Ma antibodies kuma insulin receptors

Ma antibodies kupita ku insulin amapangidwa motsutsana ndi insulin yawo yamkati. Ku insulin ndi chizindikiro chodziwika bwino cha matenda ashuga 1. Maphunziro amafunika kupatsidwa kuti azindikire matendawa.

Type Iabetes mellitus imawoneka chifukwa cha kuwonongeka kwa autoimmune kuzisumbu za gland ya Langerhans. Matendawa amatengera kufooka kwathunthu kwa insulin mthupi la munthu.

Chifukwa chake, matenda amtundu wa 1 amatsutsana ndi matenda amtundu wa 2, omalizirawa sapereka kufunikira kwa zovuta zakudwala. Mothandizidwa ndi kusiyanitsa mitundu yamitundu ya matenda ashuga, matendawa amatha kuchitika mosamala ndipo njira yoyenera yamankhwala ikhoza kukhazikitsidwa.

Kutsimikiza kwa ma antibodies ku insulin

Ichi ndi chizindikiro cha zotupa za autoimmune zama cell a pancreatic beta omwe amapanga insulin.

Ma Autoantibodies a intulin a insulin ndi ma antibodies omwe amatha kupezeka mu seramu yamagazi a mtundu 1 ashuga musanayambe mankhwala a insulin.

Zizindikiro zogwiritsidwa ntchito ndi:

• kuzindikira kwa matenda ashuga
• kukonza insulin,
• kuzindikira magawo oyamba a shuga,
• matenda a prediabetes.

Maonekedwe a ma antibodies amenewa amagwirizana ndi zaka za munthu. Ma antibodies oterewa amapezeka pafupifupi nthawi zonse ngati matenda ashuga amawonekera mwa ana ochepera zaka zisanu. Mu 20% ya milandu, ma antibodies oterewa amapezeka mwa anthu omwe ali ndi matenda ashuga 1.

Ngati palibe hyperglycemia, koma pali ma antibodies awa, ndiye kuti matenda a mtundu woyamba wa shuga satsimikiziridwa. Pakati pa matendawa, kuchuluka kwa ma antibodies ku insulin kumachepa, mpaka kutha kwawo kwathunthu.

Ambiri omwe ali ndi matenda ashuga ali ndi mitundu ya HLA-DR3 ndi HLA-DR4. Ngati achibale ali ndi matenda amtundu woyamba, mwayi wodwala ungawonjezeke ka 15. Maonekedwe a autoantibodies kwa insulini adalembedwa kale kwambiri asanakhale matenda oyamba a matenda ashuga.

Pazizindikiro, mpaka 85% ya maselo a beta ayenera kuwonongedwa. Kuwunika kwa ma antibodies amenewa kumawonetsa kuopsa kwa matenda obwera mtsogolo mwa anthu omwe ali ndi vuto.

Ngati mwana yemwe ali ndi vuto lobadwa nako ali ndi mankhwala osokoneza bongo a insulini, chiopsezo chotenga matenda amtundu wa 1 m'zaka khumi zikubwera ndi 20%.

Ngati ma antibodies awiri kapena kuposerapo apezeka omwe ali amtundu wa matenda a shuga 1, ndiye kuti matendawa amatha kudwala mpaka 90%. Ngati munthu alandila mankhwala a insulin (exo native, recombinant) mu njira yothana ndi matenda a shuga, ndiye kuti pakapita nthawi thupi limayamba kupanga ma antibodies ake.

Kuwunikira pankhaniyi kudzakhala kwabwino. Komabe, kusanthula sikumapangitsa kuti kumveketsa ngati ma antibodies amapangidwa pa insulin ya mkati kapena kunja.

Chifukwa cha insulin yothandizira odwala matenda ashuga, kuchuluka kwa ma antibodies kupita ku insulin yakunja m'magazi kumawonjezeka, komwe kungayambitse kukana kwa insulin ndikusokoneza mankhwalawa.

Tiyenera kudziwa kuti kukana insulini kumatha kuonekera pakumwa mankhwala osakonzekera bwino a insulin.

Chithandizo cha odwala omwe ali ndi mtundu 1 wa matenda a shuga ndi ma antibodies a insulin

Mlingo wa ma antibodies kuti mupeze insulin m'magazi ndi njira yofunika kwambiri yodziwunikira. Zimathandizira adotolo kuwongolera chithandizo, kuletsa kukula kwa kukana kwa chinthu chomwe chimathandizira kuchuluka kwa glucose m'magazi wamba. Kutsutsa kumawonekera ndikumayambitsa kukonzekera kosayeretsedwa bwino, komwe mumapezekanso proinsulin, glucagon ndi zinthu zina.

Ngati ndi kotheka, mapangidwe oyera oyeretsedwa (nthawi zambiri nkhumba) amapatsidwa mankhwala. Samatsogolera pakupanga ma antibodies.
Nthawi zina ma antibodies amapezeka m'magazi a odwala omwe amathandizidwa ndi mankhwala a hypoglycemic.

Chizindikiro cha autoimmune chimayambitsa kukana komanso thupi lawo siligwirizana ndi insulin yothandizira pa insulin.

Ma antibodies a Autoimmune kupita ku insulin ndi amodzi mwa mitundu ya ma autoantibodies omwe amapezeka mu zotupa za autoimmune za islet pancreatic zida zokhudzana ndi matenda a shuga a insulin.

Kupanga kwa autoimmune pathology ya pancreatic beta cell kumalumikizidwa ndi genetic predisposition (modulating zotsatira za chilengedwe). Zolemba za autoimmune zimakhalapo 85 - 90% ya odwala omwe ali ndi matenda a shuga omwe amadalira insulin ndi kupezeka koyambirira kwa hyperglycemia, kuphatikizapo ma antibodies mpaka insulin - pafupifupi 37% ya milandu. Pakati pa abale apamtima odwala omwe ali ndi matenda a shuga 1, ma antibodies awa amawonekera 4% ya milandu, mwa anthu ambiri amoyo wathanzi - mwa 1.5% milandu. Kwa achibale a odwala matenda ashuga amtundu woyamba, chiopsezo cha matendawa ndichopambana ma 15 times kuposa anthu ambiri.

Kuwona ma antibodies a autoimmune kupita ku ma pancreatic islet cell antigen kumatha kuzindikira anthu omwe amakonda kwambiri matendawa. Ma anti-insulin antibodies amatha kupezeka m'miyezi yambiri, ndipo nthawi zina, ngakhale zaka zambiri isanayambike zizindikiro za matenda. Nthawi yomweyo, popeza pakadali pano palibe njira zoletsa kukula kwa matenda ashuga amtundu 1, ndipo, kuwonjezera apo, ndizotheka kudziwa ma antibodies kuti apange insulin mwa anthu athanzi, kafukufuku wamtunduwu sagwiritsidwa ntchito kawirikawiri pazomwe zimachitika popitilira matenda azachipatala pofufuza mayeso a matenda ashuga komanso mayeso .

Ma anti-insulin autoantibodies omwe amawongolera motsutsana ndi insulin ya insulin ayenera kusiyanitsidwa ndi ma antibodies omwe amawoneka odwala a insulin omwe amadalira odwala omwe akuchita chithandizo ndi insulin yokonzekera chiyambi cha nyama. Zotsirizazi zimayenderana ndi kuwoneka kwa zovuta pamankhwala (zamkati zamkati pathupi, mapangidwe a insulin depot, kuyerekeza kotsutsana ndi chithandizo cha mahomoni ndi insulin yokonzekera nyama).

Kafukufuku wofufuzira amkati a insulin autoantibodies m'magazi, omwe amagwiritsidwa ntchito pozindikiritsa mtundu wa matenda osokoneza bongo a mtundu wa 1 odwala omwe sanalandire chithandizo ndi kukonzekera kwa insulin.

Synonyms Russian

Chingerezi Chingerezi

Insulin Autoantibodies, IAA.

Njira yofufuzira

Olumikizidwa ndi Enzyme-immunosorbent assay (ELISA).

Mgwirizano

U / ml (gawo lililonse mwa millilita).

Kodi ndi zotsalira ziti zomwe zingagwiritsidwe ntchito kafukufuku?

Momwe mungakonzekerere phunzirolo?

Osasuta kwa mphindi 30 musanapereke magazi.

Phunziro Mwachidule

Ma antibodies kupita ku insulin (AT to insulin) ndi autoantibodies opangidwa ndi thupi motsutsana ndi insulin yake. Ndiwo okhawo omwe ali ndi mtundu woyamba wa matenda ashuga a mtundu 1 ndipo akufufuzidwa kuti adziwe ngati ali ndi matendawa. Matenda a shuga 1 amtundu wa shuga (wodalira insulin) amadwala chifukwa cha kuwonongeka kwa autoimmune? Maselo a kapamba, zomwe zimapangitsa kuti insulansi yathunthu isoweka. Izi zimasiyanitsa matenda amtundu wa shuga 1 a shuga amtundu wa 2, momwe matenda amthupi amatenga gawo laling'ono kwambiri. Kuzindikira kusiyanasiyana kwa mitundu ya matenda ashuga ndikofunikira kwambiri pakupanga chidziwitso ndi njira zamankhwala.

Pozindikira kusiyanasiyana kwa matenda ashuga, ma autoantibodies opangidwa motsutsana? Maselo a zisumbu za Langerhans amawunikiridwa. Odwala ambiri omwe ali ndi matenda amtundu woyamba amakhala ndi ma antibodies kuma cell awo kapamba. Ndipo, mmalo mwake, autoantibodies zoterezi sizimagwira kwa odwala omwe ali ndi matenda a shuga a 2.

Insulin ndi autoantigen popanga matenda a shuga a mtundu 1. Mosiyana ndi ma autoantigen ena odziwika omwe amapezeka ndi matendawa (glutamate decarboxylase ndi mapuloteni osiyanasiyana am'ming'alu ya Langerhans), insulin ndiye okhawo okhazikika pancreatic autoantigen. Chifukwa chake, kuwunika bwino kwa ma antibodies ku insulin kumadziwika kuti ndi chidziwitso cha kuwonongeka kwa autoimmune ku kapamba mu mtundu 1 wa shuga (m'magazi a 50% ya odwala omwe ali ndi matenda amtundu wa 1, ma autoantibodies mpaka insulin apezeka). Ma autoantibodies ena omwe amapezekanso m'magazi a odwala matenda ashuga a 1 amaphatikizanso ma antibodies kupita ku ma cell ochepa a kapamba, ma antibodies kuti glutamate decarboxylase, ndi ena. Panthawi yodziwitsa, 70% ya odwala ali ndi mitundu itatu ya antibodies, ochepera 10% ali ndi mtundu umodzi wokha, ndipo 2-4% alibe ma autoantibodies ena. Nthawi yomweyo, maantiantibacteries okhala ndi matenda amtundu woyamba si omwe amayambitsa kukula kwa matendawa, koma amawonetsa kuwonongeka kwa maselo a pancreatic.

AT kupita ku insulin ndi ana ambiri omwe ali ndi matenda amtundu wa 1 ndipo sakonda kwenikweni kwa odwala. Monga lamulo, mwa ana odwala, amawonekera koyamba mu titer yapamwamba kwambiri (izi zimatchulidwa kwambiri mwa ana osakwana zaka 3). Popeza izi, kusanthula kwa ma antibodies ku insulin kumatengedwa ngati mayeso abwino kwambiri othandizira kutsimikizira matenda a shuga 1 amtundu wa ana omwe ali ndi hyperglycemia. Komabe, ziyenera kudziwika kuti zotsatira zoyipa sizipatula kukhalapo kwa matenda ashuga a mtundu woyamba. Kuti mupeze chidziwitso chokwanira kwambiri mukamazindikiritsa, tikulimbikitsidwa kusanthula osati ma antibodies okha komanso insulin, komanso ma autoantibodies ena a mtundu 1 shuga. Kuzindikira ma antibodies kuti mupeze insulin mwa mwana popanda hyperglycemia sikukuganiziridwa pokomera kuzindikira mtundu wa matenda ashuga 1. Ndi matendawa, kuchuluka kwa ma antibodies kupita ku insulin kumatsika kukhala kosawoneka, komwe kumasiyanitsa ndi ma antibodies ena a antibodies ena amtundu wa matenda amtundu wa 1, kutulutsa kwake komwe kumakhala kosakhazikika kapena kuwonjezeka.

Ngakhale kuti ma antibodies omwe amapezeka ku insulin amadziwika kuti ndi chizindikiro cha matenda amtundu wa 1, milandu ya matenda amtundu wa 2 imafotokozedwa, momwe ma autoantibodies ena anapezekanso.

Matenda a shuga a Type 1 ali ndi mawonekedwe amtundu. Odwala ambiri omwe ali ndi matendawa amakhala onyamula ma HLA-DR3 ndi ma HLA-DR4. Chiwopsezo cha kukhala ndi matenda amtundu woyamba wa abale achibale a wodwala omwe ali ndi matendawa chimawonjezeka ka 15 ndipo zimafika pa 1:20. Monga lamulo, zovuta za immunological mu kapangidwe ka ma autoantibodies ku zigawo zikuluzikulu zalembedwa kale kwambiri isanayambike matenda a shuga 1. Izi zikuchitika chifukwa chakuti kukulira kwa njira zakukula zamatenda a matenda amtundu woyamba 1 kumafuna kuwonongedwa kwa maselo a 80-90% a maselo a masumbu a Langerhans. Chifukwa chake, kuyesedwa kwa ma antibodies ku insulin kungagwiritsidwe ntchito kuwunika mwayi wokhala ndi matenda ashuga m'tsogolo mwa odwala omwe ali ndi mbiri yamatendawa. Kukhalapo kwa ma antibodies ku insulin m'magazi a odwala oterewa kumalumikizidwa ndi chiwopsezo cha matenda a shuga 1 kwazaka 10 zikubwerazi. Kudziwika kwa mitundu iwiri kapena zingapo za autoantibodies za mtundu woyamba wa shuga kumawonjezera mwayi wokhala ndi matendawa ndi 90% pazaka 10 zikubwerazi.

Ngakhale kuti kusanthula kwa ma antibodies a insulin (komanso magawo ena a labotale) sikulimbikitsidwa ngati kuwunika matenda a shuga 1, kafukufukuyu akhoza kukhala wothandiza pofufuza ana omwe ali ndi mbiri yakuyamba ya matenda ashuga. Pamodzi ndi mayeso ololera a glucose, zimakupatsani mwayi wofufuza matenda amtundu wa 1 musanakhale ndi zovuta zakuchipatala, kuphatikizapo matenda ashuga a ketoacidosis. Mlingo wa C-peptide panthawi yodziwikiratu ulinso wapamwamba, zomwe zimawonetsa bwino kwambiri zotsalira za ntchito zotsalira? - Amayang'aniridwa ndi njirayi yoyang'anira odwala omwe ali pachiwopsezo. Tiyenera kudziwa kuti chiopsezo chotenga matenda mwa wodwala wokhala ndi zotsatira zabwino zoyesedwa ndi insulin komanso kusakhalapo kwa mbiri ya matenda amtundu wa 1 sikusiyana ndi chiopsezo chotenga matendawa.

Odwala ambiri omwe amalandila insulin kukonzekera (exo native, recombinant insulin) amayamba kupanga ma antibodies kwa iwo pakapita nthawi. Adzakhala ndi mayeso abwino, ngakhale atulutsa ma antibodies a endo native insulin kapena ayi. Chifukwa cha izi, kafukufukuyu sanapangidwe kuti azindikire matenda a shuga 1 amtundu wa odwala omwe alandila kale insulin. Zoterezi zimatha kuchitika ngati mtundu wa 1 wa matenda ashuga ukayikiridwa mwa wodwala yemwe ali ndi vuto la 2 la matenda ashuga omwe amalandila chithandizo ndi exo native insulin kuti akonze hyperglycemia.

Odwala ambiri omwe ali ndi matenda amtundu woyamba amakhala ndi vuto limodzi kapena zingapo za autoimmune. Matenda ofala kwambiri a autoimmune chithokomiro (matenda a Hashimoto's chithokomiro kapena Graves), matenda adrenal osakwanira (matenda a Addison), celiac enteropathy (matenda a celiac) komanso magazi opatsirana. Chifukwa chake, ndi zotsatira zabwino za kusanthula kwa ma antibodies kuti mupeze insulin ndikutsimikizira kuti mukudwala matenda amtundu wa 1, kuyesa kwina kowonjezera ndikofunikira kupatula matenda awa.

Kodi kafukufukuyu amagwiritsa ntchito chiyani?

• Pozindikira kusiyanitsa mtundu 1 ndi mtundu 2 wa shuga.
• Kupanga zakutsogolo kwa mtundu 1 wa shuga kwa odwala omwe ali ndi mbiri yotenga matenda amtunduwu, makamaka ana.

Kodi phunziroli lidzakonzedwa liti?

• Mukamayang'ana wodwala wokhala ndi zizindikiro zamankhwala a hyperglycemia: ludzu, kuchuluka kwamkodzo wa tsiku ndi tsiku, kuchuluka kwa chilimbikitso, kuchepa thupi, kuchepa kwa masomphenya, kutsika kwamphamvu kwa khungu la miyendo, komanso mapangidwe a phazi lalitali osachiritsa komanso zilonda zam'miyendo zam'munsi.
• Mukamayang'ana wodwala yemwe ali ndi mbiri ya matenda ashuga amtundu woyamba, makamaka ngati ali mwana.

Zotsatira zake zikutanthauza chiyani?

Mfundo zofunikira: 0 - 10 U / ml.

• mtundu 1 shuga
• autoimmune insulin syndrome (matenda a Hirat),
• autoimmune polyendocrine syndrome,
• Ngati kukonzekera insulin (exo native, recombinant insulin) - mankhwala a antibodies kukonzekera insulin.

• zizolowezi
• pamaso pa zizindikiro za hyperglycemia, kupezeka kwa matenda a shuga a 2 kungayambike.

Kodi chingachitike ndi chiyani?

• AN to insulin imadziwika kwambiri kwa ana omwe ali ndi matenda ashuga a mtundu woyamba (makamaka mpaka zaka 3) ndipo sakonda kupezeka mwa anthu akuluakulu.
• Kuchuluka kwa ma antibodies ku insulin kumachepa mpaka matendawa asadziwike m'miyezi isanu ndi umodzi yoyambirira.
• Odwala omwe amalandira kukonzekera kwa insulin, zotsatira za phunzirolo zimakhala zabwino, ngakhale apange ma antibodies a endo native insulin kapena ayi.

Zolemba zofunikira

• Phunziroli sililola kusiyanitsa pakati pa autoantibodies ku insulin yawo insulin ndi ma antibodies kuti akhale exo native (injectable, recombinant) insulin.
• Zotsatira zakuwunika ziyenera kuwunikidwa limodzi ndi deta yoyesa ya ma autoantibodies ena amtundu wa matenda ashuga 1 ndi zotsatira za kusanthula kwakanthawi kachipatala.

Yalimbikitsidwanso

Ndani amatsogolera phunziroli?

Endocrinologist, dokotala wamkulu, wa ana, kupatsanso mankhwala okonza, opaleshoni yamitsempha, nephrologist, neurologist, zamtima.

Zolemba

1. Franke B, Galloway TS, Wilkin TJ. Zochitika pakulosera kwa matenda a shuga 1, makamaka kutanthauza insulin autoantibodies. A shuga Metab Res Rev. 2005 Sep-Oct, 21 (5): 395-415.
2. Bingley PJ. Ntchito zamankhwala poyesa wodwala matenda ashuga. J Clin Endocrinol Metab. 2010 Jan, 95 (1): 25-33.
3. Kronenberg H et al. Williams buku la Endocrinology / H.M. Kronenberg, S. Melmed, K.S. Polonsky, P.R. Larsen, 11 ed. - Saunder Elsevier, 2008.
4. Felig P, Frohman L. A. Endocrinology & Metabolism / P. Felig, L. A. Frohman, 4 th ed. - McGraw-Hill, 2001.

Siyani Imelo yanu ndikulandila nkhani, komanso zomangika kuchokera ku labotale ya KDLmed

1. 
   Neumyvakin, I.P. Matenda a shuga / I.P. Neumyvakin. - M: Dilya, 2006 .-- 256 p.
2. 
   Skorobogatova, E.S. Vision chilema chifukwa cha matenda a shuga mellitus / E.S. Skorobogatova. - M: Mankhwala, 2003. - 208 p.
3. 
   Matenda a Gressor M. Matenda. Zambiri zimadalira inu (lotanthauziridwa kuchokera ku Chingerezi: M. Gressor. "Matenda a shuga, osokoneza bongo", 1994).SPb., Nyumba yosindikiza "Norint", 2000, masamba 62, kufalitsidwa kwa makope 6000.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka patsamba lino kuti athetse zovuta koma osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusayiti, kukambirana ndi akatswiri ndizofunikira nthawi zonse.

Kodi insulin ndi chiyani

Zinthu zomwe zimapangidwa ndi maselo osiyana siyana a zisumbu za pancreatic a Langerhans

Insulin ndi chinthu chamafuta cha chilengedwe cha polypeptide. Amapangidwa ndi ma pancreatic β-cell omwe amapezeka mu makulidwe a islets a Langerhans.

Woyang'anira wamkulu wa kapangidwe kake ndi shuga wamagazi. Mokulirapo kuchuluka kwa glucose, kumapangitsanso kwambiri kuchuluka kwa insulin.

Ngakhale kuti mapangidwe a mahomoni insulin, glucagon ndi somatostatin amapezeka m'maselo oyandikana nawo, amakhala otsutsana nawo. Otsutsana ndi insulin amaphatikizapo mahomoni a adrenal cortex - adrenaline, norepinephrine ndi dopamine.

Ntchito za insulin timadzi

Cholinga chachikulu cha hormone ya insulin ndikuwongolera kwa kagayidwe kazachilengedwe. Ndi thandizo lake kuti gwero lamphamvu - glucose, lomwe lili m'madzi am'magazi, limalowa m'maselo a minofu ya minofu ndi minyewa ya adipose.

Molekyulu ya insulin ndi kuphatikiza 16 amino acid ndi zotsalira 51 za amino acid

Kuphatikiza apo, hormone ya insulin imagwira ntchito zotsatirazi m'thupi, zomwe zimagawidwa m'magulu atatu, kutengera zotsatira zake:

• Anticatabolic:
  1. kutsika kwa kuchepa kwa mapuloteni hydrolysis,
  2. Kuletsa magazi ochulukitsa ndi mafuta acid.
• Metabolic:
  1. kubwezeretsanso kwa glycogen m'chiwindi ndi maselo a mafupa am'mimba zotupa pakukweza polima yake m'magazi.
  2. kutsegula kwa michere yayikulu yopatsa mpweya wopanda okosijeni wa mamolekyu a glucose ndi zakudya zina,
  3. kuletsa mapangidwe a glycogen mu chiwindi kwa mapuloteni ndi mafuta,
  4. kukondoweza kwa kapangidwe ka mahomoni ndi michere ya m'mimba thirakiti - gastrin, anhibitory gastric polypeptide, secretin, cholecystokinin.
• Wotsutsa:
  1. mayendedwe a magnesium, potaziyamu ndi phosphorous amapanga maselo,
  2. kuchuluka mayamwidwe amino acid, makamaka valine ndi leucine,
  3. kukulitsa mapuloteni a biosynthesis, omwe amathandizira pakuchepetsa mwachangu kwa DNA (kuwirikiza musanagawike),
  4. kuthamanga kwa kaphatikizidwe ka triglycerides ku glucose.

Kwa mawu. Insulin, limodzi ndi kukula kwa mahomoni ndi ma anabolic steroid, amatanthauza mahomoni otchedwa anabolic. Adapeza dzinali chifukwa ndi thandizo lawo thupi limakulitsa kuchuluka ndi kuchuluka kwa minofu yamitsempha. Chifukwa chake, mahomoni a insulini amadziwika kuti ndi masewera osangalatsa ndipo kugwiritsa ntchito koletsedwa kumasewera osewera ambiri.

Kusanthula kwa insulin ndi zomwe zili m'madzi a m'magazi

Pakuyezetsa magazi kwa mahomoni a insulin, magazi amatengedwa kuchokera m'mitsempha

Mwa anthu athanzi, momwe mulingo wa insulin umalumikizana ndi kuchuluka kwa shuga m'magazi, chifukwa chake, kuti adziwe molondola, kuyesedwa kwamtundu wa insulin (kusala kudya) kumaperekedwa. Malamulo okonzekera sampling yamagazi kuyezetsa insulin ndi muyezo.

Malangizo achidule ndi awa:

• musamadye kapena kumwa zakumwa zina koma zopanda madzi - kwa maola 8,
• kupatula zakudya zamafuta ndi kunenepa kwambiri, osanyoza ndipo musachite mantha - mu maola 24,
• musasute - 1 ora musanalandire magazi.

Komabe, pali mfundo zina zomwe muyenera kudziwa ndikukumbukira:

1. Beta-adreno-blockers, metformin, furosemide calcitonin ndi mankhwala ena angapo amachepetsa kupanga kwa insulin.
2. Kutenga njira zakulera za pakamwa, quinidine, albuterol, chlorpropamide ndi mankhwala ena ambiri zimakhudza zotsatira za kusanthula, kuwonjezerera. Chifukwa chake, mukalandira malangizo okayezetsa insulin, muyenera kufunsa dokotala kuti amwe mankhwala ati omwe ayenera kuyimitsidwa komanso kwa nthawi yayitali bwanji magazi asanatenge.

Ngati malamulowo atsatiridwa, ndiye kuti kapamba ikugwira ntchito moyenera, muyembekezere zotsatirazi:

Zindikirani Ngati ndi kotheka, kuyambiranso kwa zizindikiro mu pmol / l, formula μU / ml x 6.945 imagwiritsidwa ntchito.

Asayansi amafotokoza kusiyana kwa mfundo motere:

1. Chamoyo chomwe chikukula nthawi zonse chimafunikira mphamvu, chifukwa chake, mwa ana ndi achinyamata momwe kapangidwe ka timadzi ta insulin kamatsalira pang'onopang'ono kuposa momwe zidzakhalire atatha kutha, zomwe zimayambira zimapangitsa kukulira pang'onopang'ono.
2. Mulingo wambiri wa insulin m'mwazi wa amayi apakati pamimba yopanda kanthu, makamaka munthawi yachitatu ya trimester, umachitika chifukwa chakuti umakamizidwa pang'onopang'ono ndi maselo, pomwe ukuwonetsanso kuyesetsa pang'ono pochepetsa shuga.
3. Mwa amuna ndi akazi okalamba atatha zaka 60, njira zolimbitsa thupi zimatha, zolimbitsa thupi zimachepa, thupi silifunikira mphamvu zambiri, mwachitsanzo, monga momwe zimakwanitsira zaka 30, kotero kuchuluka kwakukulu kwa mahomoni a insulin amawonedwa ngati abwinobwino.

Decoding mayeso a insulin

Kusanthula sikunataye pamimba yopanda kanthu, koma mutatha kudya - kuchuluka kwa insulini kumatsimikizika

Kupatuka kwa kusanthula komwe kumachitika kuchokera kumatchulidwe, makamaka pamene zinthu za insulin zili pansipa, sizabwino.

Mulingo wotsika ndi chimodzi mwazomwe zatsimikizira izi:

• mtundu 1 shuga
• mtundu 2 shuga
• hypopituitarism.

Mndandanda wazomwe zimapangitsa kuti insulini ikhale yayitali kuposa zofunikira kwambiri:

• insulinoma
• prediabetes ndi chitukuko cha mtundu wa 2,
• matenda a chiwindi
• ovary polycystic,
• Itsenko-Cushing's syndrome,
• kagayidwe kachakudya matenda
• minofu fiber
• chibadwa chololera ku fructose ndi galactose,
• acromegaly.

NOMA Index

Chizindikiro chomwe chikuwonetsa kukana kwa insulini - chikhalidwe chomwe minofu imasiya kuzindikira bwino insulin, imatchedwa NOMA Index. Kuti adziwe, magazi amatengedwanso pamimba yopanda kanthu. Mitsempha ya glucose ndi insulin imakhazikitsidwa, pambuyo pake kuwerengedwa kwa masamu kumachitika malinga ndi njira: (mmol / l x μU / ml) / 22.5

Zotsatira za NOMA ndizotsatira - ≤3.

Mndandanda wamndandanda wa HOMA & gt, 3 umawonetsa kukhalapo kwa pathologies amodzi kapena zingapo:

• kulolerana kwa shuga,
• kagayidwe kachakudya matenda
• lembani matenda ashuga 2
• ovary polycystic,
• mavuto a kagayidwe kazakudya-lipid kagayidwe,
• dyslipidemia, atherosulinosis, matenda oopsa.

Zambiri. Anthu omwe apezeka kuti ali ndi matenda a shuga 2 ayenera kuyesedwa pafupipafupi, chifukwa amafunika kuwunika momwe mankhwalawa amathandizira.

Kupanikizika ndi ntchito nthawi zambiri komanso kumangokhala moyo wakhanda kumayambitsa matenda a shuga

Kuphatikiza apo, kuyerekezera kwa zizindikiro za insulin ndi glucose kumathandiza dokotala kumveketsa bwino zomwe zimayambitsa kusintha kwa thupi:

• Insulin yayikulu yomwe ili ndi shuga yokhazikika ndi cholemba:

1. kukhalapo kwa chotupa mu ma cell a kapamba, mbali yakumbuyo ya ubongo kapena adrenal cortex,
2. kulephera kwa chiwindi ndi zina za matenda amchiwindi,
3. kusokoneza kwa pituitary gland,
4. utachepa katulutsidwe wa glucagon.

• Insulin yochepa yokhala ndi shuga wabwinobwino imatheka ndi:

1. kupanga kwambiri kapena kuchiritsa ndi mahomoni olimbana ndi mahomoni ena,
2. matenda a pituitary - hypopituitarism,
3. kupezeka kwa matenda oyamba,
4. Panthawi yovuta matenda opatsirana,
5. zopsinjitsa
6. kulakalaka zakudya zotsekemera komanso zamafuta,
7. zolimbitsa thupi kapena mosinthanitsa, kusakhalitsa kwakuthupi.

Kwa mawu. Mwambiri, kuchuluka kwa insulini yokhala ndi magazi abwinobwino sikuti ndi chizindikiro cha matenda ashuga, koma simuyenera kupuma. Ngati matendawa ndi okhazikika, ndiye kuti adzatsogolera kukula kwa matenda ashuga.

Insulin Antibody Assay (Insulin AT)

Mtundu woyamba wa matenda a shuga amayamba kuubwana

Kuyesa kwamagazi kwamtunduwu ndi chisonyezo cha kuwonongeka kwa autoimmune ku β-cell yotulutsa insulin. Amalandira ana omwe ali ndi vuto lotengera matenda ashuga a mtundu woyamba.

Mothandizidwa ndi kafukufukuyu, ndizothekanso:

• kusiyanitsa komaliza kwa matenda a shuga a mtundu 1 kapena mtundu 2,
• kutsimikiza mtima kwa mtundu 1 wa shuga,
• kumveketsa zomwe zimayambitsa hypoglycemia mwa anthu omwe alibe shuga,
• Kuyesa kwa kukana ndi kuyatsa kwa ziwopsezo zamkati za insulin,
• kudziwa kuchuluka kwa anansulin antibodies pa mankhwala ndi insulin kuchokera nyama.

Ma antibodies kuti mupeze insulin - 0.0-0.4 U / ml. M'malo momwe izi zimapambaniratu, ndikulimbikitsidwa kuti mumve zowonjezera zama antibodies a IgG.

Chidwi Kuwonjezeka kwa misempha ya antibody ndi njira yabwinobwino 1% ya anthu athanzi.

Kulekerera kwa glucose kowonjezereka kwa glucose, insulin, c-peptide (GTGS)

Kuyesedwa kwa magazi kwamtunduwu kumachitika mkati mwa 2 maola. Gawo loyamba la magazi limatengedwa pamimba yopanda kanthu. Pambuyo pa izi, kupatsidwa shuga wa glucose, ndiko kuti, kapu ya madzi amchere (200 ml) shuga (75 g) aledzera. Pambuyo pamtolo, mutuwo uyenera kukhala phee kwa maola awiri, zomwe ndizofunikira kwambiri kudalirika kwa zotsatira zowunikira. Ndipo pamakhala kuwerengedwa kobwereza magazi.

Chizindikiro cha insulin pambuyo pakuchita masewera olimbitsa thupi ndi 17.8-173 mkU / ml.

Zofunika! Asanadutse mayeso a GTG, kuyezetsa magazi mwachangu ndi glucometer ndikofunikira. Ngati kuwerenga kwa shuga ndi ≥ 6.7 mmol / L, palibe kuyesedwa kochitidwa. Mwazi umaperekedwa kuti uunikidwe pokhapokha pa c-peptide.

Kuchulukitsa kwa c-peptide m'magazi ndikokhazikika kuposa kuchuluka kwa insulin. Chikhalidwe cha c-peptide m'magazi ndi 0.9-7.10 ng / ml.

Zisonyezo za mayeso a c-peptide ndi:

• kusiyanitsa kwa mtundu 1 ndi matenda ashuga 2, komanso mikhalidwe yoyambitsidwa ndi hypoglycemia,
• Kusankha njira ndi njira zochizira matenda ashuga,
• polycystic ovary syndrome,
• kuthekera kosokoneza kapena kukana chithandizo ndi ma insulin mahomoni,
• matenda a chiwindi
• kuwongolera pambuyo opaleshoni kuti muchotse kapamba.

Zotsatira zakuyesa kuchokera ma labotale osiyanasiyana zimasiyana.

Ngati c-peptide ndi yokwera kuposa yachilendo, ndiye kuti ndizotheka:

• mtundu 2 shuga
• kulephera kwa aimpso
• insulinoma
• chotupa chowopsa cha tiziwalo tating'onoting'ono ta endocrine, ziwalo zaubongo kapena ziwalo zamkati,
• kukhalapo kwa ma antibodies ku hormone ya insulin,
• somatotropinoma.

Muzochuluka pomwe c-peptide ili pansipa, zosankha ndizotheka:

• mtundu 1 shuga
• kupsinjika kwanthawi yayitali
• uchidakwa
• kukhalapo kwa ma antibodies kuma insulin hormone receptors omwe ali kale ndi mtundu wachiwiri wa matenda ashuga.

Ngati munthu akuthandizidwa ndi mahomoni a insulin, ndiye kuti mlingo wochepetsetsa wa c-peptide ndiye chizolowezi.

Ndipo pomaliza, tikukulimbikitsani kuti muwone kanema wamfupi yemwe angakuthandizireni kukonzekera mayeso a magazi ndi mkodzo, kusunga nthawi, kupulumutsa mitsempha ndi bajeti ya mabanja, chifukwa mtengo wa maphunziro ena omwe ali pamwambawa ndiwopatsa chidwi.