Li-antibodies ho li-insulin receptor

Li-antibodies ho insulin li hlahisoa khahlanong le insulin ea bona ea ka hare. Ho insulin ke letšoao le ikhethang ka ho fetisisa la lefu la tsoekere la mofuta oa 1. Boithuto bo hloka ho abeloa ho fumana lefu lena.

Mofuta oa lefu la tsoekere la mofuta oa I o hlaha ka lebaka la tšenyo ea autoimmune lihlekehlekeng tsa tšoelesa ea Langerhans. Psychology e joalo e lebisa ho haella ha insulin 'meleng oa motho.

Kahoo, lefu la tsoekere la mofuta oa 1 le hanyetsoa le lefu la tsoekere la mofuta oa bobeli, lona ha le supe bohlokoa ba mafu a amanang le immunological. Ka thuso ea tlhahlobo e khethollang ea mefuta ea lefu la tsoekere, lefu lena le ka etsoa ka hloko 'me le ka fuoa leano le nepahetseng la kalafo.

Boikemisetso ba li-antibodies ho insulin

Ena ke letšoao la li-autoimmune lesions tsa lisele tsa pancreatic beta tse hlahisang insulin.

Li-autoantibodies ho insulin ea tlhaho ke li-antibodies tse ka fumanoang serum ea mali ea lefu la tsoekere la mofuta oa pele ho kalafo ea insulin.

Matšoao a sebelisoang ke:

• ts'oaetso ea lefu la tsoekere
• khalemelo ea kalafo ea insulin,
• Tlhahlobo ea methati ea lefu la tsoekere,
• ts'oaetso ea prediabetes.

Ponahalo ea li-antibodies tsena e lumellana le lilemo tsa motho. Li-antibodies tse joalo li fumanoa hoo e batlang e le maemong ohle haeba lefu la tsoekere le hlaha ho bana ba ka tlase ho lilemo tse hlano. Maemong a 20%, li-antibodies tse joalo li fumanoa ho batho ba nang le lefu la tsoekere la mofuta oa 1.

Haeba ho se na hyperglycemia, empa ho na le li-antibodies, joale tlhahlobo ea lefu la tsoekere la mofuta oa 1 ha e tiisoe. Nakong ea lefu lena, boemo ba li-antibodies ho insulin boa fokotseha, ho fihlela bo nyamela ka botlalo.

Boholo ba lefu la tsoekere bo na le mefuta ea HLA-DR3 le HLA-DR4. Haeba beng ka motho ba na le lefu la tsoekere la mofuta oa 1, menyetla ea ho kula e eketseha ka makhetlo a 15. Ponahalo ea li-autoantibodies ho insulin e tlalehiloe nako e telele pele ho matšoao a pele a kliniki ea lefu la tsoekere.

Bakeng sa matšoao, ho fihlela 85% ea lisele tsa beta e tlameha ho senngoa. Tlhahlobo ea li-antibodies tsena e lekola kotsi ea lefu la tsoekere le nakong e tlang ho batho ba nang le tšekamelo ea kelello.

Haeba ngoana ea nang le lefutso a e-na le li-antibodies ho insulin, menyetla ea ho ba le lefu la tsoekere la mofuta oa 1 lilemong tse leshome tse tlang e eketseha ka 20%.

Haeba li-antibodies tse peli kapa ho feta li fumaneha tse tobileng bakeng sa mofuta oa 1 lefu la tsoekere, menyetla ea ho kula e eketseha ho fihla ho 90%. Haeba motho a amohela litokisetso tsa "insulin" (exo native, recombinant) tsamaisong ea kalafo ea lefu la tsoekere, joale ka mor'a nako 'mele o qala ho hlahisa li-antibodies ho lona.

Tlhahlobo ntlheng ena e tla ba e ntle. Leha ho le joalo, tlhahlobo ha e etse hore ho utloisisehe hore na li-antibodies li hlahisoa ka insulin ea ka hare kapa kantle.

Ka lebaka la kalafo ea insulin ho diabetics, palo ea li-antibodies ho insulin ea kantle maling e eketseha, e ka bakang insulin le ho ama kalafo.

Ho lokela ho hopoloa hore ho hanyetsa insulin ho ka hlaha nakong ea kalafo ka litokisetso tsa insulin tse sa hloekang hantle.

Phekolo ea bakuli ba nang le mofuta oa 1 lefu la tsoekere le li-antibodies ho insulin

Boemo ba li-antibodies ho insulin maling ke bohloeki bo bohlokoa ba tlhahlobo ea mafu. E lumella ngaka ho lokisa kalafo, e emisa nts'etsopele ea ho hanyetsa ntho e thusang ho laola maemo a tsoekere ea mali maemong a tloaelehileng. Ho hanyetsa ho hlaha ka ho hlahisoa ha litokisetso tse sa hloekang hantle, tseo ho tsona ho nang le proinsulin, tsoekere le likarolo tse ling.

Haeba ho hlokahala, ho laetsoe mokhoa o hloekisitsoeng hantle (hangata nama ea kolobe). Ha li etelle pele ho thehoa ha li-antibodies.
Ka linako tse ling li-antibodies li fumanoa maling a bakuli ba ntseng ba phekoloa ka meriana ea hypoglycemic.

Letšoao la ts'ebetso ea autoimmune e lebisang ho hanyetsanang le karabelo ea mafu ho tsoa ho insulin nakong ea kalafo ea insulin.

Li-antibodies tsa Autoimmune ho insulin ke e 'ngoe ea mefuta ea autoantibodies e shebelloang ho autoimmune lesions ea islet pancreatic lisebelisoa tsa mofuta oa lefu la tsoekere le itšetlehileng ka insulin.

Nts'etsopele ea autoimmune pathology ea lisele tsa pancreatic beta e amahanngoa le tlhaho ea lefutso (ka phello ea modulating ea lintlha tsa tikoloho). Matšoao a ts'ebetso ea autoimmune a teng ho 85 - 90% ea bakuli ba nang le lefu la tsoekere le lahleloang ke insulin ka tlhahlobo ea pele ea hyperglycemia e potlakileng, ho kenyelletsa li-antibodies ho insulin - maemong a ka bang 37%. Har'a beng ka motho ea haufi le bakuli ba nang le lefu la tsoekere la 1, li-antibodies tsena li bonoa maemong a 4%, hara bongata ka kakaretso ba batho ba phetseng hantle - ho 1.5% ea linyeoe. Ho beng ka bakuli ba nang le lefu la tsoekere la mofuta oa 1, menyetla ea lefu lena e phahame makhetlo a 15 ho feta har'a bongata ka kakaretso.

Ho hlahlojoa ha li-antibodies tsa autoimmune ho li-pancreatic islet cell antijeni ho ka khetholla batho ba atileng haholo ho lefu lena. Li-antibodies tsa anti-insulin li ka fumanoa likhoeli tse ngata, 'me maemong a mang, le lilemo pele ho matšoao a lefu lena. Ka nako e ts'oanang, kaha hajoale ha ho na mekhoa ea ho thibela nts'etsopele ea lefu la tsoekere la mofuta oa 1, 'me, ho feta moo, hoa khoneha ho fumana li-antibodies ho insulin ho batho ba phetseng hantle, mofuta ona oa lipatlisiso ha o sebelisoe hangata litloaelong tsa bongaka tsa ho hlahloba lefu la tsoekere le tlhahlobo ea liteko. .

Li-autoantibodies tse khahlanong le insulin tse lebisitsoeng khahlanong le insulin ea nako e telele li lokela ho khetholoha ho li-antibodies tseo li hlahang ho bakuli ba lefu la tsoekere ba itšetlehileng ka insulin ba ntseng ba e-ba le kalafo ka litokisetso tsa insulin tsa tlhaho ea liphoofolo. Tsena tsa morao-rao li amana le ponahalo ea karabelo e mpe nakong ea kalafo (karabelo ea letlalo la lehae, ho theoa ha depo ea insulin, ho ts'oaroa ha khanyetso khahlanong le kalafo ea lihormone ka litokisetso tsa insulin tsa mohloli oa phoofolo).

Phuputso ea ho fumana li-insulin autoantibodies maling, e sebelisetsoang tlhahlobo e khethollang ea lefu la tsoekere la mofuta oa 1 ho bakuli ba sa fumanang kalafo ka litokisetso tsa insulin.

Synonyms

Synonyms Senyesemane

Insulin Autoantibodies, IAA.

Mokhoa oa ho etsa lipatlisiso

Enunemolated enzunosor ass assume (ELISA).

Mekha

U / ml (yuniti ka millilita).

Ho ka sebelisoa lipatlisiso life tse amanang le lipatlisiso?

U ka itokisetsa thuto joang?

Se ke oa tsuba metsotso e 30 pele u fana ka mali.

Tlhahlobo ea Tlhahlobo

Li-antibodies ho insulin (AT ho insulin) ke autoantibodies e hlahisoang ke 'mele khahlano le insulin ea eona. Ke matšoao a hlakileng a lefu la tsoekere la mofuta oa 1 lefu la tsoekere, 'me ho ntse ho etsoa lipatlisiso bakeng sa tlhahlobo ea lefu lena. Mofuta oa 1 oa lefu la tsoekere (lefu la tsoekere le itšetlehileng ka insulin) o hlaha ka lebaka la tšenyo ea autoimmune?? Lisele tsa manyeme, a lebisang ho haelloang ke insulin ka botlalo mmeleng. Sena se khetholla lefu la tsoekere la mofuta oa 1 le lefu la tsoekere la mofuta oa 2, leo ho lona mafu a amanang le ente a ka etsang karolo e nyane haholo. Tlhahlobo e fapaneng ea mefuta ea lefu la tsoekere ke ea bohlokoa haholo ho etseng mahlale a kalafo le mekhoa ea kalafo.

Bakeng sa tlhahlobo e fapaneng ea mefuta ea lefu la tsoekere, li-autoantibodies tse lebisitsoeng khahlanong le tsona? Lisele tsa lihlekehleke tsa Langerhans lia hlahlojoa. Boholo ba bakuli ba nang le lefu la tsoekere la mofuta oa 1 ba na le li-antibodies likarolong tsa makhopho a bona. Ho fapana le hoo, autoantibodies tse joalo ha li sebetse ho bakuli ba nang le lefu la tsoekere la mofuta oa 2.

Insulin ke autoantigen kholisong ea lefu la tsoekere la mofuta oa 1. Ho fapana le li-autoantigener tse ling tse fumanehang ho lefu lena (glutamate decarboxylase le liprotheine tse fapaneng tsa lihlekehleke tsa Langerhans), insulin ke eona feela e khethehileng e totobatsang pancreatic autoantigen. Ka hona, tlhahlobo e nepahetseng ea li-antibodies ho insulin e nkoa e le letšoao le ikhethang la tšenyo ea autoimmune ho makhopho a mofuta oa 1 lefu la tsoekere (maling a 50% a bakuli ba nang le lefu la tsoekere la 1, li-autoantibodies ho insulin li fumanoe). Li-autoantibodies tse ling tse fumanehang maling a bakuli ba nang le lefu la tsoekere la mofuta oa 1 li kenyelletsa li-antibodies ho islet cell ea li-pancreas, antibodies ho glutamate decarboxylase, le ba bang. Nakong ea tlhahlobo ea mafu, 70% ea bakuli ba na le mefuta e 3 kapa ho feta ea li-antibodies, ba ka tlase ho 10% ba nang le mofuta o le mong, mme 2-4% ha e na li-autoantibodies tse ikhethang. Ka nako e ts'oanang, li-autoantibodies tse nang le lefu la tsoekere la mofuta oa 1 ha se sesosa se tobileng sa nts'etsopele ea lefu lena, empa li bontša feela ts'abo ea lisele tsa "pancreatic".

HO HO insulin ho na le tšobotsi e ngata ho bana ba nang le lefu la tsoekere la mofuta oa 1 mme ha le atisehe haholo ho bakuli ba baholo. Ha e le molao, ho bakuli ba bana ba hlaha pele ka karolo e phahameng haholo (mokhoa ona o boleloa haholo baneng ba ka tlase ho lilemo tse 3). Ha ho fanoa ka likarolo tsena, tlhahlobo ea li-antibodies ho insulin e nkoa e le teko e ntle ka ho fetisisa ea laboratori ho netefatsa ho fumanoa ha lefu la tsoekere la mofuta oa 1 ho bana ba nang le hyperglycemia. Leha ho le joalo, ho lokela ho hlokomeloa hore sephetho se seng ha se khetholle boteng ba lefu la tsoekere la mofuta oa 1. Ho fumana tlhaiso-leseling e phethahetseng ka ho fetisisa nakong ea ts'oaetso, ho kgothaletswa ho se hlahlobe feela li-antibodies ho insulin, empa le li-autoantibodies tse ikhethileng bakeng sa lefu la tsoekere la mofuta oa 1. Ho fumanoa ha li-antibodies ho insulin ho ngoana ntle le hyperglycemia ha ho nkoe e le molemong oa tlhahlobo ea lefu la tsoekere la mofuta oa 1. Ha lefu lena le ntse le tsoela pele, boemo ba li-antibodies ho ea ho insulin bo fokotseha ho ea ho bo sa bonahaleng, bo khethollang li-antibodies tsena ho li-antibodies tse ling tse ikhethang tsa mofuta oa 1 lefu la tsoekere, mahloriso a lona a lulang a tsitsitse kapa a eketseha.

Leha taba ea hore li-antibodies ho insulin li nkuoa e le lets'oao le itseng la lefu la tsoekere la 1, ho hlalositsoe linyeoe tsa lefu la tsoekere la 2, tseo ho tsona ho ileng ha fumanoa li-autoantibodies tsena.

Mofuta oa 1 oa lefu la tsoekere o na le tloaelo e boletsoeng ka tlhaho. Boholo ba bakuli ba nang le lefu lena ke bajari ba mofuta o itseng oa HLA-DR3 le HLA-DR4. Kotsi ea ho ba le lefu la tsoekere la mofuta oa 1 ho beng ka motho ea haufi le lefu lena le eketseha ka makhetlo a 15 'me e fihla ho 1:20. Ha e le molao, mathata a amanang le tšoaetso ea 'mele ka mokhoa oa tlhahiso ea li-autoantibodies ho likarolo tsa manyeme a tlalehiloe nako e telele pele ho qala ha lefu la tsoekere la mofuta oa 1. Sena se bakoa ke taba ea hore nts'etsopele ea matšoao a atolositsoeng a kliniki ea lefu la tsoekere la 1 a hloka ho felisoa ha 80-90% ea lisele tsa lihlekehleke tsa Langerhans. Ka hona, tlhahlobo ea li-antibodies ho insulin e ka sebelisoa ho lekola kotsi ea ho ba le lefu la tsoekere ho bakuli ba nang le nalane ea lefu lena. Ho ba teng ha li-antibodies ho insulin maling a bakuli ba joalo ho amana le keketseho ea karolo ea 20 lekholong ea monyetla oa lefu la tsoekere la 1 lilemong tse 10 tse tlang. Ho fumana li-autoantibodies tse peli kapa ho feta tse ikhethang bakeng sa lefu la tsoekere la mofuta oa 1 ho eketsa monyetla oa ho fumana lefu lena ka 90% lilemong tse 10 tse tlang.

Leha taba ea hore tlhahlobo ea li-antibodies ho insulin (hammoho le litekanyetso tse ling tsa laboratori) ha e khothalletsoe e le tlhahlobo ea lefu la tsoekere la mofuta oa 1, thuto e ka ba molemo ho ho hlahloba bana ba nang le nalane ea lefutso ea lefu la tsoekere la mofuta oa 1. Hammoho le tlhahlobo ea mamello ea glucose, e u lumella ho khetholla lefu la tsoekere la 1 pele o ba le matšoao a matla a kliniki, ho kenyeletsoa le lefu la tsoekere la lefu la tsoekere. Boemo ba C-peptide ka nako ea tlhahlobo ea mafu le bona bo phahame, bo bonts'ang matšoao a nepahetseng a ts'ebetso e setseng ea batho? - O bonoa ka leano lena la ho laola bakuli ba kotsing. Re lokela ho hlokomela hore kotsi ea ho ba le lefu ho mokuli e nang le litholoana tse ntle tsa tlhahlobo ea AT bakeng sa insulin le ho ba sieo ha nalane ea lefutso ea lefu la tsoekere ea 1 ha e fapana le kotsi ea ho ba le lefu lena ho baahi.

Boholo ba bakuli ba fumanang litokisetso tsa insulin (exo native, recombinant insulin) ba qala ho nts'etsapele li-antibodies ho fihlela ka nako. Ba tla ba le sephetho se nepahetseng sa tlhahlobo, ho sa tsotelehe hore na ba hlahisa li-antibodies ho li-insulin tsa tlhaho kapa che. Ka lebaka lena, thuto ha e reretsoe ho khetholla lefu la tsoekere la mofuta oa 1 ho bakuli ba seng ba amohetse litokisetso tsa insulin. Boemo bo joalo bo ka hlaha ha lefu la tsoekere la mofuta oa 1 le belaelloa ho mokuli ea nang le lefu la tsoekere la mofuta oa 2 ea amohetseng kalafo ka insulin ea khale ho lokisa hyperglycemia.

Bakuli ba bangata ba nang le lefu la tsoekere la mofuta oa 1 ba na le lefu le le leng kapa a mangata a autoimmune. Maloetse a tšoaetsanoang ka ho fetisisa a autoimmune thyroid (lefu la Hashimoto's thyroiditis kapa lefu la Graves), lefu la mantlha la adrenal (lefu la Addison), celiac Enteropathy (lefu la celiac), le anemia e bolaeang. Ka hona, ka sephetho se setle sa tlhahlobo ea li-antibodies ho insulin le netefatso ea tlhahlobo ea lefu la tsoekere la mofuta oa 1, ho hlokahala liteko tse ling tsa laboratori ho khetholla mafu ana.

Phuputso e sebelisetsoa eng?

• Bakeng sa tlhahlobo e khethollang ea mofuta oa 1 le mofuta oa 2 lefu la tsoekere.
• Ho etsa nalane ea kholo ea lefu la tsoekere la mofuta oa 1 ho bakuli ba nang le nalane ea lefutso ea lefu lena, haholoholo baneng.

Thuto e reriloe neng?

• Ha ho hlahlojoa mokuli ka matšoao a kliniki a hyperglycemia: lenyora, ho eketseha ha moroto oa letsatsi le letsatsi, takatso e eketsehileng ea lijo, boima ba 'mele, ho fokotseha ho tsoelang pele ha pono, ho fokotseha ha methapo ea letlalo la maoto, le ho thehwa ha maoto a malelele a sa phekoleheng le liso tsa leoto tse tlase.
• Ha u hlahloba mokuli ka nalane ea lefu la tsoekere la mofuta oa 1, haholo haeba e le ngoana.

Liphetho li bolelang?

Likhakanyo tsa litšupiso: 0 - 10 U / ml.

• mofuta oa 1 lefu la tsoekere
• autoimmune insulin syndrome (lefu la Hirat),
• autoimmune polyendocrine syndrome,
• haeba litokisetso tsa insulin (exogenous, recombinant insulin) li ne li laetsoe - boteng ba li-antibodies ho litokisetso tsa insulin.

• tloaelehileng
• boteng ba matšoao a hyperglycemia, tlhahlobo ea lefu la tsoekere la mofuta oa 2 e ka etsahala.

Ke eng e ka susumetsang phello?

• AT ho insulin e tsebahala haholo ho bana ba nang le lefu la tsoekere la mofuta oa 1 (haholoholo ho fihlela lilemo tse 3) mme ha ho bonolo hore ba fumanoe ho bakuli ba baholo.
• Keketseho ea li-antibodies ho insulin ea fokotseha ho fihlela lefu le sa bonahale nakong ea likhoeli tse 6 tse qalang.
• Ho bakuli ba fumanang litokisetso tsa insulin, litholoana tsa lipatlisiso li tla ba ntle, ho sa tsotelehe hore na ba hlahisa li-antibodies ho fana ka insulin ea tlhaho kapa che.

Lintlha tsa bohlokoa

• Boithuto bona ha bo lumelle ho khetholla pakeng tsa li-autoantibodies le li-insulin tsa tsona tsa tlhaho le li-antibodies ho ba insulin ea ka ntle (injectable, recombinant).
• Sephetho sa hlahlobo se lokela ho hlahlojoa hammoho le tlhaiso ea tlhahlobo ea lefu la tsoekere la mofuta o mong le sephetho sa tlhahlobo ea kakaretso ea kliniki.

E khothalelitsoe hape

Ke mang ea fanang ka thuto?

Endocrinologist, ngaka e akaretsang, ngaka ea bana, ramatiki ea ho tsosa takatso, ngaka ea methapo, nephrologist, neurologist, ngaka ea methapo ea pelo.

Lingoliloeng

1. Franke B, Galloway TS, Wilkin TJ. Ntšetso-pele ho phatlalatso ea mofuta oa 1 lefu la tsoekere, ka ho bua ka ho khethehileng ho li-insulin autoantibodies. Lefu la tsoekere Metab Res Rev. 2005 Sep-Oct, 21 (5): 395-415.
2. Bingley PJ. Lisebelisoa tsa tleleniki tsa liteko tsa lefu la tsoekere. J Clin Endocrinol Metab. 2010 Jan, 95 (1): 25-33.
3. Kronenberg H et al. Buka ea Williams ea 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.

Tlohela lengolo-tsoibila la hau u fumane litaba, hammoho le limpho tse ikhethang tse tsoang laboratoring ea KDLmed

1. 
   Neumyvakin, I.P. Lefu la tsoekere / I.P. Neumyvakin. - M .: Dilya, 2006 .-- 256 leq.
2. 
   Skorobogatova, E.S. Bokooa ba pono ka lebaka la lefu la tsoekere mellitus / E.S. Skorobogatova. - M: Bongaka, 2003. - 208 leq.
3. 
   Mofuta oa lefu la tsoekere la M. Ho itšetlehile haholo ka uena (ho fetoletsoe ho tsoa ho Senyesemane: M. Gressor. "Lefu la tsoekere, ho leka-lekanya", 1994).SPb., Ntlo ea phatlalatso "Norint", 2000, maqephe a 62, ho ajoa ha likopi tse 6000.

E re ke itsebise. Lebitso la ka ke Elena. Ke qetile lilemo tse fetang 10 ke sebetsa ke le setsebi sa endocrinologist. Ke lumela hore hajoale ke setsebi lebaleng la ka mme ke batla ho thusa baeti bohle ba sebakeng sa marang-rang ho rarolla mesebetsi e rarahaneng eseng joalo. Lisebelisoa tsohle tsa sebaka sena sa marang-rang li bokelloa ebe li sebetsoa ka hloko e le hore li fetise litaba tsohle tse hlokahalang ka hohle kamoo ho ka khonehang. Pele o sebelisa se hlalosoang webosaeteng, ho hlokahala tumellano ea ho buisana le litsebi kamehla.

Insulin ke eng

Lintho tse hlahisoang ke lisele tse fapaneng tsa lihlekehleke tsa li-pancreatic tsa Langerhans

Insulin ke ntho ea hormonal ea tlhaho ea polypeptide. E entsoe ka lisele tsa "pancreatic β-" tse fumanehang ka har'a lihlekehleke tsa Langerhans.

Mohloli o ka sehloohong oa tlhahiso ea ona ke tsoekere ea mali. Ha khatello ea tsoekere e phahama ka ho fetisisa, e matla le ho feta ke tlhahiso ea hormone ea insulin.

Leha taba ea hore synthetic ea li-insulin, li-glucagon le somatostatin li etsahala liseleng tse haufi, ke bahanyetsi. Liphetoho tse khahlanong le insulin li kenyelletsa lihormone tsa adrenal cortex - adrenaline, norepinephrine le dopamine.

Mesebetsi ea hormone ea insulin

Morero o ka sehloohong oa hormone ea insulin ke taolo ea metabolism ea carbohydrate. Ke ka thuso ea eona moo mohloli oa matla - glucose, e leng plasma ea mali, o kenang liseleng tsa mesifa ea mesifa le lithane tsa adipose.

Molek'hule ea insulin ke motsoako oa li-amino acid tse 16 le masala a 51 a amino acid

Ntle le moo, hormone ea insulin e etsa mesebetsi e latelang 'meleng, e arotsoe ka likarolo tse 3, ho latela litlamorao:

• Anticatabolic:
  1. fokotseha ha boleng ba protheine ea hydrolysis,
  2. thibelo ea ho ata haholo ha mali ka mafura acid.
• Metabolic:
  1. ho nchafatsa glycogen ka har'a sebete le lisele tsa mesifa ea masapo ka ho potlakisa polymerization ea eona maling a tsoang maling.
  2. ts'ebetso ea li-enzyme tsa bohlokoa tse fanang ka oxidation e se nang oksijene ea limolek'hule tsa glucose le lik'habohaedreite tse ling.
  3. ho thibela ho thehwa ha glycogen ka har'a sebete ho tsoa liprotheine le mafura,
  4. tshusumetso ea motsoako oa lihormone le li-enzyme tsa seterata sa ka mpeng - gastrin, inhibitory gastric polypeptide, secretin, cholecystokinin.
• Anabolic:
  1. ho tsamaisoa ha metsoako ea magnesium, potasiamo le phosphorus ho lisele,
  2. ho kenyelletsa ho eketsehileng ha li-amino acid, haholo-holo valine le leucine,
  3. ho matlafatsa biosynthesis, e tlatsetsang phokotsong ea kapele ea DNA (makhetlo a mabeli pele ho karohano),
  4. ho potlakisa motsoako oa triglycerides ho tsoa ho tsoekere.

Ho elelloa. Insulin, hammoho le lihormone tsa kholo le li-anabolic steroids, li bua ka li-hormone tse bitsoang li-anabolic. Ba na le lebitso lena hobane ka thuso ea bona 'mele o eketsa palo le boholo ba mesifa ea mesifa. Ka hona, hormone ea insulin e amoheloa e le sethala sa lipapali mme ts'ebeliso ea eona e thibetsoe bakeng sa baatlelete ba lipapali tse ngata.

Ts'ebetso ea insulin le litaba tsa eona ho plasma

Bakeng sa tlhahlobo ea mali bakeng sa hormone ea insulin, mali a nkuoa mothapong

Ho batho ba phetseng hantle, boemo ba lihomone tsa insulin bo ikamahanya le boemo ba tsoekere maling, ka hona, ho bo tseba ka nepo, ho fanoa ka tlhahlobo ea tlala ea "insulin". Melao ea ho itokisetsa sampole ea mali bakeng sa tlhahlobo ea insulin e tloaelehile.

Litaelo tse khutšoanyane li tjena:

• u se ke ua ja kapa ua noa lino leha e le life ntle le metsi a hloekileng - bakeng sa lihora tse 8,
• kenyelletsa lijo tse nang le mafura le boima bo bongata ba 'mele, u se ke oa nyenyefatsa' me u se ke oa tšoha - ka lihora tse 24,
• u se ke ua tsuba - hora e le 1 pele ho sampole ea mali.

Leha ho le joalo, ho na le mehopolo eo u hlokang ho e tseba le ho e hopola:

1. Beta-adreno-blockers, metformin, furosemide calcitonin le lithethefatsi tse ling tse ngata li fokotsa tlhahiso ea lihormone tsa insulin.
2. Ho nka lithibela-pelehi tsa molomo, quinidine, albuterol, chlorpropamide le palo e kholo ea lithethefatsi tse ling ho tla ama sephetho sa tlhahlobo, ho li kopitsa. Ka hona, ha u fumana litaelo tsa tlhahlobo ea insulin, o lokela ho botsa ngaka ea hau hore na ke meriana efe e lokelang ho emisoa le hore na mali a lokela ho emisoa ho fihlela neng.

Haeba melao e se e latetsoe, ha feela makhopho a sebetsa hantle, o ka lebella sephetho se latelang:

Hlokomela Haeba ho hlokahala, ho bala lipontšo hape ho pmol / l, ho sebelisoa formula μU / ml x 6.945.

Bo-rasaense ba hlalosa phapang ea boleng ka tsela e latelang:

1. Setho se holang se lula se hloka matla, ka hona, ho bana le lilemong tsa bocha popeho ea li-insulin li fokola hanyane ho feta kamoo e tla ba ka mora ho kena bohlankaneng, e leng qalo ea eona e fanang ka tšusumetso ho hola butle butle.
2. Tloaelo e phahameng ea "insulin" maling a basali baimana ka mpeng e se nang letho, haholoholo nakong ea nako ea boraro, e bakoa ke hore e kenella butle ka lisele, ha e ntse e bonts'a katleho e tlase ho fokotseng litekanyo tsa tsoekere ea mali.
3. Ho banna le basali ba baholo ka mor'a lilemo tse 60, ts'ebetso ea 'mele ea fela, ho ikoetlisa hoa fokotseha,' mele ha o hloke matla a mangata, ka mohlala, joalo ka ha a le lilemo li 30, ka hona, palo e phahameng ea li-insulin e hlahisoang e nkoa e le ntho e tloaelehileng.

Ho hlahisa tlhahlobo ea tlala ea insulin

Tlhahlobo ha ea ka ea inehela ka mpeng e se nang letho, empa kamora ho ja - boemo bo eketsehileng ba insulin bo tiisitsoe

Ho kheloha phello ea tlhahlobo ho latela boleng ba litšupiso, haholo ha boleng ba insulin bo le ka tlase ho tloaelehileng, ha se hantle.

Boemo bo tlase ke bo bong ba bopaki ba netefatso:

• mofuta oa 1 lefu la tsoekere
• mofuta oa lefu la tsoekere
• hypopituitarism.

Lethathamo la maemo le lipilisi tsa "insulin" tse phahameng ho feta tse tloaelehileng li atile haholo:

• insulinoma
• prediabetes e nang le mokhoa oa ntlafatso oa mofuta oa 2,
• lefu la sebete
• ovary ea polycystic,
• Itsenko-Cushing's syndrome,
• metabolic syndrome
• mesifa ea fiber fiber
• lefutso la lefutso ho Fructose le galactose,
• acromegaly.

Index ea NOMA

Letšoao le bonts'ang ho hanyetsa insulin - boemo boo mesifa e emisang ho lemoha li- "insulin" hantle, e bitsoa NOMA Index. Ho e tseba, mali le 'ona a nkuoa ka mpeng e se nang letho. Tekanyo ea glucose le insulin li thehiloe, kamora moo ho baloa lipalo ho ea ka foromo: (mmol / l x μU / ml) / 22.5

Tloaelo ea NOMA ke sephetho - ≤3.

Lenane la index ea HOMA & gt, 3 e bonts'a ho ba teng ha pathologies e le 'ngoe kapa tse' maloa:

• mamello ea tsoekere e sa sebetseng hantle,
• metabolic syndrome
• mofuta oa 2 lefu la tsoekere,
• ovary ea polycystic,
• mathata a metabolism ea carbohydrate-lipid,
• dyslipidemia, atherosclerosis, khatello ea mali.

Bakeng sa tlhaiso-leseling. Batho ba sa tsoa fumanoa ba tšoaetsoa lefu la tsoekere la mofuta oa 2 ba tla tlameha ho etsa tlhahlobo ena hangata, hobane ho hlokahala ho hlokomela ts'ebetso ea kalafo e boletsoeng.

Ho sithabela ha mosebetsi khafetsa le ho lula u lutse ho ka lebisa ho lefu la tsoekere

Ntle le moo, papiso ea matšoao a hormone ea insulin le tsoekere e thusa ngaka ho hlakisa moelelo le lisosa tsa liphetoho 'meleng:

• Insulin e phahameng e nang le tsoekere e tloaelehileng ke letšoao:

1. boteng ba ts'ebetso ea hlahala liseleng tsa manyeme, karolo e ka ntle ea bokong kapa adrenal cortex,
2. ho hloleha ha sebete le maloetse a mang a sebete.
3. tšilafalo ea tšoelesa ea senya
4. secretion ea glucagon e fokotsehile.

• Insulin e tlase e nang le tsoekere e tloaelehileng e ka etsahala ka:

1. tlhahiso e feteletseng kapa kalafo e nang le lihormone tse loantšanang le li-contra.
2. pathology - hypopituitarism,
3. boteng ba methapo e sa foleng,
4. nakong ea maloetse a tšoaetsanoang haholo,
5. boemo bo sithabetsang
6. takatso ea lijo tse monate le tse mafura,
7. ho ikoetlisa ka ho feteletseng kapa ho se sebetse hantle, ho se ikoetlise ka nako e telele.

Ho elelloa. Maemong a mangata, insulin e tlase e nang le tsoekere e tloaelehileng ea mali hase sesupo sa lefu la tsoekere, empa ha ua lokela ho phomola. Haeba boemo bona bo tsitsitse, ka tsela e hlakileng bo tla lebisa kholong ea lefu la tsoekere.

Insulin Antibody Assay (Insulin AT)

Mofuta oa 1 oa lefu la tsoekere hangata o hlaha bongoaneng le bohlankeng

Tlhahlobo ea mali a venous ke letšoao la tšenyo ea autoimmune ho β-lisele tse hlahisang insulin ea manyeme. E fuoe bana ba nang le kotsi ea lefutso ea ho ba le lefu la tsoekere la mofuta oa 1.

Ka thuso ea thuto ena, ho ka etsahala:

• phapang ea ho qetela ea ts'oaetso ea lefu la tsoekere la mofuta oa 1 kapa mofuta oa 2,
• qeto ea boikemisetso ba ho khetha lefu la tsoekere la 1,
• Tlhaloso ea lisosa tsa hypoglycemia ho batho ba se nang lefu la tsoekere,
• Tlhahlobo ea ho hanyetsa le ntlafatso ea allergy ho li-insulin tsa kantle,
• qeto ea boemo ba antibodies nakong ea kalafo ka insulin ea tlhaho ea liphoofolo.

Li-antibodies ho tloaelo ea insulin - 0.0-0.4 U / ml. Maemong moo tloaelo ena e fetisoang, ho kgothaletsoa ho etsa tlhahlobo e eketsehileng bakeng sa li-antibodies tsa IgG.

Hlokomela Keketseho ea maemo a antibody ke khetho e tloaelehileng ho 1% ea batho ba phetseng hantle.

Teko ea mamello ea glucose e atolositsoeng ea tsoekere, insulin, c-peptide (GTGS)

Tlhahlobo ea mali a venous e etsahala nakong ea lihora tse peli. Sampole ea pele ea mali e nkuoa ka mpeng e se nang letho. Kamora sena, ho fuoa mojaro oa tsoekere, e leng, khalase ea tharollo ea glucose e metsi (200 g) ea metsi (75 g). Kamora mojaro, taba e lokela ho lula e khutsitse lihora tse peli, e leng sa bohlokoa haholo bakeng sa ts'episo ea sephetho sa tlhahlobo. Ebe ho na le sampole ea mali e phetoang.

Tloaelo ea insulin ka mor'a ho ikoetlisa ke 17.8-173 mkU / ml.

Bohlokoa! Pele o fetisa tlhahlobo ea GTG, tlhahlobo ea mali e potlakileng ka glucometer e tlameha. Haeba ho bala tsoekere ke ≥ 6.7 mmol / L, ha ho etsoe liteko tsa mojaro. Mali a fanoa bakeng sa tlhahlobo e arohaneng ea c-peptide feela.

Ho bokellana ha c-peptide maling ho tsitsitse ho feta boemo ba hormone ea insulin. Tloaelo ea c-peptide maling e tsoa ho 0.9-7.10 ng / ml.

Matšoao a tlhahlobo ea c-peptide ke:

• phapang ea mofuta oa 1 le lefu la tsoekere la mofuta oa 2, hammoho le maemo a bakoang ke hypoglycemia,
• khetho ea maqheka le mofuta oa kalafo bakeng sa lefu la tsoekere,
• polycystic ovary syndrome,
• monyetla oa ho kena-kenana kapa ho hana kalafo ka li-hormone tsa insulin,
• lefu la sebete
• laola ka mor'a ho buuoa ho tlosa manyeme.

Liphetho tsa liteko tse tsoang lilaboratoring tse fapaneng li ka fapana.

Haeba c-peptide e phahame ho feta e tloaelehileng, ho ka etsahala:

• mofuta oa lefu la tsoekere
• ho hloleha ha rems
• insulinoma
• hlahala e mpe ea litšoelesa tsa endocrine, likarolo tsa bokong kapa litho tsa ka hare,
• ho ba teng ha li-antibodies ho "hormone ea" insulin,
• somatotropinoma.

Maemong moo boemo ba c-peptide bo ka tlase ho tloaelehileng, likhetho li ka khoneha:

• mofuta oa 1 lefu la tsoekere
• boemo ba khatello ea nako e telele
• bokhoba ba joala
• boteng ba li-antibodies ho li-insulin tsa li-insulin tse nang le tlhahlobo ea tlhahlobo ea lefu la tsoekere la mofuta oa 2.

Haeba motho a phekoloa ka lihormone tsa insulin, joale boemo bo fokolitsoeng ba c-peptide ke ntho e tloaelehileng.

Ha re phethela, re khothaletsa ho shebella video e khuts'oane e tla u thusa ho itokisetsa liteko tsa mali le tsa moroto, ho boloka nako, ho boloka methapo le litekanyetso tsa lelapa, hobane theko ea tse ling tsa lithuto tse kaholimo e ea khahla.