Caabin Insulin - waa maxay? The syndrome dheefshiidka waa adkaysiga insuliinta

Waayo, dad kala duwan lagu gartaa kala duwan kartida insulin si ay u kicin qaadashada glucose. Waxaa muhiim ah in la ogaado in qofku yeelan karaa dareen caadi ah in hal ama in ka badan oo ka mid ah saamaynta xarunta iyo waqti isku mid ah - iska caabin ah oo buuxda kale. Next, waxaan u falanqeeyaan fikirka ah "caabbinta insulin": waxa ay tahay, sida loo muujiyay.

Guudmarka

Ka hor inta qabashada fikirka ah "caabbinta insulin", waxa ay tahay iyo waxa u yeelaa sameeya, waa in la sheegay in cudurka tani ma aha wax aan caadi ahayn. In ka badan 50% dadka qaba dhiig-karka xanuunadan qaba waxay. Inta badan, adkaysiga insuliinta (taas oo ay tahay, in la hoos lagu qeexay doonaa) waxaa laga helaa dadka waayeelka ah. Laakiin mararka qaarkood waxaa la ogaado in carruurnimada. insulin iska caabin syndrome inta badan aan la ogaan ka hor, waxa aanu bilaabi si ay u muujiyaan xadgudub ku ah geeddi socodka dheefshiidka. Kuwa halista waxaa ka mid ah dadka qaba dyslipidemia ama dulqaad glucose si daciif ah, cayilka, hypertension.

caabin insulin

Waa maxay? Waa maxay astaamaha sameeya xadgudubka? syndrome Metabolic iska caabin insulin waa jawaab qaldan ee u shaqeeyo in ay tallaabo ka mid ah mid ka mid ah xeryaha ku. Fikradda waa mid ku habboon in saamaynta noolaha kala duwan. Tani, gaar ahaan, la xidhiidha saamaynta insulin on protein iyo shiid la egyahay, hadal hiddo, shaqo vascular endothelial. jawaab Dhiman keenaysaa in la kordhiyo fiirsashada dhiigga xarunta looga baahan yahay in mugga qaraabo glucose heli karo. insulin iska caabin syndrome - disorder ah isu geeyey. Waxay ku lug leedahay isbedel ku dulqaadka sonkorta, 2 diabetes type, dyslipidemia, cayilka. "Syndrome X" iyo sidoo kale ku lug leedahay iska caabin qabashada of glucose (insulin-ku tiirsan).

hab horumarineed

Si buuxda u sahamiyo khubaro ay taariikhda ku guuldareystay. Xanuunka oo keeni horumarinta adkaysiga insuliinta ayaa dhici kara ee heerarkan soo socda:

• Receptor. Xaaladdan oo kale, gobolka muujiyay buuna ama hoos u dhac tirada soo dhaweeyayaasha.
• At heerka of gaadiidka glucose. Xaaladdan oo kale, ka ogaado hoos u dhac ah u taagoo GLUT4.
• Pre-receptoral. Xaaladdan oo aynu ka hadalno oo ku saabsan insulin ah aan caadi ahayn.
• Postreceptor. Xaaladdan oo kale waxaa jira phosphorylation xadgudub iyo carqalad la isugu gudbiyo signal ah.

Aan caadi ahayn ee u taagoo insulin ku filan yihiin dhif ah oo aan muujinta bukaan. cufnaanta receptor la hoos laga yaabaa in ay sabab u tahay bukaanka-celin xun. Waxaa sabab u ah hyperinsulinemia. Inta badan, qofku hoos u dhacay tirada receptor dhexdhexaad ah. Xaaladdan oo kale, heerka jawaab-celin ah looma tixgeliyo Faraj by kaas oo la go'aamiyo waxa degree ayaa iska caabin ah insulin. Sababaha cudurka la yareeyo by khubaro ah si ay postreceptor gudbinta xadgudubyada. By-qaabo arrimood, gaar ahaan, waxaa ka mid ah:

• Sigaar.
• Kordhinta waxyaabaha TNF-Alfa.
• Yaree dhaqdhaqaaqa jirka.
• Kordhinta uruureen ee acids dufanka aan esterified.
• Age.

Kuwani waa arrimaha ugu weyn ee dhalin kara iska caabin insulin si joogta ah in ka badan dadka kale. Daaweynta waxaa ka mid ah codsiga:

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

kor u adkaysiga insuliinta

Saamaynta on-shiid glucose dhacdaa unugyada adipose, murqaha, iyo beerka. murqaha lafaha metabolizes qiyaastii 80% ee xarunta. muruqyada ku kiiskan u dhaqmo sida ilaha muhiimka ah ee iska caabin ah insulin. Qabashadooda glucose unugyada waxaa lagu fuliyaa iyadoo adeegsanayo protein GLUT4 gaadiidka gaarka ah. Marka receptor la shaqeysiin by insulin kiciyay taxane ah oo dareen diidmo phosphorylation. Waxay ugu danbeyn keeni translocation ee GLUT4 in xuub gacanta ka cytosol ah. Tan iyo glucose waa in ay soo galaan gacanta awoodaan. Insulin iska caabin ah (heerka la sheegi doonaa halkan) waxaa keena hoos u dhac in heerka uu translocation of GLUT4. Waxaa la xusay hoos u dhac ku isticmaalka iyo qaadashada glucose. Oo ay la socoto this, ka sokow fududeynta qabashadooda glucose in unugyada durugsan, marka hyperinsulinemia u dhigan wax soo saarka sonkorta, cagaarshowga. In 2 diabetes type waxaa dib u bilaabay.

buurnida

Waxaa la weheliso caabbinta insulin inta badan ku filan. Marka aad iyo aad u miisaanka bukaanka 35-40% dareen dhibciyo by 40%. Waxay ku taallaa in derbiga caloosha unugyada baruurta ayaa hawl sare dheefshiidka ka badan mid ka mid ah taas oo hoos ku yaal. Intii lagu guda jiray galku caafimaad shaaca ka qaaday in la sii daayo korodhka gelin acids dufan wareegga portal ka fiiloyin caloosha dhirfinaya-soo-saarka ee triglycerides beerka.

calaamado clinical

caabin Insulin, oo astaamaha xiriirka la leh rabshooyin dheefshiidka laga yaabaa advantageously la tuhunsan yahay in bukaanada qaba cayilka caloosha, sonkorowga uurka, taariikhda qoyska nooca 2aad ee sonkorowga, dyslipidemia iyo dhiig-karka ah. Halis ah iyo Haweenka polycystic ovary syndrome (PCOS). Sababo la xaqiiqada ah in buurnaanta u dhaqmo sida calaamad of adkaysiga insuliinta, waxaa lagama maarmaan ah si ay u qiimeeyaan dabeecadda, on taas oo ay jirto qaybinta unugyada adipose. Its goobta lagu ginekoidnomu karo - in qaybta hoose ee jidhka, ama nooca looba - derbiga hore ee peritoneum ah. Raasamaal qeybtii sare ee jirka ayaa saadaaliye ka sii weyn ee adkaysiga insuliinta, dulqaad glucose doorsoon iyo macaanka, cayilka badan qaybihii hoose. Si loo ogaado xaddiga unugyada baruurta caloosha isticmaali kartaa nidaamkii soo socda: si loo ogaado ratio of goobada ku xidhnaa, goobada hip iyo BMI. At heerka of 0.8 haweenka iyo 0.1 ragga iyo BMI ka weyn 27 sheego cayilka caloosha iyo adkaysiga insuliinta. Cudurka Calaamadaha muuqdaa muujiyey. Gaar ahaan maqaarka calaamadeeyay duuduubku, meelaha xunxunna hyperpigmented. Inta badan waxay u muuqataa in kilkilooyinka, suxullada, naasaha hoostooda. Falanqaynta caabbinta insulin waa formula xisaab ah. Homa-IR waxaa loo xisaabiyaa sida soo socota: insulin sooman (mu / L) x glucose soonka (mmol / L). Natiijadan ayaa waxa ay ka heli waxaa loo qaybiyaa by 22.5. Taasi waxay yeelan doonaan insulin index iska caabin ah. Norma - <2,77. Marka weecasho ah jihada of dareenka sii kordhaya lagu ogaan karaa unugyada disorder.

Xanuunka nidaamyada kale: atherosclerosis

Maanta ma jirto sharaxaad hal hab ay saamayn insulinorezistenotnosti guuldarada nidaamka wadnaha. Waxaa laga yaabaa in saameyn toos ah ku atherogenesis. Waxaa sabab u ah awoodda ay insulin si ay u kicin ereygu wuxuu ahaa ee subaga iyo qaybaha ka mid ah kororka muruqyada siman derbiga markabka. Oo ay la socoto this waxaa sababi kara arteriosclerosis la xiriira cudurada dheefshiidka. Tusaale ahaan, waxaa laga yaabaa in hypertension, dyslipidemia, isbeddel ah ee sonkorta. In pathogenesis cudurka waa gaar function muhiimadda naafada ah endothelium ku vascular. Hawshoodu waa inay ilaaliyaan midab ah ee channels dhiig by secreting neurotransmitters vasodilation iyo vasoconstriction. In gobolka xeerarka insulin wuxuu kobciyaa nasashada oo ka mid ah macdantaa muruqa siman derbiga markabka oo lagu sii daynayo xabagta nitric (2). Waxaa intaa dheer, awoodda si kor loogu qaado vasodilation endothelium ku tiirsan si weyn loo beddeli in bukaanka qaba cayilka. Isla sidaas u dhaqmaan bukaanka qaba adkaysiga insuliinta. Iyadoo horumarinta halbowlaha wadnaha ku fashilmeen in ay ka jawaabaan ku meersan waxa caadi ah, iyo si loo ballaariyo, waxaad la hadli kartaa ee ku saabsan marxaladda koowaad ee cudurada microcirculatory - microangiopathy. Xaaladani waxay bahal ah ayaa lagu arkay inta badan ee bukaannada qaba diabetes (mellitus diabetes).

caabin Insulin keeni kartaa atherosclerosis by rabshooyin ee geedi socodka of fibrinolysis. PAI-1 (plasminogen inhibitor activator) waa in ay isugu soo urureen sare ee bukaan diabetic iyo nondiabetic buuran. Avv PAI-1 dhiiri proinsulin iyo insulin. Heerka fibrinogen iyo arrimo kale oo procoagulant sidoo kale kor u kacay.

dulqaadka sonkorta doorsoon iyo nooca 2aad ee sonkorowga

caabin Insulin waa arrin ka hor muujin caafimaad ee cudurka macaanka. Waayo, yaraynta fiirsashada of glucose kulmi unugyada beta ee beeryarada ah. Yaraynta fiirsashada waxaa lagu fuliyaa iyadoo la kordhinayo wax soo saarka ee insulin, taas oo keenta in hyperinsulinemia qof qaraabo ah. Euglycemia waxaa lagu sugi karaa in bukaanka ilaa inta unugyada beta ee ay awoodaan si ay u ilaaliyaan heerarka sare ee insulin plasma in ay ka gudbaan iska caabin ah. Ugu dambayntii, kartida this lumo, iyo ka-fiirsashada ee glucose si weyn u kordhiyaa. Arrin weyn oo ah, taas oo masuul ka ah hyperglycemia calool madhan ku saabsan asalka ah ee sonkorowga nooca 2, adkaysiga insuliinta waa beerka. jawaab Healthy waa in la yareeyo wax soo saarka sonkorta. Marka adkaysiga insuliinta, jawaabta waa laga badiyay. Sidaas darteed, wax soo saarka sonkorta beerka xad-dhaaf ah sii, taasoo keentay in sooman hyperglycemia. Iyada oo khasaare ku yimaada awoodda unugyada beta si ay u bixiyaan hypersecretion insulin dhigan guurka ka adkaysiga insuliinta la hyperinsulinemia in dulqaad glucose doorsoon. Ka dibna, gobolka waxaa loo beddelaa diabetes daawayn iyo hyperglycemia.

hypertension

Waxaa jira dhowr farsamooyinka taas oo u horseedi in ay horumarka ku saabsan asalka ah ee iska caabin ah insulin. Kormeerka ayaa muujinaya in daciifisa of vasodilation iyo vasoconstriction dardargelinta laga yaabaa in ay gacan caabiga vascular. Insulin kor u nidaam ku kiciyaha dareemaha maqaarka (dabacsanaadaan). Tani waxay keenaysaa in la kordhiyo fiirsashada norepinephrine plasma. In bukaanka qaba adkaysiga insuliinta kordhay jawaab u angiotensin. Intaa waxaa dheer, nidaamyada lagu xadgudbi karo vasodilation. The insulin xeerarka gobolka kobciyaa nasashada derbiga muruqa vascular. Vasodilatation kiiskan waxaa dhex dhexaadin by jiilka / siidaynta xabagta nitric endothelial ah. In bukaanka qaba adkaysiga insuliinta, function endothelial waa daciif. Tani waxa ay yaraynaysaa vasodilation ah by 40-50%.

dyslipidemia

Marka adkaysiga insuliinta carqaladeeyey acids free saarka dufanka leh xakamaynta caadi ah ka dib markaad cunto ka unugyada adipose. fiirsashada la kordhiyo saarta substrate a for ereygu wuxuu sare ee triglycerides. Tani waa talaabo muhiim ah in wax soo saarka VLDL. Marka hyperinsulinemia hoos u dhaqdhaqaaqa of muhiim enzyme - lipase lipoprotein. Waxaa ka mid ah isbedel tayo ku spectrum asalka LDL nooca 2aad ee sonkorowga iyo adkaysiga insuliinta waa in la soo sheegnay degree sii kordhaya ee lagu qayilo qayb LDL. More nugul habkan waxaa loo tixgeliyaa apolipoproteins glycated.

tallaabooyin daweynta

Kordhinta dareen insulin waxaa lagu gaari karaa siyaabo dhowr ah. Muhiimad gaar ah waa hoos u miisaamidda iyo dhaqdhaqaaqa jirka. Cuntada waxa kale oo ay muhiim u tahay dadka qaba cudurka adkaysiga insuliinta. Cuntada ka tarta dejinta in dhowr maalmood. In kor loo qaado dareenka dheeraad ah kor u qaadaan doonaa miisaanka oo yaraada. Waayo, dadka la iska caabin ah insulin go'an, daaweynta ka kooban yahay dhowr marxaladood. Xasilinta dhaqdhaqaaqa cuntada iyo jir ahaan waxaa loo arkaa in ay marxalada koowaad daaweynta. Waayo, dadka loo aqoonsaday insulin, cuntada waa in ay ahaataa hooseeyo-calorie. hoos u dhac A dhexdhexaad ah ee miisaanka jidhka (5-10 kiilo) inta badan waxay ka caawisaa si loo hagaajiyo gacanta heerarka glucose. Calories 80-90% waxaa loo qaybiyey inta u dhaxaysa carbohydrate iyo baruurtii, 10-20% ka borotiinada.

daawooyinka

Oo macnaheedu yahay "Metamorfin" waxa loola jeedaa koox ka mid ah daawooyinka biguanide. Daawada hagaajinaysaa dareen insulin ah durugsan iyo cagaarshowga. Xaaladdan oo kale waxay ka dhigan tahay saameyn ah kuma laha ay dheecaan. Maqnaanshaha diyaarinta insulin "Metamorfin" xumaada. Oo macnaheedu yahay "Troglitazone" waa koox tiazolidinedionov ugu horeysay medicament oo loo ogol yahay in ay isticmaalaan ee USA. Daawada kordhiyaa gaadiidka ee glucose. Tan waxaa laga yaabaa in ay keento dardargelinta ee receptor PPAR-gamma. Oo taas wanaajiyey hadal GLUT4, taas oo keenta in la kordhiyo in qabashada glucose insulin-shidan yihiin. Waayo, bukaanka qaba caabbinta insulin ah, daaweynta loo qaadan karaa oo la isku daray. Habka kor ku xusan waxaa loo isticmaali karaa in lagu daro sulfonylurea ah, iyo mararka qaarkood qaarka kale in ay soo saaraan saamayn hammiga on guluukoosta iyo cudura kale. Daawada "Metamorfin" isku dhafan oo sulfonylurea a kordhiyaa dheecaan iyo insulin dareen. Xaaladdan oo kale, heerka sonkorta hoos ka dib cuntada iyo calool madhan. Bukaan-socodka kuwaas oo loo xilsaaray daaweynta isku dhafan, waxay ahaayeen daliilka badan ee hypoglycemia.