Ubudlelwano Phakathi Kwesibindi Esinamafutha kanye I-insulini

Ubudlelwano Phakathi Kwesibindi Esinamafutha kanye ne-Glycated Insulin buwubudlelwano obuseduze phakathi kwesibindi esinamafutha (ikakhulukazi isifo sesibindi esinamafutha esingenalo utshwala, i-NAFLD) kanyei-insulin(nomai-insulinukumelana, i-hyperinsulinemia), okubangelwa kakhulu yizinkinga ze-metabolic (isb., ukukhuluphala, uhlobo 2isifo sikashukela,njll.). Okulandelayo ukuhlaziywa okuningiliziwe kwamaphuzu abalulekile:

1. I-insuliniUkumelana Njengendlela Eyinhloko

• I-insuliniUkumelana (IR) kuyisisekelo esivamile se-pathological sesibindi esinamafutha kanye nokuguqulwa kwe-glucose okungajwayelekile. Lapho ukuzwela komzimba ku-insulin kwehla, i-pancreas ikhipha okuningi ngokunxephezelai-insulin(i-hyperinsulinemia), okubangela amazinga aphezulu e-insulin egazini.
• Imiphumela yesibindi esinamafutha: isibindii-insulinUkumelana kuvimbela ukushiswa kwe-fatty acid, kukhuthaza ukwakheka kwamafutha (ukufakwa kwe-lipid), futhi kubhebhethekise ukuqongelela kwamafutha kuma-hepatocytes (i-steatosis).
• Ubudlelwano noI-HbA1cNakuba i-insulin efakwe i-glycated ingeyona uphawu oluvame ukusetshenziswa, i-hyperglycemia ende (ehlotshaniswa ne-IR) ikhulisa i-hemoglobin efakwe i-glycated(I-HbA1c), okubonisa ukulawulwa kabi koshukela egazini, okuhlotshaniswa nokuqhubekela phambili kwesibindi esinamafutha kuya ku-steatohepatitis engeyona eye-alcoholic (NASH).

2. I-Hyperinsulinemia Ikhuthaza Isifo Sesibindi Esinamafutha

• Isenzo esiqondile: I-Hyperinsulinemia ikhuthaza i-lipogenesis yesibindi (↑ ukwakheka kwamafutha) ngokusebenzisa izici zokubhala (isb. i-SREBP-1c) ngenkathi ivimbela i-fatty acid β-oxidation.
• Umphumela Ongaqondile:I-insuliniUkumelana kubangela ukuthi izicubu zamafutha zikhiphe ama-fatty acid amaningi (ama-FFA) amahhala, angena esibindini bese eguqulwa abe ama-triglycerides, okwenza kube kubi kakhulu isibindi esinamafutha.

3. Isibindi Esinamafutha Sikhulisa ukugaywa kweglucose okungajwayelekile

• Okubangelwa YisibindiI-insuliniUkumelana: Isibindi esinamafutha sikhipha ama-cytokine avuvukalayo (isb., i-TNF-α,IL-6) kanye nama-adipokines (isb., ukumelana ne-leptin, ukwehla kwe-adiponectin), okwenza kube kubi kakhulu ukumelana ne-insulin emzimbeni.
• Ukwanda kokukhishwa kweglucose esibindini:i-insulinUkumelana kubangela ukungakwazi kwesibindi ukuvimbela i-gluconeogenesis ngendlela efanele, kanti ushukela wegazi ophakeme osheshayo wenza kube kubi kakhulu ukusebenza kwe-glucose (okungenzeka ukuthi kuqhubekele phambili kusifo sikashukela sohlobo 2).

4. Ubufakazi Bezokwelapha:I-Glycosylated Hemoglobin (HbA1c)kanye ne-Fatty Liver

• I-HbA1c ephakeme ibikezela ingozi yesibindi esinamafutha: izifundo eziningana zikhombisile ukuthiI-HbA1cAmazinga ahlobene kahle nobunzima besibindi esinamafutha, ngisho nalapho izindlela zokuxilonga isifo sikashukela zingahlangatshezwanga (ingozi iyanda kakhulu nge-HbA1c ≥ 5.7%).
• Ukulawulwa Kwe-Glycemic Ezigulini Ezinamafutha Esibindini: Iziguli ezinesifo sikashukela ezinamafutha esibindini zingadinga ukuphathwa okuqinile koshukela egazini (izinhloso eziphansi ze-HbA1c) ukuze kuncishiswe ukuqhubeka kwesifo sesibindi.

5. Amasu Okungenelela: UkuthuthukisaI-insuliniUkuzwela

• Ukuguqulwa kwendlela yokuphila: ukwehlisa isisindo (ukwehlisa isisindo ngo-5-10% kuthuthukisa kakhulu isibindi esinamafutha), ukudla okunama-carbohydrate aphansi/okunamafutha aphansi, ukuzivocavoca umzimba.
• Imithi:
  • Ii-ninsulinsIzithasiselo (isib., i-metformin, i-pioglitazone) zingathuthukisa i-metabolism yamafutha esibindini kanye ne-glucose.
  • Ama-agonist e-GLP-1 receptor (isib. i-liraglutide, i-semaglutide) asiza ekunciphiseni isisindo, ekulawuleni i-glycemic, kanye nasekunciphiseni amafutha esibindini.
• Ukuqapha: Ukuzila Ukudlai-insulin, i-HOMA-IR (inkomba yokumelana ne-insulin), i-HbA1c kanye ne-liver imaging/elastography kwahlolwa njalo.

Isiphetho

Isibindi esinamafutha kanye i-insulin (noma i-hyperinsulinemia) yakha umjikelezo omubi ngokumelana ne-insulin. Ukungenelela kusenesikhathi kwe-insulini-insulinUkumelana kuthuthukisa kokubili i-fatty liver kanye ne-glucose metabolism futhi kunciphisa ingozi yesifo sikashukela kanye ne-liver fibrosis. Izimpawu ze-metabolic zidinga ukuhlolwa ndawonye emtholampilo kunokugxila enkombeni eyodwa kuphela.

I-Baysen Medical ihlala igxile ebuchwephesheni bokuxilonga ukuze ithuthukise ikhwalithi yempilo. Sithuthukise amapulatifomu obuchwepheshe ayi-5 - i-Latex, igolide le-colloidal, i-Fluorescence Immunochromatographic Assay, i-Molecular, i-Chemiluminescence Immunoassay, i-OurUkuhlolwa kwe-HbA1c,Ukuhlolwa kwe-insulinifuthiUkuhlolwa kwe-C-peptide ukusebenza okulula futhi ungathola umphumela wokuhlolwa ngemizuzu eyi-15