Isisindo esithe xaxa kuyinkinga yomhlaba wonke ethinte iRussia namuhla. Sonke sazi kahle ukuthi kungakanani noma yisiphi isigaba sokukhuluphala okuthinta impilo: kuthinta umsebenzi wenhliziyo nemithambo yegazi, konakalisa amalunga kuholele ekwakhiweni kwesifo sikashukela.
Lesi sihloko esibalulekile sinikezelwe Incwadi entsha eyenziwe yi-endocrinologist eneminyaka engama-30 yamava u-Olga Demicheva "amaHormones, ufuzo, isifiso sokudla." Okucashunwe kukho, okubhekisela "esilinganisweni sokufa" - lokhu kubizwa nangokuthi yi-metabolic syndrome, sikuletha ukunaka kwakho.
Ngenxa yokukhethwa kwemvelo, abantu bakudala baba ngamadlozi asebenzayo esintu sanamuhla, ahlukaniswa ezizweni zabo ngamakhono abo okuqongelela ngokushesha amafutha isikhathi esifushane sokudla okubaningi futhi, ngakho-ke, bayaphila ngezikhathi ezaphoqwa isikhathi eside sokuba khona kwendlala. Njengoba isisho sihamba, "ngenkathi i-sox enamafutha, ifile ifile."
Yilezi zokhokho ezikude zakithi, ezikwazi ukugcina amanoni, owanikeza inzalo esebenzayo, ehlanganisa leli khono lokuqongelela amanoni ezingeni lofuzo. Leli khono laqanjwa kanjani?
Iqiniso ngukuthi ekuqongeleleni ngokushesha kwezicubu ze-adipose nokulondolozwa kwayo (ukonga), kudingeka inani elikhulu le-insulin. Okusho ukuthi, ukunqwabelana kwamafutha amaningi kuhlotshaniswa ne-hyperinsulinism. Kepha, ngenkathi igcina amandla okugcina amafutha kakhulu, umzimba bekufanele uzivikele ekunciphiseni okukhulu kwamazinga kashukela wegazi ngokumelene nesizinda se-hyperinsulinism ekhona. Ngemuva kwakho konke, umsebenzi wesibili oyinhloko we-insulin ukwehlisa ushukela wegazi ngokuwuthumela kumaseli ukuze kukhiqizwe amandla. Futhi lapha okhokho bethu banokushintshwa kwezakhi zofuzo okunikeza indlela yasekuqaleni yokuvikela, ebizwa ngokuthi "ukumelana ne-insulin". Ukumelana ne-insulin kungukuncipha kokuzwela kwamaseli omzimba emiphumeleni yokwehlisa ushukela kwe-insulin.
Abantu abane- "genotype yezomnotho", njengoba bevumelana nezimo ezingezinhle zezemvelo, baba nomthelela ekusakazekeni kwalezi zakhi zofuzo kubantu. I-Hyperinsulinism, ebisize okhokho bethu ukuba baqoqe amasheya amaningi ngezikhathi ezimfushane zokudla okuningi, ayizange ilimaze, ngoba yanyamalala isikhathi eside lapho bekungekho ukudla okwanele. Ngezikhathi zendlala, abantu bokuqala babehlala emafutheni anamafutha anqwabelene. I-hyperinsulinism yabo ayikaze ibe yingelapheki. Thina, inzalo yabo ekude, asinazo izinkathi zokuzila isikhathi eside, kepha sinamandla okuqongelela amafa atholakala kokhokho: kukhona ukumelana ne-insulin kanye ne-hyperinsulinism.
I-hyperinsulinism engapheli kanye nokumelana ne-insulin yizinkomba ezibalulekile kulokhu okubizwa nge- "metabolic shifts" okuholela ekutheni ukukhuluphala, isifo sokuqina kwemithambo yegazi, umfutho wegazi ophakeme nesifo sikashukela i-mellitus. Nasi isipho esihle sofuzo esisitholile kokhokho bethu, saphoqelelwa ukuthi siphile lapho sibhekene nezinkinga ezivamile zokudla.
Uyazi ukuthi yini okuthiwa i-endocrine organ enkulu kumuntu okhuluphele ibizwa ngokuthi? Izicubu ze-Adipose!
Lokhu kuyiqiniso: ngokweqile, amafutha "agulayo" anomsebenzi omkhulu we-endocrine. Ngo-1988, uSolwazi G. Reaven waphakamisa okokuqala ukuthi kungukungabi namandla kwe-insulin okubangela i-hyperinsulinism yokunciphisela ebanga i-metabolic Cascade: ukukhuluphala, ukungasebenzi kahle kwe-carbohydrate kanye ne-lipid metabolism, kanye nokuthuthuka kwe-pathology yenhliziyo.
Ukukhula ngokushesha kwesifo sokukhuluphala kanye nohlobo 2 lwesifo sikashukela kunomthelela "ekuqhekekeni" kwesifo sokuqina kwemithambo yegazi kanye ne-hypertension ye-arterial, okwandayo ukushona kwenhliziyo. Akuzenzekeli ukuthi le "kit" - ukukhuluphala, isifo sikashukela, isifo sokuqina kwegazi kanye ne-atherosclerosis - ngasekupheleni kweminyaka yama-80s, ngesandla sikaProfessor N. Kaplan, sabizwa ngokuthi "umugqa obulalayo". Eminyakeni yama-90s, oprofesa uM. Henefeld noW. Leonhardt bahlongoza igama elithi "metabolic syndrome", osekuyisikhathi eside lisebenza ngabasebenza emtholampilo.
USolwazi uM. R. Stern ngonyaka we-1995 wabeka phambili umbono ophathelene ne "mpande evamile" ye-atherosulinosis kanye nesifo sikashukela - ukumelana ne-insulin. Namuhla sazi ngokuqinisekile ukuthi kubantu abanokuphazamiseka kwengqondo kwe-carbohydrate metabolism (lokhu kuphazamiseka kuchazwa ngokuningiliziwe encwadini yami ethi "Diabetes Mellitus" ochungechungeni lwe- "Doctor Rodionov Academy", izinqubo ze-atherossteosis zishesha kakhulu kunabantu abane-metabolism ejwayelekile ye-carbohydrate.
Ngokufanelekile, kufanele kuphawulwe ukuthi emuva ngo-1948, udokotela odumile uE. M. Tareev wabhala: "Umqondo we-hypertension uvame ukuhlotshaniswa nama-hypersthenics ama-feta nokulimala okungenzeka kwe-carbohydrate kanye ne-protein metabolism, ngokuvalwa kwegazi ngemikhiqizo ye-metamorphosis engaphelele - i-cholesterol, i-uric acid ..." . Ngakho-ke, ngaphezu kweminyaka engama-70 eyedlule, umuntu wakithi omkhulu wasungula umbono we-metabolic syndrome.
Ukwanda kwesifo se-metabolic syndrome kuthatha ubhubhane lwamazwe amaningi, kufaka phakathi iRussia, futhi kufinyelela kuma-25-35% phakathi kwabantu abadala.
Manje ku-inthanethi yezilimi zaseRussia ungathola izixhumanisi ezingaphezu kwezinkulungwane eziyikhulu zokushicilelwa ngalolu daba. Ngakho-ke, ezweni lanamuhla, njengomphumela wokusetshenziswa kokudla okungenakulinganiswa nokusetshenziswa kwamandla nangaphansi kwezimo ze-hyperinsulinism, izicubu ezinamafutha ezisetshenziselwa ukufaniswa ukuze zifakwe zithwala ngokweqile futhi ziyagula. Bazi izinkinga zokukhuluphala kwesintu, i-WHO kanye ne-UN bahlongoza ngezinhlelo zawo wonke amazwe ukulwa "nobhadane olungahambelani." Kuletha imiphumela ethile.
Emazweni asebenzisa izinhlelo ezisebenzayo zokuvimbela izifo ezingalawuleki, ezibandakanya ukukhuluphala, isifo sikashukela, umdlavuza kanye nezifo zenhliziyo, ubhubhane lokuhlaselwa yisifo senhliziyo kanye nemivimbo seluphelile kusukela ekuqaleni kwekhulu lama-21. Abahlali bamazwe amaningi babona ubungozi bokubhema, ukungasebenzi ngokomzimba, ukuphuza ngokweqile futhi bazinqumela bona ukuthi bashintshe indlela yabo yokuphila. Kepha amazwe amaningi asasekhona emhlabeni, kubandakanya neRussia, lapho ukufa kwabantu ngaphambi kwesikhathi okuvela ezifweni zenhliziyo kungancishiswa. Isizathu salokhu "i-quartet ebulalayo," okungukuthi, i-metabolic syndrome.
Ungabona kanjani ukuthi unezimpawu zesifo se-metabolic? Ukuze wenze lokhu, ukukala ukujikeleza okhalweni, ukukala umfutho wegazi, ukwenza ukuhlolwa kwegazi okune-biochemical ye-cholesterol ephelele, i-HDL, i-LDL, i-triglycerides, ushukela kanye ne-glycated hemoglobin. Imiphumela izokwenza ukuthi uqonde ukuthi unayo okungenani ingxenye eyodwa ye “quartet ebulalayo”. Noma mhlawumbe akekho? Lihlole.
Okokuqala lokhu kukhuphuka kokujikeleza okhalweni: kwabesifazane - ngaphezu kwama-80 cm, emadodeni - ngaphezu kwama-94 cm (ukukhuluphala kwesisu).
Okwesibili ukungasebenzi kahle kwe-metabolism yamandla ngokwanda kwamazinga wegazi we-triglycerides ne-cholesterol kanye ne-low density lipoproteins (LDL), kanye nokwehla kwesibalo esikhulu se-lipoprotein cholesterol (HDL).
Okwesithathu ukwanda kwengcindezi yegazi (BP).
Okwesine, ukungasebenzi kahle kwe-glucose metabolism, kusuka ku-pre-diabetesic kuya ku-glucose engasebenzi kahle (NGN) kanye nokungabekezeleli kwe-glucose (NTG) ekukhuleni kohlobo 2 sikashukela mellitus.
Okuyingozi kakhulu ngokuya ngezingozi zenhliziyo ukukhuluphala kwesisu (noma i-visceral) ukukhuluphala. Ukukhuluphala kwesisu ukuvezwa kwamafutha esiswini nasesinqeni.
Ukukhuluphala kwe-Visceral kungabizwa ngokuthi i-violin yokuqala ye "quartet ebulalayo." Futhi, ngeshwa, le yinto esakazeke kabanzi: eRussia, ngaphezu kwengxenye yabahlali abangaphezu kuka-40 banesisindo somzimba esithe xaxa, esiphenduka ukukhuluphala ngeminyaka engama-50. Ezimweni eziningi, kuba ekukhuluphweni kwe-visceral.
Singasho ukuthi iyitheyiphu yamasentimitha, hhayi izikali, lelo yithuluzi eliyinhloko ekusunguleni ukuxilongwa "kokukhuluphala kwesisu."
Kwesinye isikhathi isisindo esikhulu semisipha, ikakhulukazi emadodeni ahlanganyela emidlalweni yamandla, kungaholela ekwandeni kwe-BMI, kepha ukujikeleza kwesinqe kuzokhombisa ngokunembile ukungabikho noma ukuba khona kwamafutha ngokweqile esiswini nasesinqeni. Ngokuthabisisayo, le nkomba kubantu abadala ayixhomekeki ekukhuleni, ngokungafani ne-BMI.
Iningi labaphenyi bakholelwa ukuthi ukukhuluphala yikho okubangela “i-quartet ebulalayo”. Kepha ubuqili besifo se-metabolic ukuthi noma iliphi ilunga leQuartet lilo elihamba phambili, ngalinye likhulisa ubungozi kwabathathu abasele. Isimo sethu sofuzo sokumelana ne-insulin akuyona inkambiso yokukhuluphala ngokuphelele uma ulandela indlela yokuphila enempilo.
