Isifo sikashukela sithinta impilo yesibindi. Lo mzimba ukhiqiza futhi ugcina ushukela, usebenza njengohlobo lwedamu kashukela, oyiphutha lomzimba, ogcina izinga elidingekayo likashukela egazini.
IGlucose nesibindi
Ngenxa yezidingo zomzimba, ukugcinwa noma ukukhishwa ushukela kubikwa yi-glucagon ne-insulin. Lapho kudliwa, kuvela okulandelayo: isibindi sigcinwa ku-glucose ngesimo se-glycogen, esizodliwa kamuva, lapho kunesidingo.
Ukwanda kwe-insulinkanye nama-degree acindezelwe we-glucagon ngesikhathi sokudla kudla kunomthelela ekuguqulweni kweglucose kuyi-glycogen.
Umzimba womuntu ngamunye ukhiqiza ushukela, uma kunesidingo. Ngakho-ke, lapho umuntu engadli ukudla (ebusuku, isikhashana esiphakathi kokudla kwasekuseni kanye nesidlo sasemini), lapho-ke umzimba wakhe uqala ukwengeza ushukela wakhe. I-Glycogen iba yi-glucose ngenxa ye-glycogenolysis.
Ngakho-ke, ekudleni kubaluleke kakhulu kwabanesifo sikashukela, noma abantu abanoshukela wegazi ophezulu noshukela.
Umzimba unenye futhi indlela yokukhiqiza ushukela ovela emafutheni, kuma-amino acid nakwimikhiqizo yokungcola. Le nqubo ibizwa nge- gluconeogeneis.
Kwenzekani ngokushoda:
- Lapho umzimba ungantuli ku-glycogen, uzama kanzima ukusindisa isamba esinoshukela kulezo zitho ezizidingayo kwasekuqaleni - izinso, ubuchopho, amaseli egazi.
- Ngaphezu kokuhlinzeka nge-glucose, isibindi siveza enye indlela kawoyela oyinhloko wezitho - ama-ketones asuselwa emafutheni.
- Isidingo sokuqala kwe-ketogeneis kungukuncipha kokuqukethwe kwe-insulin.
- Injongo eyinhloko ye-ketogenosis ukugcina izitolo ezinoshukela kulezo zitho eziyidingayo kakhulu.
- Ukwakheka kwama-ketones amaningi akuyona inkinga evamile, noma kunjalo kuyinto eyingozi, ngakho-ke, ukunakekelwa kwezokwelapha okuphuthumayo kungadingeka.
Kubalulekile! Kaningi, ushukela wegazi ophakeme ekuseni onesifo sikashukela uwumphumela wokukhuphuka kwegluconeoisis ebusuku.
Abantu abangajwayele isifo esifana nesifo sikashukela kufanele bazi ukuthi ukuqoqwa kwamafutha kumaseli wesibindi kukhulisa amathuba alesi sifo esakheka.
Ngaphezu kwalokho, inani lamafutha kwezinye izingxenye zomzimba alinamsebenzi.
Amafutha hepatosis. Ngemuva kokwenza izifundo eziningi, kwavela ukuthi i-hepatosis enamafutha iyingozi yesifo sikashukela.
Ososayensi bathole ukuthi iziguli ezine-hepatosis enamafutha zisengozini enkulu yokuqhubeka kwesifo sikashukela sohlobo 2 iminyaka emihlanu.
Ukuxilongwa kwe-hepatosis enamafutha kudinga umuntu ukuba aqaphele ngempilo yabo ukuze bangabi nesifo sikashukela. Lokhu kuphakamisa ukuthi kuzosetshenziswa isidlo, kanye nokwelashwa okuningiliziwe kwesibindi nganoma yiziphi izinkinga ngalesi sitho.
Buza i-hepatosis enamafutha usebenzisa i-ultrasound. Ucwaningo olunjalo lungabikezela ukwakheka kwesifo sikashukela naphezu kokuxineka kwe-insulin egazini.
Nakani! Ngisho nokuqukethwe okufanayo kwe-insulin egazini, abantu abane-hepatosis enamafutha basengozini ephindwe kabili yesifo sikashukela kunalabo abangasazi lesi sifo (ukukhubazeka kwesibindi).
I-Fatty hepatosis yatholakala ku-1/3 yezakhamizi zase-US. Kwesinye isikhathi izimpawu zalesi sifo azishiwongo, kodwa kwenzeka ukuthi lesi sifo sinokuholela ekuhlulekeni kwesibindi kanye nokulimala kwesibindi kungenzeka.
Abaningi bathi i-hepatosis enamafutha yisifo sesibindi esinezidakwa, kepha lesi sifo singaba nezinye izimbangela nezimpawu.
Kubalulekile! Ukukhuluphala kwesibindi kunomphumela wokumelana ne-insulin.
Izibalo
Ocwaningweni olushicilelwe ephephabhukwini iMetabolism and Clinical Endocrinology, ososayensi benza ucwaningo belufunda ukuthi amafutha e-hepatosis athinta kanjani ukukhula kwesifo sikashukela.
Lo msebenzi ubandakanya izakhamizi zaseNingizimu Korea eziyi-11,91. Ekuqaleni (2003) yocwaningo nangemva kweminyaka emihlanu kubantu, ukulinganiswa kwe-insulin nokuqina kwesibindi kwakalwa.
- Esigabeni sokuqala salolu cwaningo, i-hepatosis enamafutha yatholakala kuma-27% amaKorea.
- Ngasikhathi sinye, ukukhuluphala kwabonwa kuma-60% abahloli, uma kuqhathaniswa no-19% ngaphandle kokuwohloka kwesibindi.
- I-50% yabantu abanesibindi sokukhuluphala babenamakhanda okuxineka kwe-insulin esiswini esingenalutho (uphawu lokumelana ne-insulin), uma kuqhathaniswa ne-17% ngaphandle kwe-hepatosis enamafutha.
- Ngenxa yalokho, yi-1% kuphela yabantu baseKorea abangenayo i-hepatosis enamafutha eyakha isifo sikashukela i-mellitus (uhlobo 2), uma kuqhathaniswa ne-4% ehlushwa ukuwohloka kwesibindi.
Ngemuva kokushintsha okumaka kwe-insulin ekuqaleni kwesifundo, amathuba okuba nesifo sikashukela ayesekukhulu kune-hepatosis enamafutha.
Isibonelo, phakathi kwabantu abanamazinga e-insulin aphezulu kakhulu, ingozi yesifo sikashukela yayiphindwe kabili kathathu ekuqaleni kwesifundo sokukhuluphala kwesibindi.
Ngaphezu kwalokho, esigabeni sokuqala sokucwaninga, abantu abane-hepatosis enamafutha babetholakala kalula ekuthuthukisweni kokuntuleka kwe-insulin (amazinga aphezulu e-cholesterol ne-glucose).
Ngakho-ke, i-hepatosis enamafutha ngokuqinisekile ikhulisa amathuba esifo sikashukela. Ngenxa yalokhu, abantu abanesibindi sokukhuluphala badinga ukudla okhethekile, okufanele bagweme ukusetshenziswa koshukela, balawule ushukela wegazi futhi banqande ukudla kanye nokudla okugcwele ama-carbohydrate alula.
Nakani! Kulabo abakhuluphele ngokweqile, ukudla okunjalo kuzokwenza kuhambelane ngokwengeziwe, yize ukudla kungasekelwe kakhulu ekulahlekelweni kwesisindo njengakwelashwa nasekuvimbeleni i-hepatosis.
Futhi, ukudla okhethekile kubandakanya ukwenqaba utshwala. Lokhu kuyadingeka ekusebenzeni okugcwele kwesibindi, okwenza imisebenzi engaphezu kwe-500.
I-Cirrhosis
Ekuhlolweni kweglucose yomlomo, abantu abane-cirrhosis bavame ukuba ne-hyperglycemia. Izimbangela ze-cirrhosis azikaziwa ngokugcwele.
- Njengomthetho, kanye ne-cirrhosis, ukumelana kwezicubu ezithinta i-insulin kuthuthuka futhi ukuqashelwa kwe-insulin kuyancipha.
- Izinga lokuzwela kwe-adipocytes ku-insulin nalo liyancipha.
- Uma kuqhathaniswa nesigaba sokulawula, i-cirrhosis iyancipha ukumuncwa kwe-insulin ngesikhathi sokudlulela kokuqala ngesitho.
- Ngokuyisisekelo, ukwanda kokumelana ne-insulin kulinganiselwe ngokukhuphuka kokuqalwa kwayo yi-pancreas.
- Ngenxa yalokhu, kukhona okuqukethwe kwe-insulin okukhulayo kanye nokujwayelekile kwe-degree kashukela egazini ekuseni kanye nokwehla okuncane kokubekezelela ushukela.
Kwesinye isikhathi, ngemuva kokudla kwe-glucose kokuqala, ukugcinwa kwe-insulin kuyancipha. Lokhu kufakazela ukuphela kwe-C-peptide. Ngenxa yalokhu, ukuthathwa koshukela kuncishiswa kakhulu.
Izinga le-glucose esiswini esingenalutho lihlala livamile. Nge-hypoecretion emenyezelwe ye-insulin, ushukela ovela esibindini ungena egazini ngenxa yokungabikho komphumela we-insulin inqubo yokwenziwa kweglucose.
Umphumela wokuguqulwa okunjalo yi-hyperglycemia esiswini esingenalutho kanye ne-hyperglycemia enzima ngemuva kokudla ushukela. Le ndlela yindlela isifo sikashukela esakha ngayo, futhi ekwelashweni lokhu kufanele kubhekwe.
Ukwehla kokubekezelela kwe-glucose ku-cirrhosis kungahlukaniswa noshukela wangempela, ngoba izinga le-glucose kumuntu ongadli ukudla, ngokuyisisekelo lihlala livamile. Kulokhu, azivezwanga izimpawu zomtholampilo zesifo sikashukela.
Kulula ukuthola i-cirrhosis kushukela. Ngemuva kwakho konke, ngokuntuleka kwe-insulin, izimpawu ezifana:
- ascites;
- imithambo yesicabucabu;
- i-hepatosplenomegaly;
- jaundice.
Uma kunesidingo, ungathola i-cirrhosis usebenzisa i-biopsy yesibindi.
Ukwelashwa kwe-cirrhosis kubandakanya ukusetshenziswa kwemikhiqizo ye-carbohydrate, futhi lapha ukudla kuqala. Esikhundleni salokho, isiguli sinqunyelwe ukudla okukhethekile, ikakhulukazi, kuyadingeka nge-encephalopathy, ukwelashwa lapha kuhlobene kakhulu nokudla komsoco.
Izinkomba zomsebenzi wesibindi
Nge-mellitus enxephekile yesifo sikashukela, noma iziphi izinguquko kuma-indices zomsebenzi wesibindi azibonwa. Futhi noma ngabe zitholakele, izimpawu nezimbangela zazo azihlobene nesifo sikashukela.
Ngokuphulwa kwe-carbohydrate metabolism, izimpawu ze-hyperglobulinemia nezimpawu ezibonisa ukwanda kwezinga le-bilirubin ku-serum kungenzeka.
Ngokwesifo sikashukela esinxephekile, izimpawu ezinjalo azizona izici. Ku-80% yesifo sikashukela, ukulimala kwesibindi ngenxa yokukhuluphala kwayo kuyabonakala. Ngakho-ke, ezinye izinguquko ku-serum ziyabonakala: i-GGTP, ama-transaminases ne-alkaline phosphatase.
Ukwanda kwesibindi ngenxa ye-glycogen ephezulu yohlobo 1 sikashukela noma ushintsho lwamafutha uma lesi sifo kunguhlobo lwesibili asihlangene nokuhlaziywa kokusebenza kwesibindi.
Ukudla okulula okwelapha lapha kuzodlala indima yokuvimbela, ngenkathi ukwelashwa kule nkimbinkimbi kwamukela ukuba khona kokudla okwelaphayo.
Ukuhlobana kwezifo zamapheshana asesiswini kanye nesibindi ngesifo sikashukela
Esikhathini sikashukela, i-cirrhosis iba njalo. Njengomthetho, i-cirrhosis itholwa kuqala futhi ngemuva kwalokho ukutholakala kwe-insulin, futhi nokwelashwa kuyakhiwa.
Isifo sikashukela futhi singaba uphawu lwe-hemochromatosis yelifa. Kubuye kuhambisane ne-autoimmune hepatitis engapheli kanye nama-antigen we-main histocompatability tata DR3, HLA-D8.
Noma ngabe kunesimo sikashukela esizimele sikashukela, ama-gallstones angakha. Ngokunokwenzeka, lokhu akusebenzi kwisifo sikashukela, kepha ekushintsheni kokwakhiwa kwe-bile ngenxa yokukhuluphala. Ukudla okwelaphayo, njengokwelashwa, kulokhu kungavimba ukwakheka kwamatshe amasha.
Kungabikwa nezimpawu zokuncipha kokusebenza kwesivumelwano ku-gallbladder.
Ukwelashwa ngokuhlinzwa kwe-gallbladder in diabetesics akuyona ingozi, kepha ukuhlinzwa komgudu webhiliary kuholela ekuthelelekeni kwezifo nokufa kwabantu.
Futhi ukwelashwa nge-sulfonylurea kungaholela ezilondeni zesibindi noma ze-cholestatic zesibindi.
