UKUMELANA NE-INSULIN: IZIMPAWU NOKWELASHWA. UKUDLA KOKUMELANA NE-INSULIN

Send

Ukumelana ne-insulin kungukuphazamiseka okungokwemvelo kokuphendula kwezicubu zomzimba esenzweni se-insulin. Akukhathalekile ukuthi i-insulin ivelaphi, i-pancreas (endo native) noma kumijovo (exo native).

Ukumelana ne-insulin kukhulisa amathuba okuthi kungabi ngohlobo 2 lwesifo sikashukela kuphela, kodwa futhi ne-atherosclerosis, ukushaya kwenhliziyo, nokufa okungazelelwe ngenxa yomkhumbi ovalekile.

Isenzo se-insulin ukulawula i-metabolism (hhayi kuphela ama-carbohydrate, kodwa namafutha namaprotheni), kanye nezinqubo ze-mitogenic - lokhu ukukhula, ukuzalwa kabusha kwamangqamuzana, ukwakheka kwe-DNA, okubhalwe ku-gene.

Umqondo wesimanje wokumelana ne-insulin awulinganiselwe ekuphazamiseni i-carbohydrate metabolism kanye nengozi eyengeziwe yohlobo 2 sikashukela. Kubandakanya nezinguquko ekutholakaleni kwamafutha, amaprotheni, isakhi sofuzo. Ikakhulu, ukumelana ne-insulin kuholela ezinkingeni ngama-endothelial cell, amboza izindonga zemithambo yegazi evela ngaphakathi. Ngenxa yalokhu, i-lumen yemikhumbi iyancipha, futhi i-atherosulinosis iyaqhubeka.

Izimpawu zokumelana ne-insulin nokuxilongwa

Ungasolwa ngokuba nokuvimbela i-insulin uma izimpawu kanye / noma ukuhlolwa kukhombisa ukuthi une-metabolic syndrome. Kufaka:

ukukhuluphala okhalweni (isisu);
umfutho wegazi ophakeme (umfutho wegazi ophakeme);
ukuhlolwa kwegazi okungekuhle kwe-cholesterol ne-triglycerides;
ukutholwa kwamaprotheni emchameni.

Ukukhuluphala kwesisu wuphawu oluphambili. Endaweni yesibili yi-arterial hypertension (umfutho wegazi ophezulu). Ngokuvamisile, umuntu akakabi nokukhuluphala kanye nomfutho wegazi ophakeme, kepha ukuhlolwa kwegazi kwe-cholesterol namafutha sekuvele kubi.

Ukuxilonga ukumelana ne-insulin usebenzisa izivivinyo kuyinkinga. Ngoba ukugcwala kwe-insulin epulini yegazi kungahluka kakhulu, futhi lokhu kuvamile. Lapho uhlaziya i-insulin ye-plasma yokuzila ukudla, okujwayelekile kuvela ku-3 kuye ku-28 mcU / ml. Uma i-insulin ingaphezu kokujwayelekile egazini lokuzila, kusho ukuthi isiguli sine-hyperinsulinism.

Ukwanda kwe-insulin egazini kwenzeka lapho ama-pancreas ekhiqiza ngokweqile kwalo ukuze kunxephezele ukumelana ne-insulin kwezicubu. Lo mphumela wokuhlaziya uveza ukuthi isiguli sinobungozi obukhulu besifo sikashukela sohlobo 2 kanye / noma isifo senhliziyo.

Indlela eqondile yelebhu yokunquma ukumelana ne-insulin ibizwa ngokuthi i-hyperinsulinemic insulin clamp. Kubandakanya ukuphathwa okuqhubekayo kwe-insulin ne-glucose amahora angama-4-6. Le ndlela enzima, ngakho-ke ayisetshenziswa kakhulu ekuzenzeni. Kukhawulelwe kumazinga we-insulin wegazi okusheshayo

Ucwaningo luye lwabonisa ukuthi i-insulin ukumelana iyatholakala:

I-10% yabo bonke abantu ngaphandle kwezinkinga ze-metabolic;
e-58% yeziguli ezinomfutho wegazi ophakeme (umfutho wegazi ngaphezu kwe-160/95 mm RT. Art.);
kuma-63% abantu abane-hyperuricemia (i-serum uric acid ingaphezulu kuka-416 mmol / l emadodeni futhi ngaphezulu kwe-387 mmol / l kwabesifazane);
kuma-84% abantu abanamafutha egazi aphezulu (ama-triglycerides amakhulu kuno-2.85 mmol / l);
Ama-88% abantu abanamazinga aphansi we- “good” cholesterol (ngaphansi kuka-0.9 mmol / L emadodeni nangaphansi kwe-1.0 mmol / L kwabesifazane);
kuma-84% eziguli ezinesifo sikashukela sohlobo 2;
I-66% yabantu abanokubekezelela i-glucose engabekezeleleki.

Lapho uthatha ukuhlolwa kwegazi kwe-cholesterol - ungabheki i-cholesterol ephelele, kodwa ngokuhlukile "okuhle" futhi "kubi".

I-insulin ilawula kanjani imetabolism

Imvamisa, i-molecule ye-insulin ibopha i-receptor yayo ngaphezulu kwamaseli emisipha, emafutheni, noma kwesibindi. Ngemuva kwalokhu, i-autophosphorylation ye-insulin receptor ngokubamba iqhaza kwe-tyrosine kinase kanye nokuxhumeka kwayo okulandelayo ne-substrate ye-insulin receptor 1 noma 2 (IRS-1 no 2).

Ama-molecule we-IRS, wona asebenze i-phosphatidylinositol-3-kinase, ekhuthaza ukudluliselwa kwe-GLUT-4. Kuthwala ushukela ukungena esitokisini ngokusebenzisa ulwelwesi. Umshini onjalo unikeza ukusebenza kwe-metabolic (ushukela weglue, synthesis ye-glycogen) kanye ne-mitogenic (i-DNA synthesis) imiphumela ye-insulin.

I-insulin iyakhuthaza:

Ukuthathwa kwe-glucose ngamaseli emisipha, isibindi nezicubu ze-adipose;
I-synthesis ye-glycogen esibindini (isitoreji se-glucose "esheshayo" esitoreni);
Ukuthathwa kwama-amino acid ngamaseli;
Ukuhlanganiswa kwe-DNA;
Ukuhlanganiswa kwamaprotheni;
Amafutha e-Fatty acid;
Ukuthuthwa kwe-Ion.

I-insulin iyacindezela:

I-lipolysis (ukubola kwezicubu ze-adipose ngokufakwa kwama-acid acid egazini);
I-Gluconeogenesis (ukuguqulwa kwe-glycogen esibindini kanye noshukela egazini);
I-Apoptosis (ukuzenzakalisa kwamaseli).

Qaphela ukuthi i-insulin ivimba ukuqhekeka kwezicubu ze-adipose. Kungakho, uma izinga le-insulin egazini liphakeme (i-hyperinsulinism yenzeka kaningi ngokumelana ne-insulin), khona-ke ukwehlisa isisindo kunzima kakhulu, cishe akunakwenzeka.

Izimbangela zofuzo zokumelana ne-insulin

Ukumelana ne-insulin kuyinkinga yamaphesenti amakhulu abo bonke abantu. Kukholelwa ukuthi kubangelwa izakhi zofuzo ezaqala ukwenzeka ngesikhathi sokuvela kwemvelo. Ngo-1962, kwabikwa ukuthi kwakuyindlela yokusinda ngenkathi yendlala ende. Ngoba kuthuthukisa ukunqwabelana kwamafutha emzimbeni ngezikhathi zokudla okuningi.

Ososayensi babulawa yindlala isikhathi eside. Abantu abasinde kunabo bonke yilabo okwatholakala ukuthi banokuphikisana ne-insulin ngokwezakhi zofuzo. Ngeshwa, ezimweni zesimanje, inqubo efanayo "isebenza" ukuthuthukisa ukukhuluphala, umfutho wegazi ophakeme kanye nohlobo 2 sikashukela.

Ucwaningo luye lwabonisa ukuthi iziguli ezinesifo sikashukela sohlobo 2 zinesici sofuzo ekuhanjisweni kwesiginali ngemuva kokuxhuma kwe-insulin ne-receptor yazo. Lokhu kubizwa ngokuthi yiphutha le-postreceptor. Okokuqala, ukudluliselwa kwe-glucose transporter i-GLUT-4 kuyaphazamiseka.

Ezigulini ezinesifo sikashukela sohlobo 2, kwatholakala nezinye izakhi zofuzo ezihlinzeka ngemizwa ye-glucose ne-lipids (amafutha). Lezi yizinhlobo ze-glucose-6-phosphate dehydrogenase, glucokinase, lipoprotein lipase, i-fatty acid synthase nabanye.

Uma umuntu enesimo sofuzo sokuhlakulela isifo sikashukela sohlobo 2, lokho kungahle kutholakale noma kungabangeli isifo sikashukela nesifo sikashukela. Kuya ngempilo. Izici eziyingozi ezinkulu wukudla ngokweqile, ikakhulukazi ukusetshenziswa kwama-carbohydrate (ushukela nefulawa), kanye nokuzivocavoca okuphansi komzimba.

Kuyini ukuzwela kwe-insulin kwezicubu zomzimba ezahlukahlukene

Ukwelashwa kwezifo, ukuzwela kwe-insulin kwezicubu zemisipha ne-adipose, kanye namaseli wesibindi, kubaluleke kakhulu. Kodwa ingabe izinga lokuphikiswa kwe-insulin kwalezi izicubu liyefana? Ngo-1999, izivivinyo zabonisa ukuthi cha.

Imvamisa, ukucindezela ama-50% we-lipolysis (ukuqhekeka kwamafutha) kwezicubu ze-adipose, ukugcwala kwe-insulin egazini okungeqi kwe-10 mcED / ml kwanele. Ngokucindezela kwe-50% kokukhishwa kweglucose egazini ngesibindi, cishe i-30 mcED / ml ye-insulin egazini isivele iyadingeka. Futhi ukwandisa ukuthathwa kwe-glucose ngezicubu zemisipha ngo-50%, kudingeka i-insulin yokuhlushwa kwe-100 mcED / ml nangaphezulu.

Sikukhumbuza ukuthi i-lipolysis ukwephulwa kwezicubu ze-adipose. Isenzo se-insulin siyasinciphisa, njengoba kwenza ukukhiqizwa kweglue ngesibindi. Futhi ukuthathwa kwe-glucose yemisipha yi-insulin, kunalokho, kuyanda. Uyacelwa uqaphele ukuthi ngohlobo lwe-2 mellitus yesifo sikashukela, amanani akhonjisiwe wokuhlushwa okudingekayo kwe-insulin egazini ayashintshelwa kwesokudla, isb., Ekukhuleni kokungamelana ne-insulin. Le nqubo iqala kudala ngaphambi kokuthi isifo sikashukela siziveze.

Ukuzwela kwezicubu zomzimba kuyi-insulin kwehla ngenxa yofuzo olwenzeka kusengaphambili, futhi okubaluleke kakhulu - ngenxa yendlela yokuphila engenampilo. Ekugcineni, ngemuva kweminyaka eminingi, ama-pancreas ayeka ukubhekana nengcindezi eyandayo. Ngemuva kwalokho bathola isifo sikashukela “sangempela”. Kuyasiza kakhulu esigulini uma ukwelashwa kwe-metabolic syndrome kuqale ekuqaleni.

Uyini umehluko phakathi kokumelana ne-insulin ne-metabolic syndrome

Kufanele wazi ukuthi ukumelana ne-insulin kutholakala nakubantu abanezinye izinkinga zezempilo abangafakiwe kumqondo we- “metabolic syndrome”. Lokhu:

i-polycystic ovary kwabesifazane;
ukwehluleka okungapheli kwezinso;
izifo ezithathelwanayo;
i-glucocorticoid therapy.

Ukumelana ne-insulin kwesinye isikhathi kukhula ngesikhathi sokukhulelwa, bese kudlula ngemuva kokubeletha. Ngokuvamile kuvuka ngeminyaka. Futhi kuncike ekutheni iyiphi indlela umuntu okhulile aholela ngayo, noma ngabe izobangela isifo sikashukela 2 kanye / noma izinkinga zenhliziyo. Esihlokweni esithi "Isifo sikashukela asebekhulile" uzothola imininingwane eminingi ewusizo.

Imbangela yesifo sikashukela sohlobo 2

Kuhlobo 2 sikashukela mellitus, ukumelana ne-insulin kwamaseli emisipha, isibindi nezicubu ze-adipose kubaluleke kakhulu emtholampilo. Ngenxa yokulahleka kokuzwela kwe-insulin, ushukela omncane uyangena futhi “uyasha” kumaseli emisipha. Esibindini, ngesizatho esifanayo, ukubola kwe-glycogen to glucose (glycogenolysis) kuyasebenza, kanye nokwakheka kweglucose kusuka kuma-amino acid nakwezinye “izinto zokusetshenziswa” (gluconeogenesis).

Ukuphikiswa kwe-insulin kwezicubu ze-adipose kubonakaliswa eqinisweni lokuthi umphumela wokuphikisana ne-insulin uya buthaka. Ekuqaleni, lokhu kususwa ngokukhishwa okwenziwe nge-pancreatic insulin. Ezigabeni zakamuva zesifo, amafutha amaningi avele e-glycerin kanye nama-acid wamahhala. Kepha ngalesi sikhathi, ukunciphisa umzimba akuyona injabulo ethile.

Ama-glycerin namafutha acishe amahhala angena esibindini, lapho kukalwa khona ama-lipoprotein aphansi kakhulu kuwo. Lezi izinhlayiya eziyingozi ezibekwe odongeni lwemithambo yegazi, futhi i-atherosulinosis iyaqhubeka. Inani ngokweqile le-glucose, okuvela njengomphumela we-glycogenolysis ne-gluconeogeneis, nalo lingena ligazi lisuka esibindini.

Izimpawu ze-metabolic syndrome kubantu isikhathi eside zandulela ukuthuthukiswa kwesifo sikashukela. Ngoba ukumelana ne-insulin eminyakeni edlule kususwe ukukhiqizwa ngokweqile kwe-insulin kwe-pancreatic. Kulesi simo, kunokwanda kwe-insulin egazini - hyperinsulinemia.

I-Hyperinsulinemia enamazinga weglucose ejwayelekile uphawu lokumelana ne-insulin kanye ne-harbinger yentuthuko yesifo sikashukela sohlobo 2. Ngokuhamba kwesikhathi, amaseli we-beta we-pancreas ayeka ukubhekana nomthwalo, ophindwe kaningi kunokujwayelekile. Bakhiqiza i-insulin engaphansi nengaphansi, isiguli sinoshukela wegazi ophezulu noshukela.

Okokuqala, isigaba sokuqala se-insulin secretion sine, i.e., ukukhishwa ngokushesha kwe-insulin egazini ngokuphendula umthwalo wokudla. Futhi ukuvikela okuyisisekelo kwe-insulin kuhlala ngokweqile. Lapho izinga likashukela wegazi likhuphuka, lokhu kuthuthukisa futhi ukumelana ne-tisulin insulin futhi kuvimbela umsebenzi wamaseli we-beta ekusithekeni kwe-insulin. Le ndlela yokwakha ushukela ibizwa ngokuthi “ubuthi be-glucose.”

Ingozi yenhliziyo

Kuyaziwa ukuthi ezigulini ezinesifo sikashukela sohlobo 2, ukushona kwenhliziyo kwandisa izikhathi ezingama-3-4, uma kuqhathaniswa nabantu abangenakho ukuphazamiseka kwe-metabolic. Manje ososayensi nabodokotela abengeziwe bayaqiniseka ukuthi ukumelana ne-insulin futhi, kanye nayo, i-hyperinsulinemia kuyingozi enkulu yokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi. Ngaphezu kwalokho, lobu bungozi abuyi ekutheni isiguli sisungule isifo sikashukela noma cha.

Kusukela ngawo-1980s, ucwaningo luye lwabonisa ukuthi i-insulin inomphumela oqondile we-atherogenic ezindongeni zemithambo yegazi. Lokhu kusho ukuthi ama-plagi atherosulinotic kanye nokuncipha kwe-lumen yemikhumbi kuyaqhubeka ngaphansi kwesenzo se-insulin egazini eligeleza kuzo.

I-insulin ibangela ukwanda kanye nokufuduka kwamaseli omzimba abushelelezi, ukwakheka kwama-lipid kuzo, ukwanda kwama-fibroblasts, ukusebenza kohlelo lwegazi lokuwohloka, kanye nokwehla komsebenzi we-fibrinolysis. Ngakho-ke, i-hyperinsulinemia (inani elandayo le-insulin egazini ngenxa yokumelana ne-insulin) liyimbangela ebalulekile yokwakhiwa kwe-atherosulinosis. Lokhu kwenzeka kudala ngaphambi kokuvela kwesifo sikashukela sohlobo 2 esigulini.

Ucwaningo lukhombisa ubudlelwane obucacile obuphakathi kwe-insulin ngokweqile kanye nezici zobungozi zesifo senhliziyo. Ukumelana ne-insulin kuholela eqinisweni lokuthi:

ukukhuluphala kwesisu esiswini;
Iphrofayli ye-cholesterol yegazi iya isiba mbi, kanye nama-cholesterol amafomu “amabi” ezindongeni zemithambo yegazi;
amathuba okuqhekeka kwegazi emithanjeni ayanda;
udonga lomthambo we-carotid liba likhulu (ukukhanya kolwelwesi lomthambo).

Lobu budlelwano obuzinzile bufakazelwe bobabili ezigulini ezinesifo sikashukela sohlobo 2 nakubantu abangenawo.

Ukwelashwa kwe-insulin

Indlela ephumelelayo yokwelapha ukumelana ne-insulin ezigabeni zokuqala zesifo sikashukela sohlobo 2, futhi okungcono kakhulu ngaphambi kokuba ikhule, ukusebenzisa indlela yokudla evimbela ama-carbohydrate ekudleni kwakho. Ukucacisa, lena akuyona indlela yokwelashwa, kepha ulawula kuphela, ubuyisela ibhalansi uma kwenzeka umetabolism ophazamisekile. Ukudla okune-carbohydrate ephansi ngokumelana ne-insulin - kumele kunamathelwe impilo yonke.

Ngemuva kwezinsuku ezingama-3-4 zokushintshela ekudleni okusha, abantu abaningi babona ukuthuthuka enhlalakahleni yabo. Ngemuva kwamaviki angama-6-8, ukuhlolwa kukhombisa ukuthi i-cholesterol "enhle" esegazini iyakhuphuka bese kuthi enye "embi" ihle. Izinga lama-triglycerides egazini lehla liye kwelejwayelekile. Ngaphezu kwalokho, lokhu kwenzeka ngemuva kwezinsuku ezingama-3-4, kanti ukuhlolwa kwe-cholesterol kuthuthuka ngokuhamba kwesikhathi. Ngakho-ke, ubungozi be-atherosclerosis bancishiswa kaningana.

Okwamanje azikho izindlela zokwelapha zangempela zokumelana ne-insulin. Ochwepheshe emkhakheni we-genetics kanye ne-biology bayasebenza kulokhu. Ungayilawula kahle le nkinga ngokulandela ukudla okune-carbohydrate ephansi kakhulu. Okokuqala, udinga ukuyeka ukudla ama-carbohydrate akhanyisiwe, okungukuthi, ushukela, amaswidi kanye nemikhiqizo kafulawa omhlophe.

Umuthi weMetforminum (siofor, glucophage) unikeza imiphumela emihle. Yisebenzise ngokungeziwe ekudleni, futhi hhayi esikhundleni sakho, bese uthintana nodokotela wakho kuqala ngokuthatha amaphilisi. Zonke izinsuku silandela izindaba ekwelapheni ukumelana ne-insulin. I-genetics yanamuhla kanye ne-microbiology isebenza izimangaliso zangempela. Futhi sethemba ukuthi eminyakeni ezayo bazokwazi ekugcineni ukuxazulula le nkinga. Ngabe uyafuna ukwazi kuqala - bhalisela i-newsletter yethu, kumahhala.