Ubudlelwano Phakathi Kwesibindi Esinamafutha kanye I-insulin

Ubudlelwano Phakathi Kwesibindi Esinamafutha kanye Ne-Glycated Insulin kuwukuhlobana okuseduze phakathi kwesibindi esinamafutha (ikakhulukazi isifo sesibindi esinamafutha angewona utshwala, i-NAFLD) kanyei-insulin(nomai-insulinukumelana, i-hyperinsulinemia), eqondiswa ngokuyinhloko ngenxa yokuphazamiseka kwe-metabolic (isb., ukukhuluphala, uhlobo 2).isifo sikashukela,njll.). Okulandelayo ukuhlaziya okuningiliziwe kwamaphuzu abalulekile:

1. I-insulinUkumelana Njengendlela Eyinhloko

• I-insulinukumelana (IR) kuyisisekelo esivamile se-pathological sesibindi esinamafutha kanye ne-glucose metabolism engavamile. Lapho ukuzwela komzimba ku-insulin kuncipha, amanyikwe anxephezela akhiqiza okwengeziwei-insulin(hyperinsulinemia), okuholela ekukhuphukeni kwamazinga e-insulin egazini.
• Imiphumela yesibindi esinamafutha: i-hepatici-insulinukumelana kuvimbela i-oxidation ye-fatty acid, ikhuthaza ukuhlanganiswa kwamafutha (i-lipid deposition), futhi kwandisa ukuqoqwa kwamafutha ku-hepatocytes (steatosis).
• Ukuhlangana neI-HbA1c: Nakuba i-insulin ene-glycated ingeyona inkomba yomtholampilo esetshenziswa kakhulu, i-hyperglycemia (exhunywe ne-IR) inyusa i-glycated hemoglobin.(I-HbA1c), okubonisa ukulawulwa kabi kukashukela egazini, okuhlotshaniswa nokuqhubekela phambili kwesibindi esinamafutha kuya ku-steatohepatitis engeyona utshwala (NASH).

2. I-Hyperinsulinemia Ikhuthaza Isifo Sesibindi Esinamafutha

• Isenzo esiqondile: I-Hyperinsulinemia ikhuthaza i-hepatic lipogenesis (↑ lipid synthesis) ngokwenza kusebenze izici zokuloba (isb. SREBP-1c) kuyilapho ivimbela i-β-oxidation ye-fatty acid.
• Umthelela Ongaqondile:I-insulinukumelana kubangela ukuthi izicubu ze-adipose zikhiphe ama-fatty acids (FFAs) amahhala amaningi, angena esibindini aguqulelwe abe ama-triglycerides, okuqhubeka kwandisa isibindi samafutha.

3. Isibindi Esinamafutha Senyusa i-glucose metabolism engavamile

• Okubangelwa IsibindiI-insulinUkumelana: Isibindi esinamafutha sikhipha ama-cytokines avuthayo (isb., TNF-α,I-IL-6) kanye nama-adipokines (isb., ukumelana ne-leptin, ukuncipha kwe-adiponectin), okwenza kube kubi kakhulu ukumelana ne-insulin yesistimu.
• Ukwenyuka kokuphuma kwe-glucose ku-hepatic:i-insulinUkumelana ne-glucose kubangela ukungakwazi kwesibindi ukuvimbela kahle i-gluconeogenesis, futhi izinga likashukela wegazi elikhuphukayo lenze libe mbi kakhulu i-glucose metabolism (ukuqhubekela phambili okungenzeka kohlobo 2 lwesifo sikashukela).

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

• I-HbA1c ephakeme ibikezela ingozi yesibindi esinamafutha: izifundo ezimbalwa zikhombisile lokhoI-HbA1camazinga ahlotshaniswa kahle nokuqina kwesibindi esinamafutha, noma ngabe izindlela zokuxilonga isifo sikashukela zingafinyelelwanga (ingozi ikhuphuka kakhulu nge-HbA1c ≥ 5.7%).
• Ukulawulwa Kwe-Glycemic Ezigulini Zesibindi Esinamafutha: Iziguli ezinesifo sikashukela ezinesibindi esinamafutha zingase zidinge ukulawulwa kashukela wegazi okuqinile (okuhlosiwe kwe-HbA1c ephansi) ukuze kubambezeleke ukukhula kwesifo sesibindi.

5. Amasu Okungenelela: Ukwenza ngconoI-insulinUkuzwela

• Ukuguqulwa kwendlela yokuphila: ukulahlekelwa isisindo (ukulahlekelwa kwesisindo esingu-5-10% kuthuthukisa kakhulu isibindi esinamafutha), ukudla okune-carbohydrate ephansi / okunamafutha aphansi, ukuvivinya umzimba kwe-aerobic.
• Imithi:
  • Ii-nsulinsama-ensitizers (isb., i-metformin, i-pioglitazone) angathuthukisa isibindi samafutha kanye ne-glucose metabolism.
  • I-GLP-1 receptor agonists (isb, i-liraglutide, i-semaglutide) isiza ekunciphiseni isisindo, ukulawulwa kwe-glycemic, kanye nokunciphisa isibindi esinamafutha.
• Ukuqapha: Ukuzila ukudlai-insulin, i-HOMA-IR (inkomba yokumelana ne-insulin), i-HbA1c kanye ne-imaging/elastography yesibindi zazihlolwa njalo.

Isiphetho

Isibindi esinamafutha kanye i-insulin (noma i-hyperinsulinemia) yakha umjikelezo ononya ngokumelana ne-insulin. Ukungenelela kusenesikhathi kwei-insulinukumelana kuthuthukisa kokubili isibindi esinamafutha kanye ne-glucose metabolism futhi kunciphisa ingozi yesifo sikashukela kanye ne-fibrosis yesibindi. Omaka be-Metabolic badinga ukuhlolwa ndawonye emtholampilo kunokugxila enkomba eyodwa kuphela.

I-We Baysen Medical ihlale igxile kumasu okuxilonga ukuze sithuthukise izinga lempilo. Senze izinkundla zobuchwepheshe ezi-5- i-Latex, igolide eli-colloidal, i-Fluorescence Immunochromatographic Assay, i-Molecular, i-Chemiluminescence Immunoassay, YethuUkuhlolwa kwe-HbA1c,Ukuhlolwa kwe-insulinfuthiUkuhlolwa kwe-C-peptide ukusebenza okulula futhi angathola umphumela wokuhlolwa emizuzwini eyi-15