Ubudlelwane Phakathi Kwesibindi Esinamafutha kunye I-insulin

Ubudlelwane Phakathi Kwesibindi Esinamafutha kunye ne-Glycated Insulin lulwalamano olusondeleyo phakathi kwesibindi esinamafutha (ingakumbi isifo sesibindi esinamafutha esinganxilisiyo, i-NAFLD) kunyei-insulin(okanyei-insulinukumelana, i-hyperinsulinemia), ebangelwa ikakhulu ziingxaki zemetabolism (umz., ukutyeba kakhulu, uhlobo lwesibiniisifo seswekile,njl.njl.). Oku kulandelayo luhlalutyo oluneenkcukacha lwamanqaku aphambili:

1. I-insulinUkuxhathisa njengeNkqubo ePhambili

• I-insulinUkuxhathisa (IR) sisizathu esiqhelekileyo sesifo sesibindi esinamafutha kunye ne-metabolism engaqhelekanga yeswekile. Xa uvakalelo lomzimba kwi-insulin luncipha, i-pancreas ikhupha ngakumbi ngokuhlawulelai-insulin(i-hyperinsulinemia), nto leyo ebangela ukuba amanqanaba aphezulu e-insulin egazini.
• Iziphumo zesibindi esinamafutha: isibindii-insulinUkuxhathisa kuthintela i-oxidation ye-fatty acid, kukhuthaza ukwenziwa kwamafutha (ukugcinwa kwe-lipid), kwaye kuyenza mandundu ingqokelela yamafutha kwi-hepatocytes (i-steatosis).
• Ubudlelwane noI-HbA1cNangona i-insulin ene-glycated ingeyona nto isetyenziswa kakhulu, i-hyperglycemia ende (enxulunyaniswa ne-IR) iyandisa i-hemoglobin ene-glycated(I-HbA1c), nto leyo ebonisa ukungalawuleki kakuhle kweswekile egazini, nto leyo enxulunyaniswa nokuqhubela phambili kwesibindi esinamafutha ukuya kwi-steatohepatitis engeyo-alcoholic (NASH).

2. I-Hyperinsulinemia Ikhuthaza Isifo Sesibindi Esinamafutha

• Isenzo esithe ngqo: I-Hyperinsulinemia ikhuthaza i-hepatic lipogenesis (↑ lipid synthesis) ngokusebenzisa izinto ezibangela ukubhalwa kwe-transcription (umz. i-SREBP-1c) ngelixa ithintela i-fatty acid β-oxidation.
• Isiphumo esingathanga ngqo:I-insulinUkuxhathisa kubangela ukuba izicubu zamafutha zikhuphe ii-fatty acids ezininzi zasimahla (ii-FFAs), ezingena esibindini zize ziguqulwe zibe yi-triglycerides, nto leyo eyenza ukuba isibindi esinamafutha sibe sibi ngakumbi.

3. Isibindi Esinamafutha Sibangela ukuba i-glucose metabolism ingasebenzi kakuhle

• Ibangelwa sisibindiI-insulinUkuxhathisa: Isibindi esinamafutha sikhupha ii-cytokines ezivuthayo (umz., i-TNF-α,IL-6) kunye nee-adipokines (umz., ukuxhathisa i-leptin, ukwehla kwe-adiponectin), okubangela ukuba ukuxhathisa i-insulin emzimbeni kube mandundu.
• Ukwanda kokuphuma kweglucose kwisibindi:i-insulinUkuxhathisa kubangela ukuba isibindi singakwazi ukuthintela i-gluconeogenesis ngokufanelekileyo, kwaye i-glucose ephezulu egazini ekhawulezayo iyenza mandundu imetabolism ye-glucose (okunokwenzeka ukuba iqhubekele kwisifo seswekile sohlobo lwesibini).

4. Ubungqina bezonyango:I-Glycosylated Hemoglobin (HbA1c)kunye neSibindi esinamafutha

• I-HbA1c ephakanyisiweyo ixela kwangaphambili umngcipheko wesibindi esinamafutha: izifundo ezininzi zibonise ukubaI-HbA1cAmanqanaba anxulumene kakuhle nobunzima besibindi esinamafutha, nokuba iikhrayitheriya zokuxilonga isifo seswekile azifezekiswanga (umngcipheko uyanda kakhulu nge-HbA1c ≥ 5.7%).
• Ulawulo lweGlycemic kwiZigulana zeSibindi esiNamanqatha: Izigulana ezineswekile ezinesifo seswekile ezinamafutha zinokufuna ulawulo oluqinileyo lweswekile egazini (iithagethi zeHbA1c ezisezantsi) ukuze kuncitshiswe ukuqhubela phambili kwesifo sesibindi.

5. Amaqhinga okungenelela: UkuphuculaI-insulinUvelwano

• Utshintsho kwindlela yokuphila: ukunciphisa umzimba (ukunciphisa umzimba nge-5-10% kuphucula kakhulu isibindi esinamafutha), ukutya okune-carbohydrate ephantsi/ukutya okunamafutha aphantsi, umthambo we-aerobic.
• Amayeza:
  • Ii-nsulinisIzithambisi-mzimba (umz., i-metformin, i-pioglitazone) zinokuphucula imetabolism yesibindi esinamafutha kunye neglucose.
  • Ii-agonists ze-GLP-1 receptor (umz., i-liraglutide, i-semaglutide) zinceda ekunciphiseni ubunzima, ukulawula i-glycemic, kunye nokunciphisa amafutha esibindini.
• Ukubeka iliso: Ukuzila ukutyai-insulin, i-HOMA-IR (i-insulin resistance index), i-HbA1c kunye ne-liver imaging/elastography zivavanywa rhoqo.

Isiphelo

Isibindi esinamafutha kunye i-insulin (okanye i-hyperinsulinemia) zenza umjikelo onzima ngokuxhathisa i-insulin. Ukungenelela kwangoko kwe-insulini-insulinUkuxhathisa kuphucula i-fatty liver kunye ne-glucose metabolism kwaye kunciphisa umngcipheko wesifo seswekile kunye ne-liver fibrosis. Iimpawu ze-metabolic kufuneka zihlolwe kunye ekliniki endaweni yokugxila kwisalathisi esinye kuphela.

I-Baysen Medical isoloko igxile kwindlela yokuxilonga ukuphucula umgangatho wobomi. Siphuhlise amaqonga etekhnoloji ama-5- iLatex, igolide ye-colloidal, uvavanyo lwe-Fluorescence Immunochromatographic, i-Molecular, i-Chemiluminescence Immunoassay, i-OurUvavanyo lwe-HbA1c,Uvavanyo lwe-insulinkwayeUvavanyo lwe-C-peptide ukusebenza lula kwaye ungafumana iziphumo zovavanyo kwimizuzu eli-15