Insulin eguzogide - ihe ọ bụ? The metabolic syndrome bụ insulin na-eguzogide

N'ihi na dị iche iche ndị mmadụ ji mgbanwe ike nke insulin na-akpali glucose uptake. Ọ dị mkpa ịmara na a nwere ike ịdị mmadụ a nkịtị uche na otu ma ọ bụ karịa nke mmetụta nke compound na n'otu oge - onye zuru iguzogide ndị ọzọ. Ọzọ, anyị nyochaa echiche nke "insulin na-eguzogide": ihe ọ bụ, otú ọ na-egosi.

Isi

Tupu na-emeso ndị echiche nke "insulin na-eguzogide", ihe ọ bụ na ihe àgwà na-eme, ọ ga-kwuru na nke a aghara bụghị ihe ọhụrụ. Karịa 50% nke ndị na-mgbali elu na-ata ahụhụ site na nsogbu a. Ọtụtụ mgbe, insulin na-eguzogide (nke ọ bụ, a ga-kọwara n'okpuru ebe a) na-hụrụ na ndị agadi. Ma mgbe ụfọdụ ọ na-ahụrụ na nwata. insulin na-eguzogide ọrịa mgbe ọ na-abụghị ahụrụ n'ihu, ọ dịghị-amalite na-egosi na a mebiri nke metabolic n'ibu. Ndị n'ihe ize ndụ na-agụnye ndị mmadụ na dyslipidemia ma ọ bụ isi glucose ndidi, ibu oké ibu, ọbara mgbali.

insulin eguzogide

Gịnị ka ọ bụ? Olee ihe ndị na-eme ndị mebiri? Metabolic syndrome nke insulin-eguzogide bụ na-ekwesịghị ịdị omume nke organism ka ihe nke onye nke ogige. The echiche bụ na ọdabara ka dị iche iche ndu mmetụta. Nke a, akpan akpan, na-akọ na mmetụta nke insulin na protein na lipid metabolism, site n'usoro okwu, na vaskụla endothelial ọrụ. Mkpọchị omume na-eduga onye na-abawanye na ọbara ịta nke compound chọrọ ikwu olu dị glucose. insulin na-eguzogide syndrome - a jikọrọ aghara. Ọ na-agụnye a mgbanwe glucose ndidi, ụdị 2 ọrịa shuga, dyslipidemia, ibu oké ibu. "Ọrịa X" na-agụnye ọdịdọ na-eguzogide nke glucose (insulin-ndabere).

mmepe usoro

Ofụri Esịt inyocha ya ọkachamara na ụbọchị na-emezughị. Ọrịa na-eduga mmepe nke insulin-eguzogide nwere ike ime ndị na-esonụ na-etoju:

• Ihe nnabata. Na nke a, na steeti gosiri mmekọrita ma ọ bụ ọnụ ọgụgụ nke na-anabata ya.
• N'ogo nke glucose iga. Na nke a, achọpụtara ọnụ nke GLUT4 ụmụ irighiri.
• Nga receptoral. Na nke a anyị na-ekwu banyere ọrịa ntutu ịdapụsị insulin.
• Postreceptor. Na nke a, e nwere a mebiri phosphorylation na-emeghasịkwa nke mgbaàmà nnyefe.

Abnormalities nke insulin ụmụ irighiri na-zuru ezu obere na-enweghị adakarị pụtara. ihe nnabata njupụta nwere ike ebelata na ọrịa n'ihi adịghị mma nzaghachi. Ọ bụ n'ihi na hyperinsulinemia. Ọtụtụ mgbe, ndị ọrịa nwere a ojuju na ihe nnabata nọmba moderately. Na nke a, na nzaghachi larịị na-adịghị na-ewere a criterion site nke ọ na-ekpebisi ihe ogo nwere insulin na-eguzogide. Na-akpata nsogbu na-ebelata site ọkachamara na-postreceptor imebi nnyefe. Site precipitating ihe, akpan akpan, na-agụnye:

• Ise siga.
• Mụbara TNF-Alfa ọdịnaya.
• Ibelata emega ahụ.
• Ịba kasịnụ nke ndị na-abụghị esterified ọdụdụ asịd.
• Age.

Ndị a bụ ndị isi ihe na nwere ike ịkpalite insulin na-eguzogide ndị ọzọ ọtụtụ ugboro karịa ndị ọzọ. Ọgwụgwọ-agụnye ngwa:

• Thiazide diuretics otu.
• Beta-adrenergic blockers.
• Nicotinic acid.
• Corticosteroids.

ụba insulin na-eguzogide

Mmetụta glucose metabolism n'akparamagwa adipose anụ ahụ, uru ahụ, na imeju na. Skeletal uru metabolizes dị 80% nke compound. The uru na nke a na-eme ka ihe dị mkpa isi iyi nke insulin eguzogide. Kpọọ nke glucose na mkpụrụ ndụ a rụrụ site pụrụ iche iga GLUT4 protein. Mgbe ihe nnabata na-arụ ọrụ site insulin triggered a usoro nke phosphorylation Jeremaya mere. Ha mesịrị ime ka translocation nke GLUT4 na cell akpụkpọ ahụ si cytosol. Ebe ọ bụ na glucose bụ ike ịbanye cell. Insulin eguzogide (ọnụego ga-gosiri dịrị gaba n'ime ebe) e mere site a ọnụ na ogo nke translocation nke GLUT4. Ọ na-e kwuru na ọnụ ke itinye n'ọrụ na glucose uptake. Yana a, e wezụga Ọrụ kpọọ nke glucose na elu anụ ahụ, mgbe hyperinsulinemia na-ewute hepatic glucose mmepụta. Na ụdị 2 ọrịa shuga ọ na-maliteghachiri.

ibu oké ibu

Ọ na-achọkwa na insulin na-eguzogide mgbe ezuru. Mgbe uku ndidi ibu 35-40% uche tụlee site 40%. Emi odude ke abdominal mgbidi abụba anụ ahụ nwere elu metabolic ọrụ karịa onye na bụ nke dị n'okpuru. N'oge ọgwụ kwuru gosiri na ubara ntọhapụ n'ime portal mgbasa ọdụdụ asịd si abdominal emep uta eri na-akpalite mmepụta nke imeju triglycerides.

adakarị ịrịba ama

Insulin eguzogide, nke mgbaàmà na-metụtara metabolic aghara nwere ike advantageously ga-enyo enyo na ọrịa na abdominal ibu oké ibu, gestational-arịa ọrịa shuga, a akụkọ ezinụlọ nke ụdị 2 ọrịa shuga, dyslipidemia na ọbara mgbali. Na n'ihe ize ndụ na ndị inyom na polycystic ovary syndrome (PCOS). N'ihi na eziokwu na ibu oké ibu na-eme ka a welara nke insulin na-eguzogide, ọ dị mkpa iji chọpụta ihe ndị e kere eke, na nke e nwere nkesa adipose anụ ahụ. Ya na ọnọdụ nwere ike ginekoidnomu - na ala akụkụ nke ahụ ahụ, ma ọ bụ humanoid ụdị - na n'ihu mgbidi nke peritoneum. Ìgwè ke elu ọkara nke ahụ nwere a ịrịba ama karị predictor nke insulin-eguzogide, gbanwere glucose ndidi na-arịa ọrịa shuga, ibu oké ibu karịa ala òkè. Iji mata ego nke abdominal abụba anụ ahụ nwere ike iji na-eso usoro: chọpụta ruru nke ukwu gbaa, hip gbaa na ọtụtụ BMI. Na udu nke 0,8 n'ihi na ndị inyom na 0,1 maka ndị ikom na ndị a ọtụtụ BMI ukwuu karịa 27 na-chọpụtara na abdominal ibu oké ibu na insulin eguzogide. Mgbaàmà ọrịa gosipụtara atugharị. Akpan akpan na akpụkpọ akara Wrinkled, ike ike hyperpigmented ebe. Ọtụtụ mgbe ha na-egosi na armpits, elbows, n'okpuru ara. Analysis nke insulin-eguzogide bụ a ngụkọta oge usoro. HOMA-Iye na gbakọọ dị ka ndị a: na-ebu ọnụ insulin (mu / L) x ebu ọnụ glucose (mmol / L). The nwetara n'ihi ekewa site 22,5. Nke ahụ ga-nwere insulin na-eguzogide index. Norma - <2,77. Mgbe a ndiiche na ntụziaka nke na-amụba uche nwere ike chọpụtara aghara arọ.

Ọrịa nke ndị ọzọ na usoro: atherosclerosis

Taa e nweghị otu nkọwa maka usoro nke mmetụta insulinorezistenotnosti meriri nke obi usoro. E nwere ike ịbụ a-emetụta atherogenesis. Ọ e mere site na ike nke insulin na-akpali njikọ nke lipids na mmiri nke proliferation nke ezigbo muscle na arịa mgbidi. Yana a nwere ike mere site na ọrịa mgbasi akwara metụtara metabolic ọrịa. Dị ka ihe atụ, ọ pụrụ ịbụ ọbara mgbali elu, dyslipidemia, mgbanwe glucose ndidi. Na pathogenesis nke ọrịa bụ nke otu dị mkpa isi ọrụ nke vaskụla endothelium. Ya ozi bụ ịnọgide na-enwe ụda ọbara ọwa site secreting neurotransmitters vasodilation na vasoconstriction. Na steeti iwu insulin -akpali ntụrụndụ nke ezigbo muscle emep uta eri arịa mgbidi atọhapụ nitric oxide (2). Ọzọkwa, ike aka endothelium-dabere vasodilation budata gbanwere na ọrịa na ibu oké ibu. The otu na-emetụta ọrịa na insulin eguzogide. Na mmepe nke akwara akwara ọdịda ime nkịtị stimuli, na mụbaa, ị nwere ike ikwu banyere mbụ ogbo microcirculatory ọrịa - microangiopathy. Nke a enweghị nchịkwa ọnọdụ a hụrụ na ọtụtụ ndị ọrịa na-arịa ọrịa shuga (-arịa ọrịa shuga mellitus).

Insulin eguzogide nwere ike ime ka atherosclerosis site na-enwe nsogbu na usoro nke fibrinolysis. Pai-1 (plasminogen activator inhibitor) dị elu kasịnụ ke ọrịa ọrịa na obese nondiabetic. Njikọ nke Pai-1 kpaliri proinsulin na insulin. Larịị nke fibrinogen na ndị ọzọ na procoagulant ihe nwekwara ụba.

Gbanwere glucose ndidi na ụdị 2 ọrịa shuga

Insulin eguzogide bụ a na-akpata tupu adakarị ngosipụta nke-arịa ọrịa shuga. Maka mbenata ịta nke glucose izute beta mkpụrụ ndụ na pancreas. Mbenata ịta a rụrụ site na ịba ụba na mmepụta nke insulin, nke n'aka nke na-eduga ná a ikwu hyperinsulinemia. Euglycemia nwere ike nọgidere na-enwe na ndị ọrịa ka ogologo dị ka mkpụrụ ndụ bụ beta na-enwe ike ịnọgide na-enwe dịtụ elu etoju nke plasma insulin imeri ndị na-eguzogide. Mee elu mee ala, ikike a na-efu, na ịta nke glucose enwekwu budata. Otu ihe bụ isi, nke bụ maka hyperglycemia na ihe efu afo on a ndabere nke ụdị 2 ọrịa shuga, insulin-eguzogide bụ imeju. Healthy omume bụ iji belata glucose mmepụta. Mgbe insulin na-eguzogide, mmeghachi omume na-efu. N'ihi ya, oké imeju glucose mmepụta na-aga n'ihu, na-akpata na-ebu ọnụ hyperglycemia. Na ọnwụ nke ike nke mkpụrụ ndụ bụ beta na-enye insulin hypersecretion n'egosi mgbanwe site insulin na-eguzogide na hyperinsulinemia ka gbanwere glucose ndidi. Mgbe e mesịrị, na steeti na-ghọọ a na-adakarị ọrịa shuga na hyperglycemia.

ọbara mgbali

E nwere ọtụtụ usoro na-eduga ya mmepe na ndabere nke insulin eguzogide. Kwuru na-egosi na-agwụ ike nke vasodilation na vasoconstriction ebighị pụrụ iso na-vaskụla eguzogide. Insulin akwalite akwara mmalite (ọmịiko) usoro. Nke a na-eduga onye na-abawanye na plasma nọrepinefrini ịta. Na ọrịa na insulin na-eguzogide ụba omume angiotensin. Ke adianade do, ndokwa nwere ike imebi vasodilation. The iwu obodo insulin-akpali ntụrụndụ nke vaskụla muscle mgbidi. Vasodilatation na nke a na-onye ogbugbo ya na ntọhapụ / ọgbọ nke endothelial nitric oxide. Na ọrịa na insulin eguzogide, endothelial ọrụ bụ isi. Nke a na-ebelata ihe vasodilation site 40-50%.

dyslipidemia

Mgbe insulin na-eguzogide akwusila nkịtị mmepụta suppression ọdụdụ free asịd mgbe eri si adipose anụ ahụ. Mụbara ịta na-arụpụta a mkpụrụ maka enwekwukwa njikọ nke triglycerides. Nke a bụ nzọụkwụ dị mkpa VLDL mmepụta. Mgbe hyperinsulinemia belata ọrụ nke otu ihe dị mkpa enzyme - lipoprotein lipase. N'etiti qualitative mgbanwe na ndabere ụdịdị dị iche iche LDL ụdị 2 ọrịa shuga na insulin na-eguzogide ga-kwuru ubara ogo ọxịdashọn nke LDL ahụ. More susceptible ka usoro a na-atụle glycated apolipoproteins.

ọgwụgwọ jikoro

Ịba insulin uche nwere ike nweta na ọtụtụ ụzọ. Of otu dị mkpa bụ Mbelata ke arọ na emega ahụ. Nri dịkwa mkpa maka ndị na-chọpụtara na insulin eguzogide. Diet eme ka stabilization na a ụbọchị ole na ole. Eme uche ọzọ ga-akwalite arọ ọnwụ. N'ihi na ndị mmadụ na a kpebisiri insulin eguzogide, ọgwụgwọ mejupụtara ọtụtụ nkebi. Stabilization nke nri na imega ahụ a na-ewere na-akpa ọgwụgwọ ogbo. N'ihi na ndị kwuru na insulin, nri kwesịrị ala-kalori. A na-agafeghị oke ọnụ ke arọ ahụ (5-10 kilogram) na-enyere aka mma akara nke glucose etoju. Calories 80-90% na-ekesa n'etiti carbohydrate na abụba, 10-20% si na-edozi.

ọgwụ

Pụtara "Metamorfin" na-ezo aka a ìgwè nke ọgwụ biguanide. The ọgwụ mma na elu na hepatic insulin uche. Na nke a ọ pụtara na ọ dịghị mmetụta ya secretion. Na-anọghị nke insulin nkwadebe "Metamorfin" adighi ike. Pụtara "Troglitazone" bụ nke mbụ agwọ ọrịa tiazolidinedionov otu nke a na-ekwe na-eji na USA. The ọgwụ enwekwu iga nke glucose. Nke a na-eleghị anya kpatara ebighị nke PPAR-gamma ihe nnabata. Ma si otú enwekwukwa GLUT4 okwu, nke n'aka nke na-eduga onye na-abawanye na insulin-kpaliri glucose kpọọ. N'ihi na ọrịa ndị na-enwe ihe insulin eguzogide, ọgwụgwọ nwere ike ndinọ na jikọtara. The n'elu n'aka ike ga-eji na Nchikota na a sulfonylurea, na mgbe ụfọdụ na onye ọ bụla ọzọ na-emepụta a synergistic mmetụta na plasma glucose na ndị ọzọ ọrịa. Ọgwụ "Metamorfin" na Nchikota na a sulfonylurea enwekwu secretion na insulin uche. Na nke a, glucose na-etoju ibelata mgbe nri na na ihe efu afo. Ọrịa ndị e kenyere Nchikota ọgwụgwọ, bụ ihe nkịtị ngosipụta nke hypoglycemia.