Ka Pilina ma waena o ke Ake Momona a me ʻInisulina

ʻO ka pilina ma waena o ke akepaʻa momona a me ka Glycated Insulin he pilina pili loa ia ma waena o ke akepaʻa momona (ʻoi aku ka maʻi ʻona momona ʻole, NAFLD) a meʻinsulina(a i ʻoleʻinsulinake kū'ē, hyperinsulinemia), ka mea i hoʻopili nui ʻia ma o nā maʻi metabolic (e laʻa, momona, ʻano 2maʻi diabetes,a pēlā aku). Eia kahi loiloi kikoʻī o nā kumu nui:

1. ʻInisulinaKe Kū'ē ma ke ʻano he ʻAno Hana Koʻikoʻi

• ʻInisulinaʻO ke kū'ē (IR) kahi kumu maʻamau no ke akepaʻa momona a me ka metabolism glucose maʻamau. Ke emi ka ʻike o ke kino i ka insulin, hoʻopuka hou ka pancreas i nā mea hou akuʻinsulinaʻO ka maʻi diabetes (hyperinsulinemia), e alakaʻi ana i ka hoʻonui ʻia o ka nui o ka insulin i ke koko.
• Nā hopena o ke akepaʻa momona: hepaticʻinsulinaHoʻopale ke kū'ē i ka oxidation o ka momona momona, paipai i ka synthesis momona (lipid deposition), a hoʻonui i ka hōʻiliʻili ʻana o ka momona i nā hepatocytes (steatosis).
• Ka pilina meHbA1cʻOiai ʻaʻole ka insulin glycated kahi māka lapaʻau maʻamau i hoʻohana ʻia, ʻo ka hyperglycemia lōʻihi (e pili ana i ka IR) e hoʻonui i ka hemoglobin glycated.(HbA1c), e hōʻike ana i ka kaohi maikaʻi ʻole o ke kō koko, kahi e pili ana me ka holomua o ke akepaʻa momona i ka steatohepatitis non-alcoholic (NASH).

2. Hoʻoulu ka Hyperinsulinemia i ka maʻi ʻaʻai momona

• Hana pololei: Hoʻolaha ka Hyperinsulinemia i ka lipogenesis hepatic (↑ lipid synthesis) ma o ka hoʻoulu ʻana i nā mea hoʻololi (e laʻa me SREBP-1c) ʻoiai e kāohi ana i ka fatty acid β-oxidation.
• Hopena ʻAʻole pololei:ʻInisulinaʻO ke kū'ē ke kumu o ka hoʻokuʻu ʻana o ka ʻiʻo adipose i nā waikawa momona manuahi (FFAs), kahi e komo ai i ke akepaʻa a hoʻololi ʻia i triglycerides, e hoʻonui hou aku ana i ka maʻi ate momona.

3. Hoʻonui ka Momona Ake i ka metabolism glucose maʻamau

• Hoʻoulu ʻia e ke akepaʻaʻInisulinaKe kū'ē: Hoʻokuʻu ke akepaʻa momona i nā cytokines mumū (e laʻa, TNF-α,IL-6) a me nā adipokines (e laʻa, ke kū'ē'ē ʻana o ka leptin, ka emi ʻana o ka adiponectin), e hoʻonui ana i ke kū'ē'ē ʻana o ka insulin systemic.
• Hoʻonui ʻia ka hoʻopuka glucose hepatic:ʻinsulinaʻO ke kū'ē ʻana ka hopena i ka hiki ʻole o ke akepaʻa ke kāohi pono i ka gluconeogenesis, a ʻo ka nui o ka glucose koko hoʻokē ʻai e hoʻopilikia hou aku i ka metabolism glucose (hiki ke holomua i ka maʻi diabetes type 2).

4. Nā Hōʻike Lapaʻau:Hemoglobin Glycosylated (HbA1c)a me ke akepaʻa momona

• Ua wānana ka HbA1c kiʻekiʻe i ka pilikia o ke akepaʻa momona: ua hōʻike ʻia e kekahi mau noiʻiHbA1cua pili pono nā pae me ke koʻikoʻi o ke akepaʻa momona, ʻoiai inā ʻaʻole i hoʻokō ʻia nā koina diagnostic diabetes (ua piʻi nui ka pilikia me HbA1c ≥ 5.7%).
• Ka Mana Glycemic i nā Maʻi Ake Momona: Pono paha nā maʻi maʻi diabetes me ke ake momona i ka hoʻokele koʻikoʻi o ke kō koko (nā pahuhopu HbA1c haʻahaʻa) e lohi ai ka holomua o ka maʻi ake.

5. Nā Hoʻolālā Hana Komo: HoʻomaikaʻiʻInisulinaʻIkepili

• Nā hoʻololi ʻana i ke ʻano o ka nohona: ka pohō kaumaha (5-10% ka pohō kaumaha e hoʻomaikaʻi nui i ke akepaʻa momona), ka ʻai haʻahaʻa-kalapona/haʻahaʻa-momona, hoʻoikaika kino aerobic.
• Nā lāʻau lapaʻau:
  • Iʻinsulinshiki i nā ensitizers (e laʻa, metformin, pioglitazone) ke hoʻomaikaʻi i ke akepaʻa momona a me ka metabolism glucose.
  • Kōkua nā agonists receptor GLP-1 (e laʻa, liraglutide, semaglutide) i ka pohō kaumaha, kaohi glycemic, a me ka hoʻēmi ʻana i ke akepaʻa momona.
• Nānā ʻana: Hoʻokē ʻaiʻinsulinaua hoʻāʻo pinepine ʻia ka HOMA-IR (insulin resistance index), HbA1c a me ke kiʻi ʻana o ke ake/elastography.

Hopena

Ake momona a me ʻinsulina (a i ʻole hyperinsulinemia) e hana i kahi pōʻai ʻino ma o ke kū'ē ʻana o ka insulin. Ke komo mua ʻana oʻinsulinaHoʻomaikaʻi ke kū'ē i ka metabolism o ke akepaʻa momona a me ka glucose a hōʻemi i ka pilikia o ka maʻi diabetes a me ka fibrosis ake. Pono e loiloi pū ʻia nā māka metabolic ma ke keʻena lapaʻau ma mua o ka nānā ʻana i hoʻokahi hōʻailona wale nō.

ʻO mākou ʻo Baysen Medical ke kālele mau nei i ka ʻenehana diagnostic e hoʻomaikaʻi i ke ʻano o ke ola. Ua hoʻomohala mākou i 5 mau kahua ʻenehana- Latex, colloidal gold, Fluorescence Immunochromatographic Assay, Molecular, Chemiluminescence Immunoassay, ʻO kā mākouHoʻāʻo HbA1c,Hoʻāʻo insulina meHoʻāʻo C-peptide he maʻalahi ka hoʻohana ʻana a hiki ke loaʻa ka hopena hoʻāʻo i loko o 15 mau minuke