Insulin na-etinye aka na nhazi nke metabolism, nnyefe nnyefe nke ion, amino acids. Mmetụta insulin na metabolic metabolism siri ike ikwubiga. Ndị na-arịa ọrịa shuga na-egosikwa ihe ịrịba ama nke metabolism na-emejọ.
Achọpụtala shuga mellitus karịa oge na-adịbeghị anya. Ọrịa na-akpata ọrịa metabolism dị iche iche. Ọrịa shuga, ọrịa physiology nke nwere ike ịdị iche iche nke ukwuu, nọ n'ọnọdụ nke atọ mgbe ọrịa oncology na ọrịa obi. Enwere ihe dị ka nde mmadụ 100 na-arịa ọrịa shuga n'ụwa. Kwa afọ 10, ọnụ ọgụgụ ndị ọrịa shuga na-aghọ karịa ugboro abụọ.
Ndị mmadụ sitere na mba ndị ka na-emepe emepe na ihe ndị dịpụrụ adịpụ na mba ndị mepere emepe nọ n'ihe ize ndụ kasịnụ nke ọrịa Ọrịa metabolism na ọrịa shuga mellitus na-eduga n'ọrịa dị iche iche. Ọrịa shuga 2dị nke Abụọ na-emetụtakarị ndị mmadụ mgbe afọ iri anọ na anọ gachara.
Usoro nke insulin
N'afọ 1869, Langerhans chọtara agwaetiti dị na pancreas nke a mechara kpọwa ya aha ya. Ọ bịara mara na ọrịa shuga nwere ike ịpụta mgbe ewepụchara gland.
Insulin bụ protein, ya bụ, polypeptide nke nwere eriri A na B. Ejikọtara ha na agba agba abụọ na-emebi emebi. A maara ugbu a na mkpụrụ ndụ beta na-akpụzi ma na-echekwa ya. Insulin na-emegharị ya anya site na enzymes ndị na-eweghachi agbụ ma na-akpọ "insulinase." Ọzọkwa, enzymes proteolytic na-etinye aka na hydrolysis nke agịga n'akụkụ akụkụ dị ala.
Ekwenyere na isi ihe na - egbochi insulin insulin bụ n'ọbara n'onwe ya, yana homonụ hyperglycemic:
- adrenaline
- ACTH,
- cortisol.
TSH, catecholamines, ACTH, STH na glucagon n'ụzọ dị iche iche na-eme ka adenylcyclase dị na sel ahụ. Nke ikpeazụ na-eme ka e guzobe ọgwụ cyclic 3,5 adenosine monophosphate, ọ na - eme ka ihe ọzọ dị - protein kinase, ọ na - akpali microtubules beta-Islands, nke na - eduga n'ịbelata insulin.
Microtubules bụ usoro beta-cell nke na - eme ka insulin na - akpụkọta na mbụ na vesicles na akpụkpọ ahụ.
Ihe kachasị ike na - akwalite insulin bụ glucose ọbara.
Usoro nke insulin na-adabakwa na mmekọrịta dị na mmekọrịta nke onye mgbasa ozi intracellular 3,5 - GMF na 3,5 AMP.
Usoro nke metabolism metabolism
Insulin na-emetụta metabolism nke carbohydrates na ọrịa shuga. Isi ihe jikọrọ ọrịa a bụ ụkọ ihe a. Insulin nwere mmetụta dị ukwuu na metabolism metabolism, yana ụdị metabolism ndị ọzọ, ebe mmiri insulin na-ebelata, ọrụ ya na-ebelata, ma ọ bụ nnabata nke anụ ahụ na-adabere na mkpụrụ ndụ na - emebilata.
N'ihi mmebi nke metabolism metabolism na ọrịa shuga mellitus, ọrụ nke glucose na-eme ka mkpụrụ ndụ belata, olu ya na-abawanye n'ọbara, na usoro glucose na-anọpụ iche nke insulin na-arụ ọrụ.
Sorbitol shunt bụ ọnọdụ ebe a na-ebelata glucose na sorbitol, ma werezie ya mee ka ọ bụrụ fructose. Ma ọ bụrụ n’ịza ihe na - erugharị site na enzyme insulin. Mgbe agbanyere polyol shunt rụọ ọrụ, sorbitol na-agbakọta n'ime anụ ahụ, nke a na-enye aka n'ọdịdị nke:
- neuropathy
- katarayta
- microangiopathies.
Enwere glucose dị n’ime na protein na glycogen, mana ọbụna ụdị nke a nke goiukosis adịghị anabata mkpụrụ ndụ, ebe ọ bụ na enweghi insulin. Aerobic glycolysis na pentose phosphate shunt na-ebelata, hypoxia cell na ụkọ ike na-apụta. Olu nke hemoglobin nke glycated na-abawanye, ọ bụghị nke na-ebugharị oxygen, nke na-eme ka hypoxia dịkwuo elu.
A pụrụ imebi metabolism protein n'ime ọrịa shuga:
- hyperazotemia (ogo mụbara nitrogen residual nitrogen),
- hyperazotemia (mmụba nke olu nke ogige nitrogen ke ọbara).
Ntọala nke protein protein bụ 0.86 mmol / L, yana mkpokọta nitrogen kwesịrị ịbụ 0.87 mmol / L.
Ihe na-akpata pathophysiology bụ:
- ụba protein catabolism
- mmebi nke amino acid na imeju,
- Nri nitrogen.
Nitrogen na-abụghị protein:
- amino acid
- urea
- amonia
- creatinine.
Nke a bụ n'ihi oke mbibi nke protein, ọkachasị na imeju na akwara.
Na mmamịrị na-arịa ọrịa shuga, olu nke nitrogen ogige na-abawanye. Azoturia nwere ihe ndị a:
- mmụba na mkpokọta nke ngwaahịa na nitrogen n'ime ọbara, nzuzo ha na mmamịrị,
- A na-eji metabolism abụba na-emetụta oke nke ketonemia, hyperlipidemia, ketonuria.
Na ọrịa shuga, hyperlipidemia na-etolite, nke bụ mmụba nke ọbara nke ọkwa lipid. Ọnụ ọgụgụ ha karịrị nke nkịtị, ya bụ, karịa 8 g / l. Ọrịa hyperlipidemia dị adị:
- anụ ahụ na-eme ka lipolysis,
- mgbochi nke lipid site na mkpụrụ ndụ,
- ụba cholesterol njikọ,
- mgbochi nke nnyefe nke oke ọdụdụ asịd na sel,
- mbelata nke ọrụ LPLase,
- ketonemia - mmụba nke olu nke ketone n'ime ọbara.
N'ime otu ahu ketone:
- acetone
- acetoacetic acid
- p-hydroxymalic acid.
Mkpokọta olu nke ketone n'ime ọbara nwere ike ịdị elu karịa 30-50 mg%. Enwere ihe kpatara nke a:
- lipolysis,
- na-abawanye ụba n’ime mkpụrụ ndụ abụba,
- nkwusioru nke lipid synthesis,
- mbelata nke ọxuru nke acetyl - CoA na hepatocytes na usoro nke aru ketone,
Itinye ahụ ketone ọnụ na mmamịrị bụ ngosipụta nke ọrịa shuga nke ọrịa na - adịghị mma.
Ihe kpatara ketonuria:
- ọtụtụ ketone ozu ndị a na-egbu egbu n'ime akụrụ,
- nsogbu nke metabolism mmiri na-arịa ọrịa shuga, nke polydipsia na polyuria gosipụtara,
Polyuria bụ nje na-egosipụta n'ụkpụrụ na mmpụta mmamịrị na elu karịa ụkpụrụ dị mma. N'okpuru ọnọdụ nkịtị, a na-ahapụ 1000 ka 1200 ml n'otu ụbọchị.
Na-arịa ọrịa shuga, diureis kwa ụbọchị bụ 4000-10 000 ml. Ihe kpatara ya bu:
- Hyperosmia nke mmamịrị, nke na - apụta n'ihi mwepụ nke glucose, ion, CT na mmiri ọgwụ. Ya mere, nnomi mmiri na glomeruli na-akpali ma na-egbochi imeghari ya,
- Mmebi nke reabsorption na excretion, nke kpatara ọrịa neuropathy mamịrị,
- Polydipsia.
Insulin na abụba metabolism
N'okpuru mmetụta nke insulin, imeju nwere ike ịchekwa naanị obere glycogen. Ọkpụkpụ glucose nke na-abanye n’arụ ga-amalite ịmị mkpụrụ nke ọ bụla ma sikwa otú a nọrọ ya n’ime sel, mana a gbanwere ha ka abụba, karịa glycogen.
Mgbanwe a na abụba bụ nsonaazụ insulin, ọbara na ebido na usoro nke abụba na-ebuga ya na anụ ahụ adi adi. N'ime ọbara, abụba bụ akụkụ nke lipoproteins, nke na-arụ ọrụ dị mkpa na ịmepụta atherosclerosis. N'ihi usoro ogwu a, o nwere ike bido:
- embolism
- obi ọgụ.
Nmepụta insulin na sel sel adipose yiri mmetụta ya na mkpụrụ ndụ imeju, mana ịmalite abụba na imeju na-arụ ọrụ karịa, ya mere a na-ebugharị ya na ya na adipose anụ ahụ. A na-echekwa abụba dị n'ime sel dị ka triglycerides.
N'okpuru mmetụta nke insulin, a na-ebelata mmebi nke triglycerides na adipose anụ ahụ n'ihi mgbochi nke lipase. Na mgbakwunye, insulin na-eme ka njikọ nke abụba abụba na-arụ ọrụ ma na-etinye ya na glycerol, nke achọrọ maka njikọ nke triglycerides. N'ihi ya, ka oge na-aga, abụba na-agbakọta, gụnyere physiology nke ọrịa shuga mellitus.
Mmetụta insulin na abụba metabolism nwere ike ịgbaghari, site na ọkwa ya dị ala, triglycerides na-ekezi ọzọ abụba na glycerol. Nke a bụ n'ihi eziokwu ahụ bụ na insulin na-egbochi lipase na lipolysis na-arụ ọrụ mgbe ọ na-ebelata olu ya.
Agwukwo ahiri nke nwere abuba, nke edobere n’oge hydrolysis nke triglycerides, n’otu oge abanye n’ime obara, a na-ejikwa ya isi iyi nke akwara. Ochicha nke acid a nwere ike diri n’ime sel niile, ewepu sel akwara.
Nnukwu mmanụ nke abụba na-ewepụta mgbe enweghi insulin site na abụba abụba na-abanye ọzọ. Mkpụrụ ndụ akwara nwere ike ime ka ihe na - eme ka mmadụ nwee ike ime ihe ọbụla ma mmadụ ịnọ insulin. N'inweghi ihe a, a na-anakọta abụba na-apụtaghị na ihe mgbochi n'ime imeju n'ụdị triglyceride.
Maka nke a, ndị na - enwe insulin, na-agbanyeghịkarị ifelata, na-ebu oke ibu.
Ọkpụkpụ na - eme ka ọ dị n ’ike na - arụ ọrụ na ume ọrụ
Na ọrịa shuga, a na-ebelata insulin glucagon index. Nke a bụ n'ihi mbelata insulin insulin, yana mmụba nke mmepụta glucagon.
A na-egosipụta nrịba nke metabolism lipid na mellitus ọrịa shuga na mkpalite adịghị ike nke nchekwa na ịba ụba nke mkpokọta nke nchekwa. Mgbe ị risịrị nri, na steeti postabsorption bụ:
- imeju
- akwara
- anụ ahụ adị.
Ngwa nri na ngwu ha di n’ime, karia ka ha chekwaa ya dika fats na glycogen, na-ekesa n’ime obara. Usoro cyclic na-ebilitekwa ruo n’ókè ụfọdụ, dịka ọmụmaatụ, usoro nke gluconeogenesis na glycolysis na-eme n’otu oge, yana usoro ọgbụgba abụba na njikọ.
Characteridị ọrịa shuga niile na-amata nnabata glucose dị ala, ya bụ, hyperglucoseemia mgbe ị risịrị nri ma ọ bụ ọbụlagodi afọ efu.
Ihe na - akpata hyperglucoseemia bụ:
- ojiji nke adipose akwara na akwara di nkpa, ebe n’enweghi insulin HLBT-4 ekpughere n’elu adipocytes na myocytes. Enweghị ike ichekwa glucose dị ka glycogen,
- Ejighị glucose na imeju maka ịchekwa n'ụdị glycogen, n'ihi na n'ibu insulin na obere olu glucagon, glycogen synthase adịghị arụ ọrụ,
- Ejighị glucose imeju maka njikọ abụba. Glycolysis na enzymes dehydrogenase dehydrogenase dị n'ụdị. A na-egbochi ntụgharị nke glucose na acetyl-CoA, nke dị mkpa maka njikọ nke ọdụdụ abụba,
- a na-eme ka ụzọ gluconeogenesis rụọ ọrụ na mkpụmkpụ nke insulin na glucagon dị elu na njikọ glucose site na glycerol na amino acid ga-ekwe omume.
Ngosiputa ozo gosiputara oria shuga bu ogo nke lipoproteins, aru nke ketone na acids nke abuba n’efu. A naghị edobe abụba a na-eri nri n'ime anụ ahụ adipose n'ihi na adipocyte lipase dị arụ ọrụ.
Ọdịnaya nke abụba abụba dị n'ime ọbara na-apụta. Ọkpụkpụ na-amịrị abụba na-adọrọ adọrọ, ụfọdụ n'ime ha na-agbanwegharị na triacylglycerols, ha na-abanye n'ọbara dị ka akụkụ nke VLDL. Otu oke abụba na-abanye na β-oxidation na imeju mitochondria, a na-ejikwa acetyl-CoA guzobere maka njikọ nke ahụ ketone.
Nsonaazụ nke insulin na metabolism dịkwa na eziokwu ahụ bụ na na ntinye nke insulin n'ụdị anụ ahụ dị iche iche, arụ ọrụ abụba na mmebi nke libids triglyceride na-eme ngwa ngwa. Ọ na - eme ka abụba ghara ịdị nkọ, ebe a na --emeju anụ ume.
Ọdịdị gabigara ókè nke cAMP na-eduga n'ịbelata njikọta protein na ibelata HDL na VLDL. N'ihi mbelata nke HDL, mbelata nke cholesterol site na membranes cell n’ime plasma ọbara na-ebelata. Cholesterol amalite itinyebere na mgbidi nke obere arịa, nke na-eduga n'ịbepụta ọrịa angiopathy na atherosclerosis.
N'ihi mbelata nke VLDL - abụba na-agbakọ na imeju, a na-apụkarị ya dịka akụkụ nke VLDL. A na-ebelata protein protein, nke na-ebute mbelata nke mgbochi, na mgbe ahụ, ndị ọrịa shuga ezughị oke maka ọrịa na-efe efe. A maara na ndị nwere metabolism na-emetụta protein na-arịa ọrịa furunculosis.
Nsogbu enwere ike
Microangiopathy bụ ọrịa mamịrị glomerulonephritis. N'ihi ọrịa mamịrị retinopathy nke ọrịa mamịrị, ndị na-arịa ọrịa shuga na-efunahụ ọhụụ na 70-90% nke ikpe. Karịsịa, ndị ọrịa mamịrị na-ebute ọnya.
N'ihi enweghi nke HDL, cholesterol riri oke na-eme n'ime sel. Yabụ, ọrịa obi obi ma ọ bụ ikpuchi endarteritis nwere ike ịpụta. Na nke a, etolite microangiopathy na nephritis.
Na ọrịa shuga, ọrịa ọgbụgba na-ebute gingivitis - periodontitis - ọrịa periodontal. N'ime ndị ọrịa mamịrị, usoro ezé na-ama jijiji ma na-emetụta nsị anụ ahụ.
Ihe na - akpata pathology nke microvessels n'ọnọdụ ndị a, o yikarịrị, bụ njikọ nke njikọta glucose na protein nke akwara mgbidi. N'okwu a, platelet na - ezobe ihe na - akpali uto nke akwara anụ ahụ dị larịị.
A na - egosipụtakwa nsogbu nke metabolism na eziokwu na mmebi imeju na - abawanye na imeju, lipid resynthesis. Dị ka ọ na-adịkarị, a na - apịpụ ha n'ụdị VLDL, usoro nke dabere na oke protein. Maka nke a, achọrọ ndị na-enye onyinye otu CHZ, ya bụ, choline ma ọ bụ methionine.
Ngwakọta choline na-akpali lipocaine, nke epithelium nke pancreatic na-emepụta. Enweghi ya na - ebute oke ibu nke imeju yana ịmalite ụdị ọrịa shuga na ngụkọta.
Enweghị insulin na-eduga na iguzogide ọrịa ndị na-efe efe. Ya mere, etolite ahihia.
Vidio dị n’isiokwu a ga-ekwu banyere nsonaazụ insulin n’ahụ.
