Glycosylated hemoglobin

Mapuloteni a hemoglobin, omwe amapezeka m'maselo ofiira a m'magazi, amathandiza maselo ofiira am'magazi kuti amange ndikupereka mamolekyulu a okosijeni m'thupi lonse. Koma sikuti aliyense amadziwa zina zake: kwanthawi yayitali kukhala mu shuga, amapanga mankhwala ena omwe sangathe kusintha nawo. Njira yolumikizirana imatchedwa glycation, kapena glycosylation, zotsatira zake ndi glycosylated hemoglobin. Amawonetsedwa ndi formula HbA1c.

Mokulirapo shuga m'magazi, mumatha mapuloteni ochulukirapo. Miyezo ya HbA1c imayezedwa ngati peresenti ya hemoglobin yathunthu yomwe imayenda m'magazi. Malingaliro a amuna ndi akazi samasiyana, pakuti ana ndi chimodzimodzi kwa akulu:

mwa munthu wathanzi, glycosylated hemoglobin 4.8-5.9% (kuwunika bwino kwa shuga ndi HbA1c: kusiyana kwake ndi kotani?

Mulingo wa shuga wamagazi ndi wosiyanasiyana. Zimasiyanasiyana osati pakati pa odwala matenda ashuga, komanso pakati pa anthu athanzi: masana, kutengera nthawi ya chaka, chimfine kapena kuzizira, kapena kugona usiku. Mwa munthu yemweyo, kuyezetsa magazi mofulumira kumatha kupereka zotsatira zosiyana. Chifukwa chake, amagwiritsidwa ntchito pozindikira komanso kuwongolera mwachangu - kuti muthe kusankha mitundu ya mapiritsi a insulin kapena hypoglycemic.

Mlingo wa HbA1c sasintha ngati munthuyo ali wamanjenje, sizimadalira nthawi yoyesa (m'mawa, madzulo, mutatha kudya kapena pamimba yopanda kanthu). Zotsatira zake zizikhala zolondola ngati phunzirolo limamwa mankhwala osamwa kapena kumwa mowa tsiku latha. Glycosylated hemoglobin, mosiyana ndi kuchuluka kwa shuga, samachepa atatha kusewera masewera ndipo samakula pambuyo pa maswiti omwe sanadye nthawi.

Kodi kuwunika pa HbA1c kukuwonetsa chiyani? Zimapangitsa kuti zitha kuwona osati zakanthawi, koma kuchuluka kwa shuga kwa masabata 4-8 apitawa. Ndiye kuti, kuwunika momwe kagayidwe kamene kamayendetsa matenda a shuga kumiyezi itatu musanayesedwe.

Kuti muthane ndi shuga mokwanira, ndikofunikira kuphatikiza mayeso onse awiri: glycosylated hemoglobin ndi shuga wamagazi. M'madera ena odwala matenda ashuga, kuchuluka kwa HbA1c kumawonetsa chizolowezi, koma kusinthasintha kwa tsiku ndi tsiku m'magazi a magazi. Mavuto amatha kuchitika kuposa omwe HbA1c adakwezedwa ndipo shuga sakhala "akulumpha" masana.

Zojambula ndi Zoyipa za Kusanthula kwa HbAlc

Erythrocyte imakhala ndi nthawi yamoyo ya masiku 120 mpaka 125, ndipo kumangiriza kwa hemoglobin ku glucose sikuchitika nthawi yomweyo. Chifukwa chake, pakuwunika bwino kagayidwe kazakudya m'thupi la anthu odwala matenda ashuga 1, kuwunikiraku kumachitika miyezi iwiri kapena itatu iliyonse, komanso ndi shuga 2 - kamodzi miyezi isanu ndi umodzi. Amayi oyembekezera omwe ali ndi gestational matenda a shuga amalangizidwa kuti ayang'ane hemlylobin ya glycosylated kumapeto kwa trimester yoyamba - masabata 10-12, koma kuwunikira uku sikuyenera kukhala kwakukulu.

HbAlc yabwinobwino kwa anthu odwala matenda ashuga ndiwopamwamba kuposa momwe imakhalira kwa anthu athanzi, koma sayenera - 7%. HbAlc ya 8-10% ikuwonetsa kuti mankhwalawo ndi osakwanira kapena olakwika, matenda a shuga salipiriridwa bwino, ndipo wodwala ali pachiwopsezo cha zovuta, HbAlc - 12% - shuga sichimalipiridwa. Chiwerengero chimasintha bwino pakatha mwezi umodzi kapena iwiri itatha shuga.

Nthawi zina kusanthula kwa glycosylated hemoglobin sikulakwa. Zimapereka zotsatira zabodza kapena zabodza:

• paokha. Mwa anthu ena, kuchuluka pakati pa HbA1C ndi glucose wapakati sikungokhala wokhazikika - wokhala ndi shuga wokwanira, HbA1C ndiyachilendo komanso mosiyanasiyana,
• mwa anthu odwala magazi m'thupi,
• odwala ndi hypothyroidism. Kuchuluka kwa mahomoni a chithokomiro kumawonjezera HbA1C, pomwe magazi a magazi amakhalabe ochepa.

Akuti hemoglobin ya glycosylated imawoneka yotsika kwenikweni ngati wodwala matenda ashuga amamwa Mlingo waukulu wa mavitamini C ndi E. Kaya mavitamini amakhudza kudalirika kwa kusanthula sikunatsimikizike. Koma ngati mukukayika kapena mwakhala ndi zotsatira zoyipa kale, musatenge mavitamini miyezi itatu musanayeze HbA1C.

HR hemoglobin pa nthawi yapakati

Mwazi wamagazi umakwera mwa amayi omwe alibe shuga. Koma njira zachizolowezi zopezera ngati zonse zili mu dongosolo ndi chakudya chamafuta mumayi oyembekezera sizigwira ntchito nthawi zonse. Simungayese mayeso osavuta a shuga kapena kuyezetsa magazi m'magazi.

1. Kwa mayi wathanzi, "glucose ochulukirapo" samayambitsa matendawa, ndipo mwina sangazindikire kuti akuyenera kuyezetsa shuga.
2. Kusala shuga mzimayi wathanzi "amadzuka" atatha kudya, kumakhalabe kwapamwamba kwa ola limodzi mpaka inayi ndipo kumakhudza mwana wosabadwayo komanso kumayambitsa zovuta za matenda a shuga.

Glycated hemoglobin siliyenera kwa iye, chifukwa amayankha kuchuluka kwa glucose ndi kuchedwa kwakukulu: HbA1C m'magazi idzawonjezeka pofika nthawi yowerengera ngati magazi a shuga akhala oposa kale kwa miyezi iwiri. Kodi mayi wapakati wa miyezi isanu ndi umodzi amakhala ndi shuga wambiri? HbA1C idzawonetsa asanabadwe komwe, ndipo miyezi yonse iyi itatu muyenera kudziwa ndikuwongolera pazokhudza kuchuluka kwa shuga.

Ndikofunika kuwona shuga m'magazi mwa amayi apakati mukatha kudya - kamodzi pa sabata kapena kamodzi pa sabata ziwiri zilizonse. Omwe ali ndi mwayi atha kuyesa mayeso a glucose. Amapangidwa m'mabotolo, ndipo amatha maola awiri. Njira yosavuta ndikuti muyeze shuga pafupipafupi ndi theka la ola - ola ndi theka mutatha kudya, ndipo ngati aposa 8.0 mmol / l, ndi nthawi yoti muchepetse.

Kuyesa kwa HbA1C

Anthu odwala matenda ashuga amalangizidwa kuti akwaniritse ndikusunga HbA1C pa - 7%. Potere, shuga imawerengedwa bwino, ndipo zovuta zomwe zimakhala zovuta ndizochepa. Kwa anthu okalamba kwambiri omwe ali ndi matenda ashuga, 7.5-8% kapena kuposa apo amatengedwa ngati chinthu wamba. Hypoglycemia ndiowopsa kwambiri kwa iwo kuposa momwe angayambire zovuta za shuga.

Madokotala, ana, achinyamata, achinyamata ndi amayi apakati amalangizidwa kwambiri kuti ayesetse kusunga HbA1C ili 6,5%, komanso mwanjira yoyandikira kwa anthu athanzi monga momwe mungathere, mwachitsanzo 5%. Ngati muchepetsa HbA1C ndi 1%, ndiye kuti chiwopsezo cha matenda ashuga chimachepa kwambiri:

Mwa njira, ndi kuwunika kwa glycosylated hemoglobin omwe amathandiza kuwongolera matendawa mu achinyamata. Achinyamata omwe ali ndi matenda ashuga asanakwane, amayamba kutsatira zakudya, kumwa mankhwala ochepetsa shuga mosamala, ndi "kusintha" shuga m'njira zina. Koma ndi kusanthula pa HbA1C izi sizigwira ntchito! Chilichonse chomwe mungachite, koma ngati chidzakwezedwa, dotolo awona momwe odwala matenda ashuga adathandizira pa miyezi itatu yapitayo.

Kodi glycosylated hemoglobin amawonetsa chiyani?

Glycated hemoglobin amatchedwanso glycated. M'malo mwake, zotsatira za kusanthula zikuwonetsa peresenti yomwe gawo la hemoglobin limalumikizana ndi shuga.

Hemoglobin ndi puloteni m'magazi yomwe ntchito yake imakhala yokwaniritsa maselo onse amthupi ndi mpweya. Ngati glycosylated hemoglobin imakwezedwa, ntchitoyi imagwira ntchito bwino, ndipo pamakhala chiwopsezo chachikulu cha matenda ashuga.

Popeza zotsatira zakusanthula zimaperekedwa ngati peresenti, chizolowezi kwa akulu ndi ana ndi chimodzimodzi. Kusanthula kumeneku sikungapusitsidwe ndi zakudya zomwe zimachitika mlungu uliwonse, zomwe zimapezeka kwambiri pakati pa achinyamata. Chilichonse chomwe chimadyedwa m'miyezi itatu chimawonekera mu glycosylated hemoglobin m'magazi.

Pakufufuza, zotsatirazi nthawi zambiri zimatchedwa HbA1C, koma mawonekedwe ngati "hemoglobin A1C" amavomerezeka, ndipo "glycosylated hemoglobin hba1c" ingapezekenso pakuwunika. Nthawi zina mawu akuti hemoglobin samasiyidwa konse.

Pali magome ena apadera omwe mungayerekeze kuchuluka kwa zotsatira za kusanthula kwanu ndi shuga. Chifukwa chake, ngati kusanthula kukuwonetsa 4%, izi zikutanthauza kuti 3.8 mmol / L shuga anali pafupifupi m'magazi miyezi itatu yapitayo. Makalata a HbA1C ndi glucose okhala mmol / L aperekedwa pansipa:

Mlingo wa hemoglobin wa glycosylated

Popeza tazindikira kuchuluka kwa shuga omwe amagwirizana ndi hemoglobin yomwe ikukhudzana ndi izi, tikambirana za phindu lomwe munthu wodwala kapena odwala matenda ashuga amathandizidwa.

1. Ngati kuchuluka kwa hemoglobin yomwe imalumikizidwa ndi glucose ndi ochepera 5.7, izi zikutanthauza kuti muli ndi khola lathanzi, kagayidwe kazachilengedwe amachitika molondola, ndipo palibe chiopsezo cha matenda ashuga.
2. Ngati glycosylated hemoglobin ichulukitsidwa pang'ono: 5.7 - 6.0%, ndikofunikira kusinthana ndi zakudya zomwe zili ndi mafuta ochepa. Izi ziyenera kuchitidwa kuti muchepetse matenda ashuga. Ngakhale chiopsezo cholandirira chimakhalabe chochepa, tiyenera kusamala.
3. Zotsatira za 6.0-6.4%, kusinthira kuzakudya zama carb ochepa komanso moyo wathanzi ndikofunikira. Simungathenso kusiya. Chiwopsezo cha matenda ashuga ndichokwera kwambiri.
4. Ngati, atazindikira kuti hemoglobin ya glycosylated, kuchuluka kwake ndizoposa 6.5, dokotala angadziwe kaye za matenda ashuga. Kuti timvetse bwino, kumene, njira zowonjezera zikufunikirabe.
5. Mlingo wa glycosylated hemoglobin wa anthu odwala matenda ashuga angathe kuonedwa mosiyanasiyana pamavuto osiyanasiyana. Mwambiri, akuti ndi zomwe zili ndi HbA1C zosaposa 7%, shuga imalipidwa ndipo mkhalidwewo ndi wokhazikika. Koma madokotala ena, mwachitsanzo, Dr. Bernstein, amati akatswiri ashuga ayenera kuyesetsa kuwonetsera 4.2 mpaka 4,6%. Nthawi yofananira ndiyotengera anthu athanzi labwino, ndipo odwala matenda ashuga ayenera kukopeka nako. Komabe, pofunafuna chipukuta cha matenda a shuga, mwina simungaone kuopsa kwa hypoglycemia. Kuti mupewe izi, muyenera kukhathamiritsa zakudya zanu ndikuphunzira kusamala pakati pa shuga ndi hypoglycemia.

Momwe mungayesere magazi a glycosylated hemoglobin?

Popeza kuwunika kwa hemoglobin ya glycated kumakhala kosavuta kwambiri komanso kuthamanga kuposa kulolera kwa glucose, odwala ambiri amakonda kupulumutsa nthawi ndi khama. Mutha kupeza nthawi yoyesa magazi nthawi iliyonse tsiku. Phindu la Glycosylation:

• Kuyesedwa ndi koyenera kutenga m'mimba yopanda kanthu m'mawa. Samva chidwi ndi chakudya chomwe chatengedwa. Itha kudutsidwa ngakhale mutachita masewera olimbitsa thupi, mwachitsanzo, kuchita masewera olimbitsa thupi, mukatha kugwira ntchito tsiku lililonse kapena nthawi ina iliyonse yabwino.
• Samayankha pang'onopang'ono, monga, mwachitsanzo, kuzizira, kupsinjika kwamalingaliro, kapena kutengera kwa nyengo. Kutenga mankhwala olimbana ndi matendawa sikugwiranso ndi kuwunika. Mankhwala a shuga okha ndi omwe amakhudza zotsatira
• Kupereka magazi kwa shuga, komwe kumachitika m'mimba yopanda kanthu, sikolondola kwenikweni kuposa hemoglobin ya glycosylated.
• Kuchuluka kwa hemoglobin inayake kumawonetsa kuti akazi omwe ali ndi glycosylated hemoglobin ndiwofanana ndi amuna.
• Amapereka tsatanetsatane wazakudya (kapena kusowa kwake) kwa wodwalayo m'miyezi itatu yapitayo.
• Surrenders mwachangu, mosavuta kwa onse odwala komanso adokotala.

Zoyipa pakusanthula

Ngakhale kuti kusanthula kuli ndi zabwino zingapo, izi, sizoyenera.

1. Poyerekeza ndi mayeso wamba a glucose, kuyesako ndikokwera mtengo kwambiri.
2. Osakhala bwino kwa anthu omwe ali ndi vuto la kuchepa kwa magazi komanso hemoglobinopathy.
3. Kugawidwa kokha muzipatala zabwino, chifukwa chomwe kufalikira kumadera akutali kumachepetsedwa.
4. Kusankha kopanda phindu kwa amayi oyembekezera omwe ali ndi chiyembekezo: glycosylated hemoglobin mwa amayi apakati amawonjezera shuga pokhapokha miyezi itatu, ndipo panthawiyi njira zimatha kuchitidwa kuti athetse kupatuka kuzinthu zomwe zimachitika. Kuphatikiza apo, shuga m'magazi amayamba kukula kuyambira mwezi wachisanu ndi chimodzi, kotero kuti hemoglobin ya glycosylated imawonetsa izi pokhapokha pakubala.
5. Zomwe zimapangitsa glycosylated hemoglobin kukwezedwa zimatha kukhudzidwa ndi kuchuluka kwamahomoni a chithokomiro.

Anthu athanzi amayenera kuyesedwa HbA1C kamodzi pazaka zitatu, odwala matenda ashuga nthawi imeneyi amatsitsidwa mpaka miyezi itatu.

Glycated and glycosylated hemoglobin: kusiyana kwake ndi kotani

Mawu osiyanasiyana amagwiritsidwa ntchito potanthauza maselo ofiira am'magazi ndi ma carbohydrate:

• glycosylated
• glycated
• glycogemoglobin,
• hba1c.

M'malo mwake, mawu onsewa amatanthauza gulu limodzi. Koma pali kusiyana pakati pawo:

• glycosylated hemoglobin - phata pakati pa shuga ndi maselo ofiira a magazi chifukwa cha ma enzyme,
• glycated hemoglobin - kulumikizana pakati pa shuga ndi maselo ofiira a magazi popanda kuyatsidwa ndi zinthu zakunja.

Zotsatira zoyambitsa sizingawonongeke, motero zimatha kutsimikizika mosavuta pogwiritsa ntchito mayeso a labotale. Maselo ofiira omwe amalumikizidwa ndi shuga amayendayenda ndi iye masiku onse 120. Chifukwa chake, wothandizira wa labotal amatha kudziwa kutalika komwe kumachitika, komanso kuchuluka kwa kuchuluka komwe kumachitika pakukhudzana ndi hemoglobin ndi chakudya.

Machitidwe a glycation omwe amapezeka mthupi amatchedwa vivo. Kwa iye, palibe chifukwa chodziwonera ma enzyme aliwonse. Chifukwa chake, tanthauzo la chizindikirocho ndilolondola kwambiri komanso lodalirika.

Glycosylated hemoglobin: yachibadwa kwa akazi mwa mibadwo

Kwa akazi, kukonzanso magazi kwakanthawi ndi kakhalidwe. Izi zikuchitika chifukwa cha kusamba. Zinthu zina zoumbidwa zimatulutsa thupi la mkazi. Kusintha kwa chizindikirochi kumapezekanso mwa amayi apakati, chifukwa amapanga mkombero wowonjezera wamagazi kudutsa mwa placenta ndi kusintha kwa ma hormonal. Pa nthawi yomwe muli ndi pakati, pamakhala chiopsezo cha matenda osokoneza bongo.

Mlingo wa chizindikirocho umatengera zaka za mkazi, umaperekedwa patebulopo.

Wazaka 40 mpaka 60

Kuyambira zaka 61 ndi kupitilira

Okalamba mkazi, omwe amatha kukhala ndi maselo ofiira amwazi kuphatikiza ndi shuga. Metabolism imakulirakulira ndi zaka, ndipo zochita za insulin zomwe zimayendetsedwa kuti zizitumiza glucose kuti zigwire maselo zimachepa. Chifukwa chake, zizindikiro zikukula.

Ngati kuchuluka kwa chizindikirocho kudaposa 6.5%, dokotala akuwonetsa ngati ali ndi matenda ashuga. Kuti mutsimikizire izi, ndikofunikira kuyambitsa maphunziro angapo a labotale omwe amatsimikizira kapena kutsutsa za matendawo.

Glycosylated hemoglobin: yachibadwa kwa amuna mwa mibadwo

Kwa amuna, Zizindikiro zokhazikika ndizodziwika. Ndi zaka, metabolism imachepetsa pokhapokha zaka 50. Chifukwa chake, kuwonjezerako kwa chizindikirocho kumawonedwa pakufika m'badwo uno.

Mulingo wabwinoko kwa amuna umawonetsedwa patebulo pansipa.

Zaka 51 mpaka 60

Kuyambira zaka 61 ndi kupitilira

Cholinga chopitilira chizindikiritso ndikucheperachepera kumasulidwa kwa zinthu zochulukirapo kudzera mu impso. Chiwalo chimagwira ntchito moyipitsitsa, motero, chimadziunjikira m'magazi ndikugwirizana ndi maselo ofiira amwazi. Chizindikirochi chimakonda anthu okalamba, amuna ndi akazi.

Miyezi yachilendo ya glycosylated hemoglobin (hba1c) imatsimikiza ndi IFCC (International Federation of Clinical Chemistry and Laboratory Medicine).

Glycosylated hemoglobin ichulukira: zikutanthauza chiyani

Chifukwa chachikulu chopitilira chizindikiro ndi matenda a shuga. Mafuta ochulukirapo omwe amapezeka m'magazi, ndiwomwe amawagawa m'magazi achilengedwe, ndipo amadziunjikira m'magazi ofiira. Kuphatikiza pa izi, zinthu zotsatirazi zimatha kuyambitsa mkhalidwe:

• kulowa m'magazi a zinthu zomwe zimawakhudza poizoni (mowa wa ethyl, mankhwala),
• kuchepa kwa magazi, chifukwa chomwe kuchuluka kwa maselo ofiira amatsika, ambiri amaphatikiza ndi shuga,
• kuphatikizika kwa ndulu, komwe mwa munthu wathanzi ndimalo otaya maselo ofiira a magazi (maselo ofiira a magazi adzaonjezera m'magazi, kulumikizana ndi shuga),
• Kulephera kwaimpso, komwe limba silingagwire bwino ntchito pochotsa zinthu zochulukirapo, glucose imadzunjikira m'magazi ndi minyewa, zomwe zimayambitsa kuwonjezeka.
• chithandizo choyipa cha matenda osokoneza bongo a shuga kapena kusakhalapo kwathunthu, chifukwa chake kuchuluka kwa glucose m'magazi kumadzadutsa zofunika zovomerezeka, chifukwa chake zimalumikizana ndi mamolekyulu okhala ndi ma cell pama cell ofiira a magazi.

Ngati dokotala, pamodzi ndi wodwala, adapeza chowonjezera chazowonjezera pang'ono pamiyeso yovomerezeka, izi zikuwonetsa matenda mu thupi. Kuchuluka kwa shuga kumatha kubweretsa zovuta, kumapangitsa kuwonongeka kwa moyo wa wodwalayo.

Glycosylated hemoglobin yotsitsidwa: zikutanthauza chiyani

Zochitika zimakhala zochepa pokhapokha chizindikiro chikatsimikiziridwa chochepa poyerekeza ndizovomerezeka. Izi zitha kukhala chifukwa cha izi:

• kuchepa kwakachepa kwa magazi mwachitsanzo, kudzera muchiberekero, matumbo, m'mimba, pamene kuchuluka kwa magazi a anthu kumachepa,
• kutaya magazi kwambiri, komwe munthu munthawi yomweyo amataya madzi ambiri amkati,
• kuthiridwa magazi kuchokera kwa olandila kwa opereka, pamene chizindikirocho chimaphatikizidwa ndi maselo ofiira amwazi omwe mulibe shuga,
• kuchepa kwa magazi m'thupi, komwe kumachitika pazifukwa zosiyanasiyana, chifukwa kuchuluka kwa maselo ofiira a magazi kumachepa, kotero gawo laling'ono limatha kulumikizana ndi chakudya,
• kudya shuga wambiri m'thupi, komwe kumatha kuchitika chifukwa cha njala, popanda kudya zakudya zopatsa mphamvu.
• matenda omwe amayambitsa hypoglycemia.

Kuti muwone momwe thanzi la anthu lakhalira, ndikofunikira kuti nthawi zina mumayezewe ma laboratore. Ambiri aiwo amatha kudziwa matendawa pakapita nthawi. Ngati kuchuluka kwa mafuta m'magazi kukwera kapena kugwa, komwe kumadutsa malire, izi zitha kubweretsanso mavuto ena m'thupi. Chifukwa chake, kuyesa kwa labotale ndikofunika kwambiri pakuwazindikira.

Werengani kuti mudziwe njira zolondola kwambiri za hemoglobin.