Ubudlelwane phakathi kweFatty Liver kunye I-insulin

Ubudlelwane phakathi kwe-Fatty Liver kunye ne-Glycated Insulin yintsebenziswano esondeleyo phakathi kwesibindi esinamafutha (ingakumbi isifo sesibindi esinamafutha, i-NAFLD) kunyeinsulin(okanyeinsulinukuxhathisa, i-hyperinsulinemia), edityaniswa ngokuyintloko ngokuphazamiseka kwemetabolism (umzekelo, ukutyeba, uhlobo 2).isifo seswekile,njl.). Oku kulandelayo luhlalutyo oluneenkcukacha lwamanqaku aphambili:

1. I-insulinUkuchasa njengeNdlela ePhambili

• I-insulinukumelana (IR) sisiseko se-pathological esiqhelekileyo sesibindi esinamafutha kunye ne-glucose metabolism engaqhelekanga. Xa uvakalelo lomzimba kwi-insulin luyancipha, i-pancreas ikhupha ngakumbiinsulin(hyperinsulinemia), okukhokelela kumanqanaba aphezulu e-insulin yegazi.
• Iziphumo zesibindi esinamafutha: i-hepaticinsulinukumelana kuthintela i-fatty acid oxidation, ikhuthaza i-fat synthesis (i-lipid deposition), kwaye ikhulise ukuqokelela kwamafutha kwi-hepatocytes (steatosis).
• Unxulumano neHbA1c: Nangona i-insulin ye-glycated ingeyiyo into esetyenziswa ngokuqhelekileyo ikliniki, i-hyperglycemia yexesha elide (edityaniswe ne-IR) yonyusa i-glycated hemoglobin.(HbA1c), ebonisa ukulawulwa kakubi kweshukela egazini, ehambelana nokunyuka kwesibindi esinamafutha ukuya kwi-non-alcoholic steatohepatitis (NASH).

2. I-Hyperinsulinemia ikhuthaza izifo zesibindi ezinamafutha

• Isenzo esithe ngqo: I-Hyperinsulinemia ikhuthaza i-hepatic lipogenesis (↑ lipid synthesis) ngokusebenzisa i-activation ye-transcription factor (umzekelo, i-SREBP-1c) ngelixa inqanda i-fatty acid β-oxidation.
• Isiphumo esingathanga ngqo:I-insulinUkuxhathisa kubangela ukuba izicubu ze-adipose zikhuphe i-fatty acids (FFAs) yamahhala, engena esibindini kwaye iguqulelwe kwi-triglycerides, isibindi esinamafutha ngakumbi.

3. I-Fatty Liver Yandisa i-glucose metabolism engaqhelekanga

• I-Liver-InducedI-insulinUkuxhathisa: Isibindi esinamafutha sikhupha iicytokines ezivuthayo (umzekelo, TNF-α,I-IL-6) kunye ne-adipokines (umzekelo, ukuxhathisa i-leptin, ukunciphisa i-adiponectin), ukunyanzeliswa kwe-insulin ye-systemic.
• Ukonyuka kwemveliso yeswekile yesibindi:insulinukuxhathisa kubangela ukungakwazi kwesibindi ukunqanda ngokufanelekileyo i-gluconeogenesis, kwaye ukunyuka kwe-glucose yegazi ngokukhawuleza kuyingozi ngakumbi kwi-glucose metabolism (ukuqhubela phambili okunokwenzeka kohlobo lwe-2 yeswekile).

4. Ubungqina boNyango:I-Glycosylated Hemoglobin (HbA1c)kunye neFatty Liver

• I-HbA1c ephakamileyo iqikelela umngcipheko wesibindi esinamafutha: izifundo ezininzi zibonise okoHbA1camanqanaba ahambelana ngokufanelekileyo kunye nobunzima besibindi esinamafutha, nangona iindlela zokuxilonga isifo sikashukela zingadibananga (umngcipheko unyuke kakhulu nge-HbA1c ≥ 5.7%).
• Ukulawulwa kweGlycemic kwiZigulana zesibindi esinamafutha: Izigulane ezinesifo seswekile ezinesibindi esinamafutha zinokufuna ulawulo olungqongqo lweswekile yegazi (iithagethi ezisezantsi ze-HbA1c) ukucothisa ukukhula kwesifo sesibindi.

5. Amaqhinga ongenelelo: UkuphuculaI-insulinUvakalelo

• Ukuguqulwa kwendlela yokuphila: ukulahleka kwesisindo (i-5-10% ukulahleka kwesisindo kuphucula kakhulu isibindi esinamafutha), i-carbohydrate ephantsi / i-fat-fat-fat, i-aerobic exercise.
• Amayeza:
  • Ii-nsulinsi-ensitizers (umzekelo, i-metformin, i-pioglitazone) inokuphucula isibindi esinamafutha kunye ne-glucose metabolism.
  • I-GLP-1 i-receptor agonists (umzekelo, i-liraglutide, i-semaglutide) inceda ekulahlekeni kwesisindo, ukulawula i-glycemic, kunye nokunciphisa isibindi esinamafutha.
• Ukubeka iliso: Ukuzila ukutyainsulin, I-HOMA-IR (i-insulin resistance index), i-HbA1c kunye ne-imaging yesibindi / i-elastography yayivavanywa rhoqo.

Ukuqukumbela

Isibindi esinamafutha kunye insulin (okanye i-hyperinsulinemia) yenza umjikelo okhohlakeleyo ngokuxhathisa i-insulin. Ukungenelela kwangethuba kweinsulinukumelana kuphucula isibindi esinamafutha kunye ne-glucose metabolism kwaye kunciphisa umngcipheko wesifo sikashukela kunye ne-fibrosis yesibindi. Iimpawu zeMetabolic kufuneka zivavanywe kunye eklinikhi kunokujolisa kwisalathisi esinye kuphela.

Thina iBaysen Medical sihlala sigxile kwindlela yokuxilonga ukuphucula umgangatho wobomi. Siphuhlise amaqonga etekhnoloji ama-5- iLatex, igolide ye-colloidal, iFluorescence Immunochromatographic Assay, iMolekyuli, iChemiluminescence Immunoassay, eyethu.Uvavanyo lwe-HbA1c,Uvavanyo lwe-insulinkwayeUvavanyo lwe-C-peptide umsebenzi olula kwaye unokufumana iziphumo zovavanyo kwimizuzu eyi-15