị ịnagide oke nchegbu. Mgbe ahụ, ha na-achọpụta ụdị ọrịa shuga “ezigbo”. Ọ nwere uru dị ukwuu na onye ọrịa ahụ ma ọ bụrụ na ịmalite ọgwụgwọ nke metabolic syndrome dị ka o kwere mee.

Kedu ihe dị iche n'etiti nguzogide insulin na ọrịa metabolic syndrome

I kwesiri ịmara na a na-ahụkwa ọgwụ insulin n’etiti ndị mmadụ nwere nsogbu ahụ ike ọzọ na-etinyeghị na echiche nke “metabolic syndrome”. Nke a bụ:

polycystic ovary n'ime ụmụ nwanyị;
ọdịda odida nke akwara;
ọrịa na-efe efe;
glucocorticoid ọgwụ.

Nlegide insulin na-ebido n’oge ịtụrụ ime, na-agafekwa ịmụ nwa. Ọ na-ebili na nká. Ọ dabere na ụdị ndụ onye agadi na-ebi, ma ọ ga-ebute ụdị ọrịa shuga 2 na / ma ọ bụ ọrịa obi. Ke ibuotikọ emi “Mme usiene udọn̄ọ ke n̄kani owo”, afo oyokụt ata nti ifiọk.

Ihe kpatara ụdị ọrịa shuga 2

N'ime ụdị ọrịa shuga abụọ nke ọrịa mamellitus, nguzogide insulin nke akwara akwara, imeju na anụ ahụ adipose bụ ihe kachasị mkpa maka ọgwụgwọ. N'ihi nnwere onwe nke insulin, glucose dị ala na-abanye ma “na-anyụ ọkụ” n'ime sel ndị ahụ. N'ime imeju, maka otu ihe ahụ, arụ ọrụ nke glycogen na glucose (glycogenolysis) na-arụ ọrụ, yana njikọta glucose site na amino acids na “ngwaọrụ ndị ọzọ” (gluconeogenesis).

E gosipụtara insulin na-egbochi anụ ahụ adize na eziokwu ahụ na mmetụta antilipolytic na insulin na-ebelata. Na mbu, ihe ndi ozo bu mmeputa insulin na-abawanye. N'ọgwụgwụ nke ọrịa ahụ, abụba na-abawanye glycerin na abụba abụba n'efu. Ma n’oge a, ifelata abụghị otu ọ joyụ.

Glycerin na abụba bara ụba na-abanye umeji, ebe a na-emepụta lipoproteins dị ntakịrị ala. Ndị a bụ ururu emerụ ahụ nke etinyebere n'ahụ mgbidi nke akwara ọbara, na atherosclerosis na-aga n'ihu. Iri oke glucose, bụ́ nke na-apụta n'ihi glycogenolysis na gluconeogenesis, na-abanyekwa n'ọbara.

Ihe mgbaàmà nke ọrịa metabolic na ụmụ mmadụ ogologo oge tupu mmepe nke ọrịa shuga. N'ihi na insulin iguzogide afọ ndị a afọ site na-emeju ọgwụ mgbochi beta-cell na-emeju insulin. N'ime ọnọdụ a, enwere insulin n'ọbara - hyperinsulinemia.

Hyperinsulinemia nwere ọ̀tọ glucose ọbara nkịtị bụ ihe akara nke nguzogide insulin yana ihe na-eweta mmepe nke ọrịa shuga nke 2. Ka oge na-aga, mkpụrụ ndụ beta nke pancreas na-akwụsị ịnagide ibu ahụ, nke dị ọtụtụ oge karịa nke nkịtị. Ha na - emepụta insulin na-erughị ala, onye ọrịa ahụ nwere shuga dị n'ọbara na ọrịa shuga.

Nke mbu, usoro mbu nke insulin na-ata ahuhu, ya bu, nbuputa insulin n’ime obara n’ime nzaghachi maka nri. Secrezọ insulin a na-ahụkarị na ya si arụ ọrụ gabiga ókè. Mgbe ọ̀tụ̀tụ̀ shuga dị n'ọbara rịa, nke a na-akwalitekwu nnagide insulin ma na-egbochi ọrụ nke mkpụrụ ndụ beta n’ime ihe nzuzo nke insulin. A na-akpọ usoro a maka ibute ọrịa shuga “nsị glucose.”

Nsogbu Cardiovascular

A maara na na ndị ọrịa nwere ọrịa shuga 2, ọrịa obi na-abawanye ugboro 3-4, ma e jiri ya tụnyere ndị na-enweghị nsogbu metabolic. Ugbu a ọtụtụ ndị ọkà mmụta sayensị na ndị na-eme ihe kwenyesiri ike na insulin na-eguzogide ọgwụ na, ya na hyperinsulinemia bụ nnukwu ihe dị ize ndụ maka nkụchi obi na ọrịa strok. Ọzọkwa, ihe ize ndụ a esiteghị na onye ọrịa ahụ ebutela ọrịa shuga ma ọ bụ na ọ kpatara.

Kemgbe 1980s, nnyocha gosipụtara na insulin nwere mmetụta atherogenic kpọmkwem na mgbidi nke arịa ọbara. Nke a pụtara na ngwugwu atherosclerotic na imechi arịa nke arịa ahụ na-aga n'ihu n'okpuru ọrụ insulin n'ime ọbara na-agabiga n'ime ha.

Insulin na-ebute mmụba na ịkwaga akwara mkpụrụ ndụ na-akwọ mụrụmụrụ, njikọ nke lipids n'ime ha, ịba ụba fibroblasts, ịgbalite usoro coagulation ọbara, yana mbelata nke ọrụ fibrinolysis. Ya mere, hyperinsulinemia (mmụba nke insulin n'ọbara n'ihi nguzogide insulin) bụ ihe dị mkpa na-ebute mmepe nke atherosclerosis. Nke a na - eme ogologo oge tupu ụdị ọrịa shuga 2 dị na onye ọrịa.

Nnyocha na-egosi n'ụzọ doro anya njikọ dị n'etiti insulin riri oke na ihe ndị dị ize ndụ maka ọrịa obi. Nmegide insulin na-eduga n'eziokwu ahụ:

oke ibu n’ime afọ;
profaịlụ cholesterol ọbara na-akawanye njọ, na plasta “cholest ”rol na-etolite na mgbidi akwara ọbara;
enwere ike inye ọbara ọgbụgba n'ime arịa na-abawanye;
mgbidi carotid artery na-ebuwanye ibu (lumen nke akwara akwara).

E gosipụtara mmekọrịta a siri ike ma ndị ọrịa nwere ọrịa shuga 2 na ndị mmadụ n'otu n'otu.

Ọgwụ insulin na-eguzogide ọgwụ

Effectivezọ dị mma isi gwọọ nguzogide insulin n'oge mmalite nke ụdị shuga 2, yana ọ ka mma tupu ịmalite, bụ iji nri na-egbochi carbohydrates na nri gị. Iji bụrụ nke ziri ezi, nke a abụghị usoro ọgwụgwọ, kama ọ bụ ya bụ ịchịkwa, weghachite nguzozi ma ọ bụrụ na metabolism agbasaghị. Nri carbohydrate nwere obere ume na nguzogide insulin - a ga-agbado ya na ndụ.

Mgbe ụbọchị 3-4 nke mgbanwe na nri ọhụrụ, ọtụtụ ndị mmadụ na-achọpụta ndozi na ọdịmma ha. Mgbe izu isii ruo asatọ, ule gosiri na kọlestrọl “dị mma” n'ime ọbara na-ebili ma “ihe ọjọọ” ahụ daa. Ọkwa triglycerides n'ime ọbara na-agbadata dị ka o kwesịrị. Ọzọkwa, nke a na-eme mgbe ụbọchị 3-4 gachara, ma nyocha nke kọlestrọl ka emesịrị. N'ihi ya, a na-ebelata ihe egwu nke atherosclerosis ọtụtụ ugboro.

Enweghị ọgwụgwọ ọ bụla ugbu a maka nguzogide insulin. Ndị ọkachamara n'ihe banyere mkpụrụ ndụ ihe nketa na ihe ọmụmụ banyere ndụ na-arụ ọrụ na nke a. Nwere ike ijikwa nsogbu a nke ọma site na ị dietụ obere carbohydrate. Nke mbụ, ịkwesịrị ịkwụsị iri nri carbohydrates nụchara anụcha, ya bụ, shuga, ihe ndị na-atọ ụtọ na ngwaahịa ntụ ọka ọcha.

Ọgwụ Metforminum (siofor, glucophage) na-enye nsonaazụ dị mma. Jiri ya na nri, ọ bụghị kama ya, sorokwa dọkịta gị buru ụzọ mata ị takingụ ọgwụ. Kwa ụbọchị, anyị na-agbaso akụkọ banyere ọgwụgwọ ọgwụ mgbochi. Ọkpụkpụ mkpụrụ ndụ ihe ochie na microbiology na-arụ ezigbo ọrụ ebube. Ma enwere olile anya na n’afọ ndị na-abịanụ, ha ga-enwe ike idozi nsogbu a. You chọrọ ibu ụzọ mara - denye aha na akwụkwọ akụkọ anyị, ọ bụ n'efu.