Insulin e kenella taolong ea metabolism, phetisetso ea transmembrane ea ions, liamino acid. Matla a insulin ho metabolism ea lik'habohaedreite ho thata ho li feta. Batho ba nang le lefu la tsoekere ba boetse ba bontša matšoao a metabolism e sa foleng.
Lefu la tsoekere le fumanoe khafetsa le morao tjena. Maloetse a baka mathata a mangata a metabolic. Lefu la tsoekere, 'mele oa methapo ea kutlo e ka fapana haholo, o sebakeng sa boraro kamora mafu a oncology le a pelo. Ho na le batho ba ka bang limilione tse 100 ba nang le lefu la tsoekere lefatšeng. Lilemo tse ling le tse ling tse 10, palo ea batho ba lefu la tsoekere e ba teng makhetlo a fetang a mabeli.
Batho ba tsoang linaheng tse tsoelang pele le ba sotlehileng linaheng tse tsoetseng pele ba kotsing e kholo ea ho kula. Mathata a Metabolic a lefu la tsoekere mellitus a lebisa ho li-pathologies tse fapaneng. Lefu la tsoekere la mofuta oa 2 hangata le ama batho kamora lilemo tse 45.
Mokhoa oa ketso ea insulin
Ka 1869, Langerhans o ile a fumana lihlekehleke makhophorong ao hamorao a ileng a reoa lebitso la hae. Ho ile ha tsebahala hore lefu la tsoekere le ka hlaha kamora ho ntšoa ha tšoelesa.
Insulin ke protheine, ke hore, polypeptide e nang le liketane tsa A le B. Li hokahantsoe ke marokho a mabeli a litšila. Joale hoa tsebahala hore insulin e thehiloe le ho bolokoa ke lisele tsa beta. Insulin e tšoenngoa ke li-enzyme tse khutlisang litlamo tsa disulfide mme li bitsoa "insulinase." Ho feta moo, li-enzyme tsa protheine li ameha ho hydrolysis ea liketane ho likarolo tse tlase tsa limolek'hule.
Ho lumeloa hore inhibitor e ka sehloohong ea insulin secretion ke insulin maling le eona ke lihormone tsa hyperglycemic:
- adrenaline
- ACTH,
- cortisol.
TSH, catecholamines, ACTH, STH le glucagon ka tsela tse fapaneng li kenya tšebetsong adenylcyclase ka membrane ea sele. Ho qetela ho thusa ho etsoa ha cyclic 3,5 adenosine monophosphate, e kenya tšebetsong ntlha e 'ngoe - protheine kinase, e phosphorylates li-microtubules tsa beta, tse lebisang ho fokotseng tokollo ea insulin.
Li-Microtubules ke sebopeho sa sele ea beta eo ka eona insulin e neng e entsoe ka nako eo pele e kenella ka har'a li-vesicles ho ea membrane ea sele.
Ntho e matlafatsang ka ho fetesisa insulin ke glucose ea mali.
Mochine oa ts'ebetso ea insulin o boetse o teng kamanong ea ho hanyetsa ea babuelli ba marang-rang ba 3,5 - GMF le 3,5 AMP.
Mochine oa metabolism ea carbohydrate
Insulin e ama metabolism ea lik'habohaedreite ho lefu la tsoekere. Khokahano ea bohlokoa ho lefu lena ke khaello ea ntho ena. Insulin e na le phello e ntle ho metabolism ea carbohydrate, hammoho le mefuta e meng ea metabolism, hobane secretion ea insulin e fokotseha, ts'ebetso ea eona ea fokotseha, kapa ho amoheloa ha li-tisulin tse itšetlehileng ka insulin ke lisele li senyehile.
Ka lebaka la tlolo ea metabolism ea carbohydrate ho tsoekere ea lefu la tsoekere, ts'ebetso ea tsoekere ea tsoekere liseleng ea fokotseha, palo ea eona maling e ea eketseha, le mekhoa ea ts'ebetso ea tsoekere e ikemetseng ea insulin e sebetsoa.
Sorbitol shunt ke boemo boo tsoekere e fokotsoang ho sorbitol, ebe e entsoe ka oxid bakeng sa fructose. Empa oxidation e lekanyelitsoe ke enzyme e itšetlehileng ka insulin. Ha polyol shunt e butsoa, sorbitol e bokellana liseleng, sena se kenya letsoho ponahalong ea:
- neuropathy
- katarayta
- microangiopathies.
Ho na le sebopeho sa kahare sa tsoekere e tsoang liprotheine le glycogen, empa le mofuta ona oa "goiukosis" ha o anngoe ke lisele, kaha ho na le insulin. Aerobic glycolysis le pentose phosphate shunt li hatelletsoe, hypoxia ea sele le khaello ea matla li hlaha. Bophahamo ba hemoglobin ea glycated e eketseha, ha se moea o tsamaisang oksijene, o matlafatsang hypoxia.
Protein metabolism ho lefu la tsoekere e ka senyeha:
- hyperazotemia (boemo bo eketsehang ba naetrojene e setseng),
- hyperazotemia (keketseho ea lenane la metsoako ea naetrojene maling).
Tloaelo ea naetrojene ea protheine ke 0,86 mmol / L, 'me naetrojene eohle e lokela ho ba 0,87 mmol / L.
Lisosa tsa pathophysiology ke:
- catabolism e eketsehileng
- activation of deamination ea li-amino acid ka har'a sebete,
- naetrojene e setseng.
Nitrogen e seng protheine ke naetrojene:
- amino acid
- urea
- ammonia
- moeinine
Sena se bakoa ke tšenyeho e eketsehileng ea liprotheine, haholo-holo ka har'a sebete le mesifa.
Ka moroto o nang le lefu la tsoekere, molumo oa metsoako ea naetrojene oa eketseha. Azoturia e na le mabaka a latelang:
- Keketseho ea bongata ba lihlahisoa tse nang le naetrojene maling, tšireletso ea bona ka har'a moroto,
- metabolism ea mafura a senyehileng e tšoauoa ka ketonemia, hyperlipidemia, ketonuria.
Ho lefu la tsoekere, hyperlipidemia ea hlaha, e leng keketseho ea palo ea mali ea lipid. Palo ea bona e feta e tloaelehileng, ke hore, e feta 8 g / l. Hyperlipidemia e latelang e teng:
- tiska activation lipolysis,
- thibelo ea ts'ebetso ea lipid ka lisele,
- eketseha cholesterol,
- thibelo ea ho tlisa li-acid tse phahameng ho lisele,
- mosebetsi o fokotsehileng oa LPLase,
- ketonemia - keketseho ea palo ea 'mele ea ketone maling.
Sehlopheng sa litopo tsa ketone:
- acetone
- acetoacetic acid
- p-hydroxymalic acid.
Palo eohle ea 'mele ea ketone maling e ka ba kholo ho feta 30-50 mg%. Ho na le mabaka a sena:
- ts'ebetso ea lipolysis,
- eketseha ha oksijene liseleng tse mafura a mangata,
- ho emisa lipid synthesis,
- ho fokotseha ha oxidation ea acetyl - CoA ho hepatocytes ka ho thehoa ha 'mele oa ketone,
Kabo ea 'mele ea ketone hammoho le moroto ke pontšo ea lefu la tsoekere la lefu le sa rateheng.
Sesosa sa ketonuria:
- 'mele o mongata oa ketone o tlhotliloeng lipelong,
- mathata a metabolism ea metsi ho tsoekere, a bonahatsoang ke polydipsia le polyuria,
Polyuria ke ts'oaetso e hlahisoang ka sebopeho le tšilafalo ea moroto ka bongata bo fetang boleng bo tloaelehileng. Tlas'a maemo a tloaelehileng, ho tloha ho 1000 ho isa ho 1200 ml ho lokolloa ka letsatsi le le leng.
Le lefu la tsoekere, diuresis ea letsatsi le letsatsi ke 4000-10 000 ml. Mabaka ke:
- Hyperosmia ea moroto, e etsahalang ka lebaka la ho tlosoa ha tsoekere e ngata, ion, CT le naetrojene. Kahoo, filtara ea mokelikeli glomeruli e hlohlelletsoa le ho thibela botjha,
- Tlolo ea ho reabsorption le excretion, e bakoang ke lefu la tsoekere,
- Polydipsia.
Insulin le metabolism ea mafura
Tlas'a tšusumetso ea insulin, sebete se ka boloka palo e itseng feela ea glycogen. Tsoekere e ngata e kenang ka har'a sebete e qala ho ba phosphorylate mme ka hona e bolokoa seleng, empa ebe e fetoloa mafura, ho fapana le glycogen.
Phetoho ena hore e be mafura ke lebaka la ho pepesetsoa insulin ka kotloloho, 'me mali a thehiloeng ts'ebetsong ea mafura acid a tsamaisoa liseleng tsa adipose. Meleng, mafura ke karolo ea lipoprotein, e phethang karolo ea bohlokoa tlhahisong ea atherossteosis. Ka lebaka la ts'ebetso ea lefu lena, e ka qala:
- embolism
- lefu la pelo.
Ketso ea insulin ho lisele tsa "adipose" ea lisele e tšoana le phello ea eona liseleng tsa sebete, empa sebopeho sa li-acid tse mafura sebeteng se sebetsa haholoanyane, ka hona li fetisetsoa ho eona ho ea ho adipose tishu. Li-acid tse mafura liseleng li bolokiloe e le triglycerides.
Tlas'a tšusumetso ea insulin, ho phatloha ha triglycerides ho lithane tsa adipose ho fokotsehile ka lebaka la thibelo ea lipase. Ntle le moo, insulin e kenya ts'ebetso ea li-acid tse mafura ke lisele mme e ameha phepelong ea tsona ka glycerol, e hlokahalang bakeng sa synthesis ea triglycerides. Kahoo, ha nako e ntse e ea, mafura a bokellana, ho kenyelletsa le physiology ea lefu la tsoekere mellitus.
Matla a insulin ho metabolism ea mafura a ka fetoha hape, ka tekanyo e tlase, triglycerides e boetse e arotsoe ka mafura acid le glycerol. Sena se bakoa ke taba ea hore insulin inhibits lipase le lipolysis e sebetsoa ha palo ea eona e fokotsoang.
Li-acids tsa mahala tse mafura, tse thehiloeng nakong ea hydrolysis ea triglycerides, ka nako e ts'oanang li kenella maling mme li sebelisoa e le mohloli oa matla bakeng sa lisele. The oxidation ea acid ena e ka ba liseleng tsohle, ntle le lisele tsa methapo.
Lenane le leholo la mafura acids a lokolloang ha ho na le insulin e tsoang mefuteng ea mafura e kenngoa hape ke sebete. Lisele tsa sebete li ka kopanya li-triglycerides esita leha ho se na insulin. Ka lebaka la ho haelloa ke ntho ena, mafura a tsoang mafung a bokelloa ka har'a sebete ka mokhoa oa triglyceride.
Ka lebaka lena, batho ba nang le khaello ea insulin, le hoja ba tloaetse ho theola boima ba 'mele, ba nona bothateng.
Lipid tse nang le phepo e matla le carbohydrate
Ho lefu la tsoekere, index ea "insulin" e ea theoha. Sena se bakoa ke ho fokotseha ha secretion ea insulin, hammoho le keketseho ea tlhahiso ea glucagon.
Liphokotso tsa metabolism ea lipid ho tsoekere ea lefu la tsoekere li hlalosoa ka mokhoa o fokolang oa ho boloka le ho khothaletsa ho eketseha ha pokello ea libaka tsa polokelo. Kamora ho ja, seterekeng sa postabsorption ke:
- sebete
- mesifa
- lithane tsa adipose.
Lihlahisoa tsa tšilo le li-metabolites tsa tsona, ho e-na le hore li bolokoe e le mafura le glycogen, li potoloha maling. Ts'ebetso ea cyclic le eona e hlaha ho isa tekanyong e itseng, ho etsa mohlala, lits'ebetso tse etsahalang ka nako e ts'oanang ea gluconeogenesis le glycolysis, hammoho le ts'ebetso ea ho phatloha ha mafura le motsoako.
Mefuta eohle ea lefu la tsoekere e tšoauoa ka mamello e fokotsehileng ea tsoekere, ke hore, hyperglucosemia ka mor'a ho ja lijo kapa esita le ka mpeng e se nang letho.
Lisosa tse ka sehloohong tsa hyperglucoseemia ke:
- ts'ebeliso ea li-tishu le mesifa ea adipose e na le moeli, hobane ha ho na insulin HLBT-4 ha e pepesoe holim'a adipocytes le myocyte. Glucose e ke ke ea bolokoa e le glycogen,
- "glucose" e leng sebete ha e sebelisoe ho bolokoa ka mokhoa oa glycogen, hobane ka "insulin" e tlase le "glucagon" e ngata ha e sebetse,
- glucose ea sebete ha e sebelisoe ka litlatsetso tsa mafura. Li-enzymes tsa glycolysis le pyruvate dehydrogenase li ka sebopeho se itlhahelang feela. Phetoho ea tsoekere ho acetyl-CoA, e hlokahalang bakeng sa tlhahiso ea mafura acid, e thibetsoe,
- tsela ea gluconeogenesis e kenngoa tšebetsong e ngata ea insulin le glucagon e phahameng le tlhahiso ea tsoekere e tsoang glycerol le amino acid e khonahala.
Pontšo e 'ngoe ea lefu la tsoekere ke boemo bo eketsehileng ba lipoprotein,' mele ea ketone le mafura a mahala maling. Mafura a jeoang ha a kentsoe ka har'a lithane tsa adipose hobane adipocyte lipase e ka sebopeho se sebetsang.
Kaholo e phahameng ea acid e mafura a mahala maling e hlaha. Li-acid tse ngata li kenngoa ke sebete, tse ling tsa tsona li fetoloa li-triacylglycerols, 'me li kena maling e le karolo ea VLDL. Tekanyo e itseng ea mafura a acid e kena ho β-oxidation ho mitochondria ea sebete, 'me acetyl-CoA e sebelisetsoa motsoako oa' mele oa ketone.
Matla a insulin ho metabolism e boetse e teng ka taba ea hore ka ho kenngoa ha insulin liseleng tse fapaneng tsa 'mele, motsoako oa mafura le ho phatloha ha lipilisi tsa triglyceride li potlakisitsoe. Metabolism e senyehileng ea lipid ke polokelo ea mafura, e sebeletsang ho khotsofatsa litlhoko tsa matla maemong a mabe.
Ponahalo e fetelletseng ea cAMP e lebisa ho fokotseha ha protheine ea tlhaho le ho fokotseha hoa HDL le VLDL. Ka lebaka la ho fokotseha ha HDL, tlhahiso ea k'holeseterole e tsoang liphoofolong tsa sele e ea ho plasma ea mali e fokotsehile. Cholesterol e qala ho kenngoa ka har'a mabota a likepe tse nyane, e lebisang ho thehoeng ha lefu la tsoekere le atherosclerosis.
Ka lebaka la ho fokotseha ha VLDL - mafura a bokellana sebeteng, hangata e hloekisoa e le karolo ea VLDL. Protein synthesis e hatelletsoe, e bakang ho fokotseha ha sebopeho sa antibody, ebe, bakuli ba sa lekaneng ba lefu la tsoekere ho mafu a tšoaetsanoang. Hoa tsebahala hore batho ba nang le metabolism e senyehileng ea protheine ba na le furunculosis.
Mathata a ka bang teng
Microangiopathy ke lefu la tsoekere la tsoekere. Ka lebaka la lefu la tsoekere le lefu la tsoekere, batho ba nang le lefu la tsoekere ba lahleheloa ke pono ea bona maemong a 70-90%. Haholo-holo, lefu la tsoekere le nts'etsopele ea likatse.
Ka lebaka la khaello ea HDL, k'holeseterole e feteletsang e hlaha liphoofolong tsa sele. Ka hona, lefu la pelo la coronary kapa endarteritis e nyarosang e ka hlaha. Hammoho le sena, ho etsoa microangiopathy e nang le nephritis.
Ho lefu la tsoekere, lefu la periodontal le thehoa ka lefu la gingivitis - periodontitis - lefu la periodontal. Ho diabetics, methapo ea meno e ea ferekana mme lisele tse tšehetsang lia ameha.
Lisosa tsa ts'ebetso ea li-microvessels maemong ana, ho ka etsahala, ke sebopeho sa khokahano e ke keng ea fetoloa ea glucose le liprotheine tsa lebota la methapo. Maemong ana, liplatelete li boloka ntho e ntlafatsang kholo ea likarolo tse boreleli tsa lesapo la mokokotlo.
Mathata a metabolism ea mafura a boetse a hlahisoa ka taba ea hore ho kenella ha mafura a mangata ho eketseha ka sebete, lipid resynthesis. Ka tloaelo, li hlahisoa ka sebopeho sa VLDL, e leng ho theoa ha eona ho latela bongata ba protheine. Bakeng sa sena, bafani ba sehlopha sa CHZ, ke hore, choline kapa methionine, baa hlokahala.
Choline synthesis e hlohlelletsa lipocaine, e hlahisoang ke epithelium ea pancreatic duct. Ho haelloa ke eona ho baka botenya ba sebete le ho thehoa ha mefuta eohle ea lefu la tsoekere.
Ho haella ha insulin ho lebisa ho hanyetsa ho tlase ha mafu a tšoaetsanoang. Ka hona, furunculosis e thehoa.
Video e sehloohong sena e tla bua ka litlamorao tsa insulin 'meleng.
