Mmekọrịta dị n'etiti imeju abụba abụba na Insulin

Mmekọrịta dị n'etiti imeju abụba abụba na insulin Glycated bụ njikọ chiri anya n'etiti imeju abụba abụba (karịsịa ọrịa imeju na-adịghị egbu egbu, NAFLD) nainsulin(ma ọ bụinsulinnguzogide, hyperinsulinemia), nke a na-ebute site na nsogbu nke metabolic (dịka, oke ibu, ụdị 2).ọrịa shuga mellitus,wdg). Nke a bụ nyocha zuru oke nke isi ihe:

1. InsulinNguzogide dị ka Core Mechanism

• InsulinNguzogide (IR) bụ ihe ndabere maka ọrịa imeju nwere abụba na metabolism na-adịghị mma. Mgbe mmetụta ahụ na-ahụ maka insulin na-ebelata, pancreas na-ewepụtakwu iheinsulinhyperinsulinemia, nke na-eduga n'ịba ụba nke insulin n'ọbara.
• Nsonaazụ nke imeju abụba abụba: imejuinsulinNguzogide na-egbochi oxidation fatty acid, na-akwalite njikọ abụba (nkwụsị nke lipid), na-eme ka mkpokọta abụba dị na hepatocytes (steatosis) dịkwuo njọ.
• Mkpakọrịta naHbA1cỌ bụ ezie na insulin glycated abụghị ihe nrịbama ụlọ ọgwụ a na-ejikarị eme ihe, hyperglycemia ogologo oge (njikọ na IR) na-abawanye haemoglobin glycated.(HbA1c), na-egosipụta njikwa shuga ọbara na-adịghị mma, nke jikọtara ya na ọganihu nke imeju abụba na steatohepatitis na-adịghị egbu egbu (NASH).

2. Hyperinsulinemia Na-akwalite Ọrịa imeju abụba abụba

• Omume kpọmkwem: Hyperinsulinemia na-akwalite lipogenesis imeju (↑ lipid synthesis) site na ịgbalite ihe odide ederede (dịka SREBP-1c) ma na-egbochi abụba acid β-oxidation.
• Mmetụta na-apụtaghị ìhè:InsulinNguzogide na-eme ka anụ ahụ adipose na-ahapụ ọtụtụ acid fatty free (FFA), nke na-abanye na imeju wee ghọọ triglycerides, na-akawanye njọ imeju abụba abụba.

3. Imeju abụba abụba na-eme ka metabolism glucose na-adịghị mma ka njọ

• Imeju na-ebuteInsulinNguzogide: imeju abụba abụba na-ahapụ cytokines na-akpasu iwe (dịka, TNF-α,IL-6) na adipokines (dịka ọmụmaatụ, nguzogide leptin, adiponectin belatara), nguzogide insulin na-akawanye njọ.
• Mmụba glucose imeju na-abawanye:insulinNguzogide na-ebute enweghị ike imeju igbochi gluconeogenesis nke ọma, yana mmụba nke glucose ọbara na-ebu ọnụ na-akawanye njọ metabolism (enwere ike ịga n'ihu na-aga ụdị ọrịa shuga 2).

4. Ihe akaebe gbasara ahụike:Glycosylated haemoglobin (HbA1c)na imeju abụba abụba

• HbA1c dị elu na-ebu amụma ihe ize ndụ imeju nwere abụba: ọtụtụ nchọpụta egosila nke ahụHbA1cA na-ejikọta ọkwa nke ọma na oke imeju abụba abụba, ọbụlagodi mgbe emezughị usoro nyocha ọrịa shuga (ihe egwu na-abawanye nke ukwuu na HbA1c ≥ 5.7%).
• Njikwa glycemic na ndị ọrịa imeju abụba abụba: Ndị ọrịa nwere ọrịa shuga nwere imeju nwere abụba nwere ike ịchọ nlekọta siri ike nke shuga ọbara (ihe HbA1c dị ala) iji belata ọrịa imeju.

5. Usoro ntinye aka: ImeziwanyeInsulinMmetụta

• Mgbanwe ụdị ndụ: ọnwụ dị arọ (5-10% arọ ọnwụ na-eme ka imeju abụba dịkwuo mma), nri nwere obere carbohydrate/abụba dị ala, mmega ahụ aerobic.
• Ọgwụ:
  • Insulinsensitizers (dịka ọmụmaatụ, metformin, pioglitazone) nwere ike melite imeju abụba na glucose metabolism.
  • Ndị na-anabata GLP-1 (dịka ọmụmaatụ, liraglutide, semaglutide) na-enyere aka na mbelata ibu, njikwa glycemic na mbelata imeju abụba abụba.
• Nlekota: ibu ọnụinsulin, HOMA-IR (Insulin resistance index), HbA1c na imeju imaging/elastography na-anwale mgbe niile.

Mmechi

Imeju abụba na insulin (ma ọ bụ hyperinsulinemia) na-etolite ajọ okirikiri site na nguzogide insulin. Ntinye aka nke mbụinsulinnguzogide na-akwalite ma imeju abụba abụba na glucose metabolism ma na-ebelata ohere nke ọrịa shuga na fibrosis imeju. Ọ dị mkpa ka enyocha ihe nrịbama metabolic ọnụ n'ụlọọgwụ kama ilekwasị anya n'otu ihe ngosi naanị.

Anyị Baysen Medical na-elekwasị anya mgbe niile na usoro nyocha iji melite ogo ndụ. Anyị mepụtara nyiwe teknụzụ 5- Latex, ọla edo colloidal, Fluorescence Immunochromatographic Assay, Molecular, Chemiluminescence Immunoassay, AnyịNyocha HbA1c,Nnwale insulinnaNnwale C-peptide ịrụ ọrụ dị mfe ma nwee ike nweta nsonaazụ ule na nkeji iri na ise