Ibasepo Laarin Ẹdọ Ọra ati Insulini

Ibasepo Laarin Ẹdọ Ọra ati Insulin Glycated jẹ ibatan isunmọ laarin ẹdọ ọra (paapaa arun ẹdọ ọra ti ko ni ọti, NAFLD) atihisulini(tabihisuliniresistance, hyperinsulinemia), eyiti o jẹ ilaja ni akọkọ nipasẹ awọn rudurudu ti iṣelọpọ (fun apẹẹrẹ, isanraju, iru 2Àtọgbẹ,ati be be lo). Atẹle ni alaye alaye ti awọn aaye pataki:

1. InsuliniResistance bi awọn Core Mechanism

• Insuliniresistance (IR) jẹ ipilẹ pathological ti o wọpọ fun ẹdọ ọra ati iṣelọpọ glukosi ajeji. Nigbati ifamọ ti ara si hisulini dinku, ti oronro ni isanpada san diẹ siihisulinihyperinsulinemia (hyperinsulinemia), eyiti o fa awọn ipele hisulini ẹjẹ ti o ga.
• Awọn abajade ti ẹdọ ọra: ẹdọ ẹdọhisuliniresistance dojuti ọra acid ifoyina, nse sanra kolaginni (ọra ipamọ), ati ki o mu awọn ikojọpọ ti sanra ni hepatocytes (steatosis).
• Association pẹluHbA1cBotilẹjẹpe hisulini glycated kii ṣe ami isamisi ile-iwosan ti o wọpọ, hyperglycemia gigun (ti o sopọ mọ IR) mu haemoglobin glycated pọ si.(HbA1c), ti o ṣe afihan iṣakoso suga ẹjẹ ti ko dara, eyiti o ni nkan ṣe pẹlu ilọsiwaju ti ẹdọ ọra si steatohepatitis ti kii-ọti-lile (NASH).

2. Hyperinsulinemia Ṣe igbega Arun Ẹdọ Ọra

• Iṣe taara: Hyperinsulinemia ṣe igbelaruge lipogenesis ẹdọ ẹdọ (↑ iṣelọpọ lipid) nipasẹ ṣiṣiṣẹ ti awọn ifosiwewe transcription (fun apẹẹrẹ SREBP-1c) lakoko ti o dẹkun fatty acid β-oxidation.
• Ipa aiṣe-taara:Insuliniresistance fa tissu adipose lati tu awọn acids fatty ọfẹ diẹ sii (FFAs), eyiti o wọ inu ẹdọ ati ti yipada si awọn triglycerides, ti o buru si ẹdọ ọra.

3. Ẹdọ Ọra Ṣe alekun iṣelọpọ glucose ajeji

• Ẹdọ-InducedInsuliniResistance: Ẹdọ ọra tu awọn cytokines iredodo silẹ (fun apẹẹrẹ, TNF-a,IL-6) ati adipokines (fun apẹẹrẹ, resistance leptin, adiponectin ti o dinku), resistance insulin eto eto ti n buru si.
• Iwajade glukosi ẹdọ pọ si:hisuliniAwọn abajade resistance ni ailagbara ti ẹdọ lati ṣe idiwọ gluconeogenesis daradara, ati glukosi ãwẹ ti o pọ si siwaju sii buru si iṣelọpọ glukosi (ilọsiwaju ti o ṣeeṣe si iru àtọgbẹ 2).

4. Ẹri isẹgun:Hemoglobin Glycosylated (HbA1c)ati Ẹdọ Ọra

• HbA1c ti o ga julọ sọ asọtẹlẹ eewu ẹdọ ọra: ọpọlọpọ awọn ijinlẹ ti fihan peHbA1cAwọn ipele ti o ni ibatan daadaa pẹlu iwuwo ẹdọ ti o sanra, paapaa nigbati awọn ibeere iwadii aisan suga ko ba pade (ewu pọ si ni pataki pẹlu HbA1c ≥ 5.7%).
• Iṣakoso Glycemic ninu Awọn alaisan Ẹdọ Ọra: Awọn alaisan ti o ni àtọgbẹ pẹlu ẹdọ ọra le nilo iṣakoso suga ẹjẹ ti o muna (awọn ibi-afẹde HbA1c kekere) lati fa fifalẹ ilọsiwaju arun ẹdọ.

5. Awọn ilana Ibaraẹnisọrọ: ImudaraInsuliniIfamọ

• Awọn iyipada igbesi aye: pipadanu iwuwo (5-10% pipadanu iwuwo ni pataki ṣe ilọsiwaju ẹdọ ọra), ounjẹ kekere-carbohydrate/ọra-kekere, adaṣe aerobic.
• Awọn oogun:
  • Insulinsensitizers (fun apẹẹrẹ, metformin, pioglitazone) le ni ilọsiwaju ẹdọ ọra ati iṣelọpọ glukosi.
  • Awọn agonists olugba GLP-1 (fun apẹẹrẹ, liraglutide, semaglutide) ṣe iranlọwọ ni pipadanu iwuwo, iṣakoso glycemic, ati idinku ẹdọ ọra.
• Abojuto: Awẹhisulini, HOMA-IR (itọka resistance insulin), HbA1c ati aworan ẹdọ / elastography ni idanwo nigbagbogbo.

Ipari

Ẹdọ ọra ati hisulini (tabi hyperinsulinemia) ṣe iyipo buburu nipasẹ resistance insulin. Tete intervention tihisuliniresistance ṣe ilọsiwaju ẹdọ ọra mejeeji ati iṣelọpọ glukosi ati dinku eewu ti àtọgbẹ ati fibrosis ẹdọ. Awọn asami ti iṣelọpọ nilo lati ṣe ayẹwo papọ ni ile-iwosan ju ki o fojusi lori atọka kan nikan.

A Baysen Medical jẹ idojukọ nigbagbogbo lori ilana iwadii lati mu didara igbesi aye dara si. A ti ṣe agbekalẹ awọn iru ẹrọ imọ-ẹrọ 5- Latex, goolu colloidal, Ayẹwo Immunochromatographic Fluorescence, Molecular, Chemiluminescence Immunoassay, WaAyẹwo HbA1c,Idanwo insulinatiIdanwo C-peptide iṣiṣẹ rọrun ati pe o le gba abajade idanwo ni awọn iṣẹju 15