Nlekọta insulin na HOMA-IR Index

atụmatụ (profaịlụ gụnyere ọmụmụ nke glucose ọnụ na insulin na-ebu ọnụ).

Mostzọ a na-ahụkarị maka ịtụle nguzogide insulin jikọtara ya na mkpebi siri ike nke basal (ibu ọnụ) nke glucose na ọkwa insulin.

Emere ọmụmụ a kpam kpam na afọ na-enweghị isi, mgbe oge awa 8-12 ga-ebu ọnụ n'abalị. Profaịlụ gụnyere ihe ngosi:

1. glucose
2. insulin
3. HOMA-IR gbakọtara usoro nyocha insulin na-emegide.

Ntinye insulin na-ejikọta ya na ohere dịwanye ukwuu nke ịmalite ọrịa shuga na ọrịa obi na, o doro anya na ọ bụ akụrụngwa nke usoro pathophysiological na-akpata njikọ nke oke ibu na ụdị ọrịa ndị a (gụnyere ọrịa metabolic). Simplezọ kachasị mfe maka ịtụle nguzogide insulin bụ HOMA-IR insulin Resistance Index, ihe ngosi sitere na Matthews D.R. et al., 1985, metụtara mmepe nke usoro ihe omimi homeostatic maka ịtụle insulin iguzogide (HOMA-IR - Ntụle Model nke Resulin Resistance). Dị ka egosiri, ogo nke insulin na ọkwa glucose, na-egosipụta njikọta ha na akaghị nzaghachi, n'ụzọ kwekọrọ na ntule nke nguzogide insulin na usoro usoro kpokọtara mmetụta nke insulin na metabolism metabolism - usoro hyperinsulinemic euglycemic clamp system.

A na-agbakọta ntụpọ HOMA-IR site n'ụkpụrụ: HOMA-IR = glucose na-ebu ọnụ (mmol / L) x insulin na-ebu ọnụ (μU / ml) / 22.5.

Site na mmụba nke glucose na-ebu ọnụ ma ọ bụ insulin, ntụpọ HOMA-IR, n'otu aka ahụ, na-abawanye. Dịka ọmụmaatụ, ọ bụrụ glucose na-ebu ọnụ bụ 4.5 mmol / L ma insulin bụ 5.0 μU / ml, HOMA-IR = 1.0, ọ bụrụ glucose na-ebu ọnụ bụ 6.0 mmol / L na insulin bụ 15 μU / ml, HOMA- IR = 4.0.

A na-akọwapụtakarị uru mbata insulin na HOMA-IR dị ka pasent 75 nke ngụkọta ọnụ ọgụgụ ndị na-ekesa. OMzọ HOMA-IR dabere na usoro iji chọpụta insulin; ọ siri ike ịhazi. Nhọrọ nke ọnụ ụzọ, gbakwunyere, enwere ike ịdabere na ebumnuche nke ọmụmụ a na otu akwụkwọ ntụaka ahọrọ.

Ejikọtaghị usoro HOMA-IR na usoro nchọpụta bụ isi nke ọrịa metabolic, mana ejiri ya dịka ọmụmụ ụlọ nyocha ndị ọzọ na profaịlụ a. N'ịchọpụta ihe egwu dị n’ibute ọrịa shuga n’etiti ndị mmadụ nwere ọ̀tụ̀tụ̀ glucose dị ala karịa 7 mmol / L, HOMA-IR bụ ihe ọmụma karịa glucose na-ebu ọnụ ma ọ bụ insulin kwa se. Ojiji nke usoro ọgwụgwọ maka ebumnuche nchọpụta nke usoro mgbakọ na mwepụ maka inyocha insulin iguzogide na mkpebi nke insulin plasma na-ebu ibu na glucose nwere ọtụtụ ihe n ’oke anabataghịkwa ya oge niile maka ikpebi nhọpụta nke usoro glucose dị ala, mana enwere ike iji ya mee ihe maka ịdị omimi. A na-ahụta nguzogide insulin na -akpata na ọnụego ugboro ugboro na ịba ọcha n'anya C (genotype 1). Mmụba na HOMA-IR n'etiti ndị ọrịa a jikọtara ya na nzaghachi na-adịghị mma maka ọgwụgwọ karịa na ndị ọrịa nwere ọgwụ insulin na-eguzogide nkịtị, ya mere, a na-ewere mgbazi nke insulin na-eguzogide dị ka otu n'ime ihe mgbaru ọsọ ọhụrụ na ọgwụgwọ ọgwụgwọ ịba ọcha n'anya C. A na-ahụ mmụba nke insulin na-eguzogide ọgwụ (HOMA-IR) na steatosis na-adịghị a alcoụ mmanya. .

Akwukwo

1. Matthews DR et al. Nlele nlele Homeostasis: nnwale insulin na arụ ọrụ beta-cell site na ibu ọnụ glucose plasma na insulin ịta mmadụ. Diabetologia, 1985, 28 (7), 412-419.

2. Dolgov VV et al. Nchọpụta ụlọ nyocha nke ọrịa metabolism metabolism. Ọrịa metabolism, ọrịa shuga mellitus. M. 2006.

3. Romero-Gomez M. et al. Ndị na - egbochi insulin na - egbochi mmeghachi nke peginterferon gbakwunyere ribavirin na ndị ọrịa ịba ọcha n'anya C. Gastroenterology, 2006, 128 (3), 636-641.

4. Mayorov Alexander Yuryevich Ọnọdụ insulin na-eguzogide na mgbanwe nke ụdị ọrịa shuga 2. Ibelata. diss. d. M.N., 2009

5. O.O. Hafisova, T.S. Polikarpova, N.V. Mazurchik, P.P. Kukumba Mmetụta nke metformin na usoro nke nzaghachi virologic kwụsiri ike n'oge ọgwụgwọ antiviral na-arịa ịba ọcha n'anya na Peg-IFN-2b na ribavirin na ndị ọrịa nwere nnwale insulin mbụ. Bulletin nke Mahadum RUDN. Ser. Ọgwụ 2011, No.2.

Ozi izugbe

Nguzogide (mbelata na uche) nke mkpụrụ ndụ na - egbochi insulin na - etopụta n'ihi nsogbu metabolic na usoro ndị ọzọ dị na ya. Ihe na-ebute ọdịda bụ ihe na - abụkarị usoro ịmụpụta mkpụrụ ndụ ma ọ bụ usoro mkpali. N’ihi nke a, mmadụ nwere ohere dị ukwuu nke ibute ọrịa shuga mellitus, metabolic syndrome, ọrịa obi, na nsị nke akwara dị n’ime (imeju, akụrụ).

Ihe omumu banyere nguzogide insulin bu nyocha nke ihe ndi a.

A na - emepụta insulin site na mkpụrụ ndụ pancreatic (mkpụrụ ndụ beta nke agwaetiti Langerhans). Ọ na-ekere òkè n'ọtụtụ usoro ọmụmụ nke anụ ahụ. Ma isi ọrụ insulin bụ:

• Nweta glucose na sel anụ ahụ,
• iwu nke lipid na carbohydrate metabolism,
• normalisation nke ọbara shuga ọkwa, wdg.

N'okpuru mmetụta nke ụfọdụ ihe, mmadụ na-enwe nguzogide insulin ma ọ bụ ọrụ ya kpọmkwem. Site na mmepe nke nguzogide sel na anụ ahụ na insulin, itinye uche ya na ọbara na-abawanye, nke na-eduga n'ịbawanye ụba nke glucose. N'ihi nke a, mmepe nke ọrịa shuga 2, metabolic syndrome, na oke ibu ga-ekwe omume. Ọrịa metabolic nwere ike imecha bute nkụchi obi na ọrịa strok. Agbanyeghị, enwere echiche “nnwale insulin nke anụ ahụ”, ọ nwere ike ime mgbe ebuliri ike ike (n'oge afọ ime, ezigbo mgbatị anụ ahụ).

Mara: Ọtụtụ mgbe, a na-ahụkarị ọgwụ insulin na ndị buru ibu. Ọ bụrụ na ịdị arọ nke anụ ahụ na-eto ihe kariri 35%, mgbe ahụ, a na-ebelata ikike insulin na-ebelata 40%.

A na-atụle ntụpọ HOMA-IR dị ka ihe na-enye nkọwa na nchoputa nke nguzogide insulin.

Ọmụmụ nyocha a na-atụle oke nke basal (ibu ọnụ) glucose na ọkwa insulin. Mmụba na nchịkọta HOMA-IR na-egosi mmụba nke glucose na-ebu ọnụ ma ọ bụ insulin. Nke a bụ ihe ọ harụ doro anya banyere ọrịa shuga.

Ọzọkwa, enwere ike iji ihe ngosi a mee ihe n'ọnọdụ nke a na-enyo enyo na ọpụpụ insulin na ụmụ nwanyị nwere ọrịa polycystic ovary syndrome, ọrịa gestational diabetes mellitus, ọdịda akụrụ na-adịghị ala ala, ọrịa ịba ọcha n'anya B na C, na steatosis imeju.

Ihe ngosi maka nyocha

• Amata insulin na-eguzogide, nyocha ya na mgbanwe mgbanwe omimi
• Amụma ihe ọghọm nke ibute ọrịa shuga na nkwenye nke nchoputa ya n'ihu ngosipụta ya nke ogwu,
• A na-enyo enyo nnwere onwe glucose,
• Ọmụmụ ihe gbasara ọmụmụ gbasara ọrịa obi - ọrịa obi, atherosclerosis, nkụda obi, wdg,
• Nyochaa ọnọdụ ndị ọrịa nwere oke ibu,
• Nnwale siri ike maka ọrịa nke usoro endocrine, nsogbu nke metabolic,
• Diagnosis nke polycystic ovary syndrome (ọnụọgụ akwara na ndabere nke endocrine pathologies),
• Nnyocha na ọgwụgwọ nke ndị ọrịa nwere ịba ọcha n'anya B ma ọ bụ C n'ụdị na-adịghị ala ala,
• Nchọpụta nke steatosis na-abụghị mmanya na-egbu egbu, ọdịda akụrụngwa (nnukwu ọrịa na-adịghị ala ala),
• Na-achọpụta ihe ọghọm nke ibute ọbara mgbali elu na ọnọdụ ndị ọzọ metụtara ọbara mgbali elu.
• Nchoputa nke oria afọ n’eriri ndi nwanyi di ime,
• Nyocha zuru oke nke ọrịa na-efe efe, nhọpụta nke ọgwụgwọ mgbanwe.

Kọwaa nsonaazụ nyocha ahụ maka nguzogide insulin nwere ike ndị ọkachamara: dibịa, pediatrician, dọkịta na-awa ahụ, dibịa na-arụ ọrụ, endocrinologist, cardiologist, gynecologist, doctor general.

Refere ụkpụrụ

• A kọwara ókèala ndị a maka glucose:
  • 3.9 - 5.5 mmol / L (70-99 mg / dl) - nkịtị,
  • 5.6 - 6.9 mmol / L (100-125 mg / dl) - ọrịa shuga,
  • ihe karịrị 7 mmol / l (ọrịa shuga mellitus).
• Oke 2.6 - 24.9 mcED kwa 1 ml ka a na-ewere dị ka usoro insulin dị.
• NOMA-IR insulin resistance index (ọnụọgụ) maka ndị okenye (afọ 20 ruo 60) na-enweghị ọrịa shuga: 0 - 2.7.

N'ime usoro ọmụmụ a, a na-atụle ihe ndị na-egosi: nchịkọta nke glucose na insulin n'ime ọbara, yana ntinye insulin resistance. A na-agbakọ nke ikpeazụ site n'ụkpụrụ:

NOMA-IR = "ịta glucose (mmol per" 1 l) * ọkwa insulin (μED kwa 1 ml) / 22.5

Usoro a dị mma ka etinye ya n'ọrụ naanị n'ọnọdụ ọbara oburu ọnụ.

Ihe ndị metụtara nsonaazụ ahụ

• Oge nlele ọbara na-enweghị ọkọlọtọ maka nnwale ahụ,
• Imebi iwu nke nkwadebe maka ihe omumu a.
• Certainnweta ọgwụ ụfọdụ
• Ime
• Hemolysis (n'ime usoro mbibi nke ọbara ọbara ọbara, ana - ahapụ enzymes nke na - ebibi insulin).
• Ọgwụ biotin (a na-enyocha insulin iguzogide insulin tupu awa 8 mgbe iwere ọgwụ dị elu).
• Usoro ọgwụgwọ insulin.

Asebawanye ueskpụrụ

• Mmepe nke nguzogide (iguzogide, mgbochi) ka insulin,
• Nsogbu oria shuga na-abawanye
• Afọ ụkwara ume ọkụ
• Ọrịa obi
• Ọrịa metabolism (mmebi nke carbohydrate, abụba na purine metabolism),
• Polycystic ovary syndrome
• Ibu oke ibu di iche-iche,
• Ọrịa imeju (ezughi oke, ịba ọcha n'anya, steatosis, nje na ndị ọzọ),
• Ọkụ akwara afọ n’ala
• Ndakpọ nke akụkụ nke usoro endocrine (adrenal gland, pituitary, thyroid na pancreas, wdg),
• Ọrịa na-efe efe
• Oncological Filiks, wdg.

Ndekọ HOMA-IR dị ala na-egosi enweghị insulin na-eguzogide ma na-ewere ya dị ka ihe dị mma.

Nkwadebe nyocha

Ihe omumu banyere ndu: ọbara venous.

Samzọ nnwale biomaterial: venipuncture nke akwara ọnya.

Ọnọdụ a chọrọ ka a rụọ ya n ’mgbidi ahụ: na-enweghị nsogbu na afọ!

• Undermụaka na-erubeghị afọ 1 ekwesịghị iri nri maka nkeji 30-40 tupu ọmụmụ ihe ahụ.
• Agedmụaka dị n’agbata afọ 1 ruo afọ ise anaghị eri nri awa 2-3 tupu ọmụmụ ihe ahụ.

Ọzụzụ ọzụzụ ọzọ

• N'ụbọchị usoro ahụ (ozugbo tupu mgbatị ahụ) ị nwere ike ị drinkụ naanị mmiri nkịtị na-enweghị gas na nnu.
• N’ụbọchị ikpe ahụ, a ga-ewepụ nri mara abụba, nke e ghere eghe na oseose, mmanụ na nri ndị na-aokedụ sịga n’ihe oriri. A machibidoro ị drinkụ ike, ihe ọ toụ toụ tonic, mmanya.
• N’ụbọchị, wezuga ibu ọ bụla (anụ ahụ na / ma ọ bụ nke mmụọ). N'ime nkeji iri atọ tupu inye onyinye ọbara, ọgba aghara ọ bụla, ọgụ ọ ,ụ, ibuli ihe dị elu, wdg.
• Otu elekere tupu ule insulin na-eguzogide ọgwụ, ị kwesịrị ịhapụ ị smokingụ sịga (gụnyere sịga na kọmputa).
• Usoro mmụta ọgwụ niile dị ugbu a ma ọ bụ na-a supụ ọgwụ nri, a ga-akọrịrị dọkịta tupu oge eruo.

E nwekwara ike kenye gị ọrụ: