Insulin Resistance le HOMA-IR Index

hakanyetsoang (boemo bo hlahang bo kenyeletsa ho ithuta ka "glucose" e potlakileng le insulin).

Mokhoa o tloaelehileng haholo oa ho hlahloba ho hanyetsa insulin ho amanang le boikemisetso ba tekanyo ea basal (ho itima lijo) ea tekanyo ea tsoekere le maemo a insulin.

Boithuto bo etsoa ka tieo ka mpeng e se nang letho, kamora nako ea lihora tse 8-12 ea ho itima lijo bosiu. Boemo bo kenyeletsa matšoao:

1. tsoekere
2. insulin
3. HOMA-IR e baloa ka insulin ea khanyetso.

Ho hanyetsa insulin ho amahanngoa le kotsi e eketsehang ea ho ba le lefu la tsoekere le mafu a pelo 'me ho hlakile hore ke karolo ea methapo ea pathophysiological e isang kopanong ea botena le mefuta ena ea mafu (ho kenyeletsa le metabolic syndrome). Mokhoa o bonolo ka ho fetisisa oa ho hlahloba ho hanyetsa insulin ke HOMA-IR Insulin Resistance Index, sesupo se tsoang ho Matthews D.R. et al., 1985, e amanang le nts'etsopele ea sebopeho sa homeostatic ea mohlala bakeng sa ho hlahloba ho hanyetsa insulin (HOMA-IR - Homeostasis Model Tlhahlobo ea Insulin Resistance). Joalokaha ho bontšitsoe, karolelano ea "basulin" e potlakileng ea "insulin" le litekanyetso tsa tsoekere, e bonts'anang ts'ebetso ea bona ho loop ea maikutlo, e lumellana haholo le tekanyetso ea ho hanyetsa insulin ka mokhoa o hlakileng oa ho hlahloba litlamorao tsa insulin ho metabolism ea glucose - hyperinsulinemic euglycemic clamp.

Lenane la HOMA-IR le baloa ho sebelisoa foromo: HOMA-IR = glucose e potlakileng (mmol / L) x insulin e potlakileng (μU / ml) / 22.5.

Ka keketseho ea tsoekere e potlakileng kapa insulin, index ea HOMA-IR, ka ho latellana, ea eketseha. Mohlala, haeba glucose e potlakileng ke 4.5 mmol / L mme insulin ke 5.0 μU / ml, HOMA-IR = 1,0, haeba glucose e potlakileng ke 6.0 mmol / L mme insulin ke 15 μU / ml, HOMA- IR = 4.0.

Boleng ba phello ea khanyetso ea insulin e hlahisitsoeng ho HOMA-IR hangata e hlalosoa e le karolo ea 75 ea palo ea sechaba sa eona se kopaneng. Tsela ea HOMA-IR e itšetlehile ka mokhoa oa ho khetholla insulin; ho thata ho e beha maemong. Khetho ea boleng ba mophahamo, ho feta moo, e kanna ea itšetleha ka sepheo sa thuto le sehlopha se khethiloeng sa tlhahlobo.

Lenane la HOMA-IR ha le kenyelletsoe ho litekanyetso tsa mantlha tsa tlhahlobo ea metabolic syndrome, empa le sebelisoa e le lithuto tse ling tsa laboratori tsa profil ena. Ha a lekola kotsi ea ho ba le lefu la tsoekere sehlopheng sa batho ba nang le boemo ba tsoekere ka tlase ho 7 mmol / L, HOMA-IR e na le tlhaiso-leseling ho feta ho itima lijo ka glucose kapa insulin ka sekhahla. Ts'ebeliso ho ts'ebetso ea bongaka bakeng sa tlhahlobo ea sepheo sa lipalo bakeng sa ho hlahloba ho hanyetsa insulin ho latela qeto ea ts'ebetso ea "plasma insulin" le "glucose" e na le meeli e mengata mme ha e amohelehe kamehla bakeng sa ho etsa qeto mabapi le ho khethoa ha kalafo ea glucose e fokotsang matla, empa e ka sebelisetsoa ho shebella ka matla. Ho loants'oa ha "insulin" khafetsa le khafetsa ho boleloa ho sa feleng hepatitis C (genotype 1). Keketseho ea HOMA-IR har'a bakuli bana e amahanngoa le karabelo e mpe ho kalafo ho feta ho bakuli ba nang le insulin e tloaelehileng ea ho hanyetsa, ka hona, khalemelo ea ho hanyetsa insulin e nkuoa e le e 'ngoe ea lipheo tse ncha kalafong ea hepatitis C. Keketseho ea ho hanyetsa insulin (HOMA-IR) e bonoa le steatosis e sa noeleng joala. .

Lingoliloeng

1. Matthews DR et al. Tlhahlobo ea mohlala ea homeostasis: ho hanyetsa insulin le ho sebetsa ha sele ho tsoa ho glucose e potlakileng ea plasma le khatello ea insulin ho monna. Diabetesologia, 1985, 28 (7), 412-419.

2. Dolgov VV et al. Tlhahlobo ea mahlale ea mathata a metabolism ea carbohydrate. Metabolic syndrome, lefu la tsoekere. M. 2006.

3. Romero-Gomez M. et al. Ho hanyetsa insulin ho senya tekanyo e tsitsitseng ea karabelo ho peginterferon le ribavirin ho bakuli ba sa feleng ba hepatitis C. Gastroenterology, 2006, 128 (3), 636-641.

4. Mayorov Alexander Yuryevich Boemo ba ho hanyetsa insulin phetohong ea lefu la tsoekere la mofuta oa 2. Qoba. diss. d. M.N., 2009

5. O.O. Hafisova, T.S. Polikarpova, N.V. Mazurchik, P.P. Likomkomere Tšusumetso ea metformin ho theweng ha karabelo e tsitsitseng ea virologic nakong ea ho kopanya li-antiviral tsa hepatitis e sa foleng le Peg-IFN-2b le ribavirin ho bakuli ba nang le insulin ea pele. Bulletin ea Univesithi ea RUDN. Seroma Ngaka 2011, No.2.

Tlhahisoleseling ka kakaretso

Resistance (ho fokotseha ha kutloelo-bohloko) ea lisele tse itšetlehileng ka insulin ho insulin ho hlaha ka lebaka la mathata a metabolic le lits'ebetso tse ling tsa hemodynamic. Sesosa sa ho hloleha hangata ke ho ba liphatsa tsa lefutso kapa ts'ebetso ea ts'oaetso. Ka lebaka leo, motho o na le kotsi e eketsehileng ea ho ba le lefu la tsoekere, lefu la metabolic, methapo ea pelo le khatello ea methapo ea litho tsa ka hare (sebete, liphio).

Phuputso mabapi le ho hanyetsa insulin ke tlhahlobo ea matšoao a latelang:

Insulin e hlahisoa ke lisele tsa pancreatic (li-beta cell tsa li-islets tsa Langerhans). O nka karolo lits'ebetsong tse ngata tsa 'mele' meleng. Empa mesebetsi ea mantlha ea insulin ke:

• Tlatsetso ea glucose ho lisele tsa lisele,
• taolo ea metabolism ea lipid le carbohydrate,
• tloaelehilengization ea maemo a tsoekere ea mali, jj.

Tlas'a tšusumetso ea mabaka a itseng, motho o hanyetsa insulin kapa ts'ebetso ea eona e itseng. Ka nts'etsopele ea ho hanyetsa lisele le lisele ho insulin, khatello ea eona maling e ea eketseha, e lebisang keketseho ea khatello ea glucose. Ka lebaka la sena, ho khoneha nts'etsopele ea lefu la tsoekere la mofuta oa 2, metabolic syndrome, le botenya. Metabolic syndrome e ka qetella e lebisitse ho ho otla ha pelo le stroke. Leha ho le joalo, ho na le mohopolo oa "ho hanyetsa insulin", e ka hlaha ha matla a eketsehileng a 'mele a hlokahala (nakong ea boimana, ho ikitlaetsa' mele haholo).

Tlhokomeliso: khafetsa, ho hanyetsa insulin ho tsebahala ho batho ba boima haholo. Haeba boima ba 'mele bo nyoloha ka ho feta 35%, joale kutloisiso ea insulin e fokotsoa ka 40%.

Lenane la HOMA-IR le nkoa e le sesupo sa tlhaiso ho khethollo ea insulin.

Boithuto bo lekanya tekanyo ea tsoekere ea basal (ho itima lijo) le maemo a insulin. Keketseho ea index ea HOMA-IR e bonts'a keketseho ea tsoekere e potlakileng kapa insulin. Ena ke harbinger e hlakileng ea lefu la tsoekere.

Letshwao lena le ka sebelisoa maemong a ts'oaetso ea ho belaelloa ha insulin ho basali ba nang le polycystic ovary syndrome, lefu la tsoekere la lefu la matsoele, ho se sebetse hantle hantle ha renal, hepatitis B le C, le steatosis e sa foleng.

Matšoao a ho hlahlojoa

• Tlhahlobo ea ho hanyetsa insulin, tlhahlobo ea eona ho matla,
• Boikemisetso ba kotsi ea ho ba le lefu la tsoekere le netefatso ea tlhahlobo eo boteng ba lipontšo tsa eona tsa bongaka,
• Mathata a mamello a tsoekere a tšoeroeng,
• Boithuto bo phethahetseng ba pathologies ea pelo - coronary lefu la pelo, atherosclerosis, ho nyekeloa ke pelo, jj.
• Ho hlokomela boemo ba bakuli ba nang le boima ba 'mele haholo,
• Liteko tse rarahaneng tsa maloetse a tsamaiso ea endocrine, mathata a metabolic,
• Tlhalo ea lefu la polycystic ovary (ho senyeha ha ovari ka morao ho methapo ea endocrine),
• Tlhahlobo le kalafo ea bakuli ba nang le lefu la sebete la mofuta oa B kapa C ba sa foleng.
• Tlhahlobo ea steatosis e sa noeng joala joala, ho se sebetse hantle ha rehe (mafu a hlobaetsang le a sa foleng),
• Ho lekola kotsi ea ho ba le khatello ea mali le maemo a mang a amanang le khatello e phahameng ea mali,
• Tlhahlobo ea lefu la tsoekere ho basali baimana,
• Tlhahlobo e felletseng ea mafu a tšoaetsanoang, ho beoa ha kalafo e hlokofatsang.

Fumana sephetho sa tlhahlobo ea insulin ho thibela litsebi: ngaka ea bongaka, ngaka e buoang, ngaka e sebetsang, diagnostologist, endocrinologist, cardiologist, gynecologist, ngaka ka kakaretso.

Melao ea litšupiso

• Meeli e latelang e hlalositsoe ka glucose:
  • 3,9 - 5.5 mmol / L (70-99 mg / dl) - e tloaelehileng,
  • 5.6 - 6.9 mmol / L (100-125 mg / dl) - prediabetes,
  • ho feta 7 mmol / l (lefu la tsoekere).
• Karolo ea 2,6 - 24,9 mcED ka ho ya ka 1 ml e nkuoa e le tloaelo ea insulin.
• Lenaneo la ho hanyetsa insulin (NOMA-IR insulin index (coeffanele) bakeng sa batho ba baholo (ea lilemo tse 20 ho isa ho 60) ntle le lefu la tsoekere: 0 - 2.7.

Nakong ea lipatlisiso, ho ithutoa matšoao: khatello ea tsoekere le insulin maling, hammoho le index ea ho hanyetsa ea insulin. Qetellong e baloa ka foromo:

NOMA-IR = "khatello ea tsoekere (mmol ka" 1 l) * boemo ba insulin (μED ka 1 ml) / 22.5

Mokhoa ona o eletsa ho etsa kopo e le 'ngoe feela haeba o ka itima lijo ka mali.

Lintlha tsa tšusumetso ho seo

• Nako ea sampole ea mali e seng e tloaelehileng ea tlhahlobo,
• Tlolo ea melao ea boitokisetso ba thuto,
• Ho nwa meriana e itseng
• Boimana
• Hemolysis (nakong ea timetso ea maiketsetso ea lisele tse khubelu tsa mali, li-enzyme tse senyang insulin lia lokolloa),
• Phekolo ea Biotin (teko ea ho hanyetsa insulin ha e ea etsoa pele ho lihora tse 8 kamora ho hlahisoa ha tekanyetso e phahameng ea lithethefatsi),
• Phekolo ea insulin.

Keketso Melao

• Nts'etsopele ea ho hanyetsa (ho hanyetsa, ho itšireletsa) ho insulin,
• Kotsi e eketsehileng ea lefu la tsoekere
• Lefu la tsoekere
• Lefu la pelo
• Metabolic syndrome (tlolo ea lik'habohaedreite, mafura le metabolite ea purine),
• Polycystic ovary syndrome
• Botenya ba mefuta e fapaneng,
• Maloetse a sebete (ho haella, "hepatitis" ea vaerase, steatosis, cirrhosis le ba bang),
• Ho hloleha ho ts'oarela ha renal
• Ho senya litho tsa tsamaiso ea endocrine (adrenal gland, pituitary, thyroid le pancreas, jj.),
• Litšoaetso tsa mafu a tšoaetsanoang
• Mekhoa ea Oncological, jj.

Lenane la HOMA-IR le tlase le supa ho haella ha insulin mme ho nkoa e le ntho e tloaelehileng.

Litokisetso tsa tlhahlobo

Patlisiso ea biomaterial: mali a venous.

Mokhoa oa sampole ea biomaterial: mokhoa o mong oa thipa oa veine.

Boemo ba terata: Ka tieo ka mpeng e se nang letho!

• Bana ba ka tlase ho selemo se le seng ha baa lokela ho ja metsotso e 3040 pele ho thuto.
• Bana ba lilemo li 1 ho isa ho 5 ha ba je lihora tse 2-3 pele ho thuto.

Litlhokahalo tse ling tsa koetliso

• Ka letsatsi la ts'ebetso (hang-hang pele ho bolotsana) u ka noa metsi a tloaelehileng ntle le khase le letsoai.
• Bosiung ba teko, ho tlosoa lijong tse mafura, tse halikiloeng le tse nokiloeng ka linoko, linoko le lijo tse tsubang. Ho thibetsoe ho noha matla, lino tse tahiloeng tsa tonic, joala.
• Motšehare, kenyelletsa mojaro o mong le o mong ('meleng le / kapa psycho-maikutlo). Metsotso e 30 pele ho nehelano ea mali, merusu leha e le efe, ho matha, ho phahamisa boima ba mmele, joalo-joalo li tiisitsoe ka molao.
• Hora pele ho tlhahlobo ea insulin, o lokela ho hana ho tsuba (ho kenyeletsa le koae ea elektroniki).
• Lithuto tsohle tsa hajoale tsa kalafo ea lithethefatsi kapa tlatsetso, livithamini li tlameha ho tlaleheloa ho ngaka esale pele.

E kanna eaba o abetsoe: