Insulin yana da hannu a cikin tsarin metabolism, canja wurin musayar ions, amino acid. Sakamakon insulin akan ƙwayar carbohydrate yana da wuya a ɗauka. Mutanen da ke da ciwon sukari suna kuma nuna alamun rashin karfin metabolism.
Ciwon sukari mellitus an gano sosai kuma kwanannan. Cututtuka suna haifar da rikice-rikice na rayuwa daban-daban. Ciwon sukari mellitus, na ilimin halittar mutum wanda zai iya bambanta sosai, yana cikin wuri na uku bayan cututtukan oncology da cututtukan zuciya. Akwai kusan mutane miliyan 100 masu ciwon sukari a cikin duniya. Kowane shekaru 10, yawan masu ciwon sukari ya zama sau 2.
Mutanen da suka fito daga kasashe masu tasowa da wasu abubuwanda aka sanyawa cikin kasashe masu tasowa suna cikin hatsarin kamuwa da rashin lafiya. Rashin narkewar ƙwayar cuta a cikin ciwon sukari mellitus yana haifar da cututtuka daban-daban. Ciwon sukari na 2 wanda galibi yakan shafi mutane bayan shekaru 45.
Hanyar aikin insulin
A cikin 1869, Langerhans ya sami tsibiran a cikin farfajiyar da aka sanya wa suna daga baya. Ya zama sananne cewa ciwon sukari na iya bayyana bayan cire glandar.
Insulin shine furotin, watau polypeptide wanda ya ƙunshi sarƙoƙin A da B. An haɗa su da gadoji biyu masu lalacewa. Yanzu an san cewa an samar da insulin kuma ana adana shi ta sel. Insulin yana damuwa da enzymes wanda ke mayar da ɗayan shaidu kuma ana kiran shi "insulinase." Hakanan, enzymes proteolytic suna cikin hydrolysis na sarƙoƙi zuwa ƙananan sassan kwayoyin.
An yi imani da cewa babban mai hana insulin insulin shine insulin a cikin jini, da kuma hormones na hyperglycemic:
- adrenaline
- ACTH,
- cortisol.
TSH, catecholamines, ACTH, STH da glucagon ta hanyoyi daban-daban suna kunna adenylcyclase a cikin membrane na sel. Latterarshen yana kunna samuwar cyclic 3,5 adenosine monophosphate, yana kunna wani sashi - protein kinase, yana samar da microtubules na beta-tsibiri, wanda ke haifar da raguwa cikin sakin insulin.
Microtubules tsarin beta-cell ne wanda a baya ya kera insulin motsawa a cikin vesicles zuwa membrane na sel.
Mafi ƙarfin ƙarfafawa na samarda insulin shine glucose jini.
Hanyar aikin insulin kuma ya ta'allaka ne da dangantakar abokantaka ta masu shiga tsakani 3,5 - GMF da 3,5 AMP.
Hanyar carbohydrate metabolism
Insulin yana shafar metabolism na carbohydrates a cikin ciwon sukari. Babban hanyar haɗin gwiwa a cikin wannan cuta ita ce rashi na wannan abu. Insulin yana da tasiri sosai a cikin metabolism, haka kuma akan sauran nau'ikan metabolism, tunda asirin insulin ya ragu, aikin sa yana raguwa, ko kuma karɓar ƙwayoyin insulin-dogara da ƙwayoyin suke lalata.
Sakamakon cin zarafin metabolism a cikin ciwon sukari mellitus, ayyukan glucose na narkewar jini a cikin sel yana raguwa, ƙarawarsa a cikin jini yana ƙaruwa, kuma hanyoyin glucose waɗanda ke da 'yanci daga insulin suna aiki.
Sorbitol shunt wani yanayi ne wanda aka rage yawan glucose zuwa sorbitol, sannan a hada shi da oxidized zuwa fructose. Amma hadawan abu da iskar shaka yana iyakance shi ta hanyar insulin-insulin-wanda ya dogara da shi. Lokacin da aka kunna polyol shunt, sorbitol ya tara a cikin kyallen, wannan yana ba da gudummawa ga bayyanar:
- jijiya
- katarayta
- microangiopathies.
Akwai samuwar ciki a cikin glucose daga furotin da glycogen, amma har ma wannan nau'in goiukosis baya dauke da kwayoyin jikinsu, tunda akwai karancin insulin. Aerobic glycolysis da pentose foshate shunt suna daɗaɗɗe, raunin sel da ƙarancin makamashi suna bayyana. Thearawar haemoglobin ta karu, ba jigilar oxygen ba ne, wanda ke haɓaka hypoxia.
Metabolism metabolism a cikin ciwon sukari ana iya rauni
- hyperazotemia (ƙara yawan matakin nitrogen saura),
- hyperazotemia (karuwa a cikin adadin mahadi nitrogen a cikin jini).
Matsakaicin sinadarin nitrogen shine 0.86 mmol / L, kuma jimlar nitrogen ya zama 0.87 mmol / L.
Sanadin cututtukan ƙwayar cuta sune:
- karuwar furotin mai gina jiki,
- kunnawa daga kasala na amino acid a cikin hanta,
- saura nitrogen.
Nitrogen da ba protein din ba shine nitrogen:
- amino acid
- urea
- ammoniya
- creatinine.
Wannan ya faru ne saboda karuwar lalata sunadarai, galibi a hanta da tsokoki.
A cikin fitsari tare da ciwon sukari, yawan ƙwayoyin mahaifa yana ƙaruwa. Azoturia yana da dalilai masu zuwa:
- da karuwa a cikin taro na samfura tare da nitrogen a cikin jini, asirin su a cikin fitsari,
- gurɓataccen mai mai narkewa ana bayyana shi ta hanyar ketonemia, hyperlipidemia, ketonuria.
A cikin ciwon sukari, hyperlipidemia yana haɓaka, wanda shine haɓakar ƙarar jini na matakan lipid. Yawan su ya fi na al'ada, wato sama da 8 g / l. Wadannan cututtukan cututtukan cuta suna wanzu:
- nama na kunnawa na lipolysis,
- hanawa daga lalata lipid ta sel,
- karuwar kwayar cholesterol,
- hanawa na bayar da mai mai yawan kitse zuwa sel,
- rage aiki na LPLase,
- ketonemia - karuwa a yawan ketone a cikin jini.
A rukuni na jikin ketone:
- acetone
- Acetoacetic acid
- p-hydroxymalic acid.
Jimlar adadin ketone a cikin jini na iya zama sama da kashi 30-50%. Akwai dalilai na wannan:
- kunnawawar lipolysis,
- karuwa hadawan abu da iskar shaka a cikin mai mai sel,
- Dakatarwar maganin lipid,
- raguwa a cikin hadawan abu da iskar shaka - AcA a hepatocytes tare da samuwar sassan jikin ketone,
Rarraba jikin ketone tare da fitsari wata alama ce ta cutar sankarar hanji ta wani halin rashin jin daɗi.
Dalilin ketonuria:
- mutane da yawa na jikin ketone da aka tatso a cikin kodan,
- rikice-rikice na metabolism ruwa a cikin ciwon sukari, wanda ya bayyana ta hanyar polydipsia da polyuria,
Polyuria wata cuta ce da aka bayyana a cikin samuwar da fitar fitsari a cikin girma wanda ya wuce dabi'un al'ada. A karkashin yanayin al'ada, daga 1000 zuwa 1200 ml ana fitar da su a cikin rana guda.
Tare da ciwon sukari, diuresis yau da kullun shine 4000-10 000 ml. Dalilan sune:
- Hyperosmia na fitsari, wanda ke faruwa saboda cire yawan glucose, ion, CT da mahallin nitrogen. Sabili da haka, ana tace ruwa a cikin glomeruli yana motsawa kuma yana hana sake buɗewa,
- Take hakkin reabsorption da excretion, wanda ke haifar da cututtukan cututtukan zuciya,
- Polydipsia.
Insulin da mai mai mai yawa
A ƙarƙashin tasirin insulin, hanta na iya adana kawai adadin adadin glycogen. Yawan wucewar glucose da ke shiga hanta ya fara zuwa phosphorylate kuma ana ajiye shi a tantanin, amma daga baya sai suka zama mai mai, maimakon glycogen.
Wannan canji zuwa mai shine sakamakon bayyanuwa kai tsaye ga insulin, kuma jinin da aka kirkira yayin aiwatar da kitse yana jigilar kwayoyin halitta zuwa adipose nama. A cikin jini, kitse sune ɓangare na lipoproteins, waɗanda ke taka muhimmiyar rawa a cikin samuwar atherosclerosis. Saboda wannan ilimin, yana iya farawa:
- embolism
- bugun zuciya.
Ayyukan insulin akan ƙwayoyin adipose nama yana kama da tasirin sa akan ƙwayoyin hanta, amma samuwar kitse mai ƙarfi a cikin hanta yafi aiki, saboda haka ana canza su daga ciki zuwa tsopose nama. Ana adana acid ɗin mai a cikin sel kamar yadda triglycerides.
A ƙarƙashin tasirin insulin, rushewar triglycerides a cikin adipose nama an rage shi saboda hanawar lipase. Bugu da ƙari, insulin yana kunna aikin mai na kitse ta sel kuma yana shiga cikin wadatarsu tare da glycerol, wanda ake buƙata don haɗin triglycerides. Saboda haka, a kan lokaci, mai yana tarawa, haɗe da ilimin halayyar mutum na ciwon sukari mellitus.
Sakamakon insulin akan mai mai zai iya zama mai sauyawa, tare da ƙarancinsa, triglycerides an sake raba su cikin mayukan mai da mai glycerol. Wannan shi ne saboda gaskiyar cewa insulin yana hana lipase kuma lipolysis yana aiki yayin da aka rage girmanta.
Abubuwan acid na kyauta, wadanda aka kirkira yayin aikin hydrolysis na triglycerides, lokaci guda suna shiga cikin jini kuma ana amfani dasu azaman makamashi don kyallen takarda. Hadawan abu da iskar shaka na wadannan acid na iya zama a cikin dukkanin sel, ban da sel na jijiyoyi.
Mafi yawan adadin mai mai wanda aka saki lokacin da aka rasa insulin daga kitse mai yana sake hanta hanta. Kwayoyin hanta na iya yin amfani da kiba koda a cikin rashin insulin. Tare da rashin wannan abu, an tattara kitse mai da aka toka daga katangar a cikin hanta a cikin nau'in triglyceride.
A saboda wannan dalili, mutanen da ke fama da karancin insulin, duk da dabi'ar gaba ɗaya ta rasa nauyi, suna haɓaka kiba a cikin hanta.
Lalacewar ƙwayar ƙwayar ƙwayar ƙwayar jiki da kuma ƙirar karuwar ma'adinai
A cikin ciwon sukari, ana rage ƙididdigar insulin glucagon. Wannan ya faru ne sakamakon raguwar narkewar insulin, har da haɓaka aikin glucagon.
Rashin daidaituwa na metabolism na lipid a cikin ciwon sukari mellitus an bayyana shi cikin rauni mai ƙarfi na adanawa da haɓaka ƙarfafa haɗuwa da ajiyar ajiya. Bayan cin abinci, a cikin yanayin postabsorption sune:
- hanta
- tsoka
- nama tsotse.
Kayan narkewa da narkewar abinci, maimakon a adana su azaman fats da glycogen, kewaya cikin jini. Tsarin tafiyar hawainiya shima ya tashi zuwa wani yanayi, alal misali, ayyukan lokaci daya na faruwa na gluconeogenesis da glycolysis, gami da aiwatar da kitse mai narkewa da kira.
Duk nau'ikan ciwon sukari ana nuna shi ta hanyar rage haƙuri, watau hyperglucoseemia bayan cin abinci ko a kan komai a ciki.
Babban abubuwan da ke haifar da cutar hawan jini shine:
- da amfani da tsopose nama da tsokoki yana da iyaka, tunda in babu insulin HLBT-4 ba a bayyana shi a saman adipocytes da myocytes ba. Ba za a adana glucose kamar glycogen ba,
- Ba a amfani da glucose a cikin hanta don adanawa a cikin nau'in glycogen, saboda tare da ƙarancin insulin da babban adadin glucagon, glycogen synthase ba shi da ƙarfi,
- Ba a amfani da glucose na hanta don mai mai ba. Glycolysis da ƙwayoyin enzymes dehydrogenase suna cikin yanayin m. Canza glucose zuwa acetyl-CoA, wanda ya zama dole don ma'adinin mai mai, yana hanawa,
- Hanyar gluconeogenesis tana aiki a cikin ƙaramin taro na insulin da babban glucagon da aikin glucose daga glycerol da amino acid mai yiwuwa ne.
Wani sifofi na halayen masu ciwon sukari shine ƙara yawan ƙwayoyin lipoproteins, jikin ketone da acid ɗin kyauta a cikin jini. Ba a adana kitse mai danshi a cikin tso adi nama saboda adipocyte lipase yana aiki.
Babban abun ciki na kitse na kitse cikin jini ya bayyana. Abubuwan da ke cikin kitse suna dauke da hanta, wasu daga cikinsu ana canza su zuwa triacylglycerols, kuma suna shiga cikin jini a matsayin wani ɓangare na VLDL. Wani adadi na kitse ya shiga β-oxidation a cikin hanta mitochondria, kuma ana amfani da acetyl-CoA don haɗin jikin ketone.
Sakamakon insulin a kan metabolism kuma ya ta'allaka ne da cewa tare da gabatarwar insulin a cikin tsokoki daban-daban na jiki, haɓakar mai da fashewar lipids na triglyceride suna haɓaka. Rashin narkewar ƙwayar cuta shine adana mai, wanda ke taimakawa don biyan bukatun makamashi a cikin mummunan yanayi.
Yawan bayyanar cAMP yana haifar da raguwa a cikin tsarin furotin da raguwa a cikin HDL da VLDL. Sakamakon raguwa a cikin HDL, ƙwayar cholesterol daga membranes tantanin halitta zuwa ƙwayar jini. Cholesterol ya fara ajiyewa a bangon kananan jiragen ruwa, wanda hakan ke haifar da samuwar cutar malaria da atherosclerosis.
Sakamakon raguwa a cikin VLDL - kitse mai tarin yawa a cikin hanta, ana cire shi kamar yadda aka saba dashi wani ɓangare na VLDL. An ƙuntata tsarin furotin, wanda ke haifar da raguwa a cikin tsarin mutum, sannan, isassun marasa lafiya na masu cutar sikari zuwa cututtukan da ke kama da juna. An sani cewa mutanen da ke fama da rashin lafiyar metabolism suna fama da cututtukan furun tarin fuka.
Matsaloli da ka iya yiwuwa
Microangiopathy ne mai ciwon sukari na gama-gari. Sakamakon maganin ciwon sukari, mutane masu ciwon sukari sun rasa hangen nesa a cikin kashi 70-90% na lokuta. Musamman, masu ciwon sukari suna haɓaka cataracts.
Sakamakon rashin HDL, yawan ƙwayoyin cuta suna faruwa a cikin membran cell. Sabili da haka, cututtukan zuciya da ke kwance ko kuma kashe endarteritis na iya bayyana. Tare da wannan, an kirkiro microangiopathy tare da nephritis.
A cikin ciwon sukari, ana haifar da cututtukan tari tare da gingivitis - periodontitis - cututtukan tari. A cikin masu ciwon sukari, tsarin haƙori ya rikice kuma yana tallafawa kyallen takarda.
Abubuwan da ke haifar da pathology na microvessels a cikin waɗannan halayen, mafi kusantar su, shine ƙirƙirar haɗin giciye tare da sunadarai tare da sunadarai na bangon jijiya. A wannan yanayin, platelets za su ɓoye wani abu wanda ke ƙarfafa haɓakar ƙwayoyin tsoka mai santsi na bango na jijiyoyin bugun gini.
Hakanan ana bayyana raunin metabolism a cikin gaskiyar cewa ƙonewar mai mai ƙonewa yana ƙaruwa a cikin hanta, lipid resynthesis. A yadda aka saba, an fesa su ta hanyar VLDL, kasancewar sun dogara da girman furotin. Don wannan, ana buƙatar masu ba da gudummawa daga ƙungiyar CHZ, watau, choline ko methionine.
Choline kira na haɓaka lipocaine, wanda aka samar da epithelium na pancreatic duct epithelium. Rashin shi yana haifar da kiba mai yawa da hanta da samuwar duka da nau'ikan ciwon sukari.
Rashin insulin yana haifar da juriya kaɗan ga cututtuka. Saboda haka, furunlera an kafa.
Bidiyo a cikin wannan labarin zai yi magana game da tasirin insulin a jiki.
