Hōʻikeʻike Insulin a me ka HOMA-IR Index

ka manaʻo (pili ka ʻōlelo hoʻopili i ka hoʻopaʻa ʻana i ka ʻaihue wikiwiki a me ka insulin.

ʻO ke ala maʻamau e nānā i ka pale ʻana i ka insulin e pili ana i ka hoʻoholo ʻana o ka pae basal (wikiwiki) ka glucose a me ka pae o ka insulin.

Hoʻopili ʻia ka hoʻopaʻa ʻana ma luna o ka ʻōpū ʻole, ma hope o ka manawa 8-12-hola o ka ʻahaʻaina pō. Kahi nā kōmona:

1. kekuhi
2. insulin
3. HOMA-IR heluʻia ke kaha kūloko o ka insulin.

Ua pāhono ʻia ka pale ʻana me ka nui o ka ulu ʻana o ka hoʻomake ʻana i ka maʻi diabetes a me nā maʻi cardiovascular a, ʻoiai, he māhele o nā mīkini pathophysiological i lalo o ka hui ʻana o ka momona a me kēia mau maʻi (me ka metabolic syndrome). ʻO ke ala maʻalahi e nānā ai i ka pale ʻana i ka insulin ʻo ia ka HOMA-IR Insulin Resistance Index, kahi hōʻailona i loaʻa mai i Matthews D.R. et al., 1985, pili i ka hoʻolālā ʻana o ka home home home pāʻai no ka loiloi ʻana i ka kūleʻa o ka insulin (HOMA-IR - Homeostasis Model Assessment of Insulin Resistance). E like me ka hōʻike ʻana, ka pae o ka basal (ka wikiwiki) i ka pae o ka insulin a me ka pae o ka glucose, e hōʻike ana i kā lākou pilina ma ke kūloko o ka pane, ka nui o ka hoʻokūkū me ka loiloi ʻana o ka kū ʻana o ka insulin i ka hana kūʻai maʻamau no ka loiloi ʻana i ka hopena o ka insulin i ka metabolism glucose - ʻo ke kumu hoʻopilepili e hoʻomālamalama e ka hyperinsulinemic euglycemic.

Kuhi ʻia ka helu HOMA-IR e ka ʻano: HOMA-IR = wikiwiki wikiwiki (mmol / L) x wikiwiki i ka insulin (μU / ml) / 22.5.

Me ka hoʻonui o ka glucose wikiwiki a i ʻole insulin, ʻo ka HOMA-IR index, ma kēlā me kēia, hoʻonui. No ka laʻana, inā ʻo ka ʻai wikiwiki ka 4,5 mmol / L a me ka insulin he 5.0 μU / ml, HOMA-IR = 1.0, inā ʻo ka wikiwiki o ka glucose ka 6.0 mmol / L a ʻo ka insulin he 15 μU / ml, HOMA- IR = 4.0.

Ua hoʻākāka ka ʻila o ka paepae ʻana o ka pale ʻana i ka insulin i ka HOMA-IR e like me ka 75th o ka helu o kāna huakaʻi kumulā. ʻO ka paepae HOMA-IR e hilinaʻi ana i ke ala no ka hoʻoholo ʻana i ka insulin; he mea paʻakikī ke hoʻohālikelike. ʻO ke koho o ka helu paepae, ʻo ia hoʻi, hiki ke hilinaʻi i nā pahuhopu o ke aʻo ʻana a me kahi pūʻulu māhele i koho ʻia.

ʻAʻole ia i ka kuhikuhi HOMA-IR i loko o nā kumu nui o ka diagnostic maʻamau o ka metabolic syndrome, akā hoʻohana ʻia ma ke ʻano he noiʻi noiʻina o kēia kiʻi kikoʻī. I ka loiloi ʻana i ka hopena o ka hoʻomohala ʻana i ka maʻi hānai ma kahi pūʻulu o nā kānaka me ka pae o ka glucose i lalo o 7 mmol / L, ʻoi aku ka ʻike o HOMA-IR ma mua o ka wikiwiki o ka glucose ʻaina a i ʻole insulin per se. ʻO ka hoʻohana ʻana ma ka hana ʻoi no ka hana diagnostic o nā kumu matematika no ka nānā ʻana i ka kūleʻa o ka insulin e pili ana i ka manaʻo o ka neʻe ʻana o ka ʻaina plasma a me nā glucose he nui o nā palena a ʻaʻole ʻae ʻia nō ia no ka hoʻoholo ʻana i ke koho i ka hoʻohaʻahaʻa i ka hau, a hiki ke hoʻohana ʻia no ka nānā ʻike. Hoʻokomo ʻia ka pale kūpaʻa insulin me ka hoʻonui pinepine ʻia i ka hepatitis C maʻi (genotype 1). Hoʻonui ka hoʻonui ʻana o ka HOMA-IR ma waena o kēia mau mea maʻi me ka pane ʻino loa ʻana i ka maʻi ma mua o nā mea maʻi me ka pale ʻana i ka insulin maʻamau, a no laila, ʻo ka hoʻoponopono ʻana i ka kūʻē ʻana o ka insulin ka mea i hōʻike ʻia kekahi o nā pahuhopu hou i ka mālama ʻana o ka maʻi hepatitis C. Ua hoʻonui ʻia ka piʻi ʻana o ka kūʻē o ka insulin (HOMA-IR) me ka steatosis non-alikaʻi. . ^ E Ha yM.

Palapala palapala

1. Matthews DR et al. ʻO ka loiloi kumu homeostasis: ka pale ʻana i ka insulin a me ka hana beta-cell mai ka papena plasma glucose a me ka hoʻoliʻi ʻana o ka insulin i ke kāne. Diabetologia, 1985, 28 (7), 412-419.

2. Dolgov VV et al. ʻO ka huli ʻana o ka lab Laboratory i nā maʻi metabolism. ʻ syndromelelo metabolika, maʻi maʻi maʻi. M. 2006.

3. Romero-Gomez M. et al. ʻO ka paleʻana i ka insulin e hoʻonā i ka hopena o ka pane i ka peginterferon a me ka ribavirin i nā maʻi maʻi hepatitis C. Gastroenterology, 2006, 128 (3), 636-641.

4. Mayorov Alexander Yuryevich ʻO ka moku'āina o ka pale kino ʻana i ka insulin i ka hoʻohou ʻana o ka maʻi maʻamau ʻo 2. Abstract. diss. e d. M.N., 2009

5. O.O. Hafisova, T.S. Polikarpova, N.V. Mazurchik, P.P. ʻŌpala ʻO ka hopena o ka metformin ma ke kūkulu ʻana i kahi pane virologic i ka wā o ka hoʻohui antiviral therapy o ka hepatitis maʻi me Peg-IFN-2b a me ka ribavirin i nā mea maʻi me ka hoʻoliʻi kū mua i ka insulin. Kūpono o ka RUDN University. Ser. Kauka 2011, No.2.

Hoike ʻike

Ke kūleʻa nei (hōʻemi i ka hoʻonaninani) nā ʻāpana a nā insulin e hilinaʻi ai i ka insulin i ka hopena o ka hopena o ka metabolic a me nā ʻano hana hemodynamic ʻē aʻe. ʻO ke kumu o ka hāʻuleʻole ka mea maʻamau ʻo ka genis predisposition a me kahi ʻano hoʻonaninani. I ka hopena, he nui ka piʻi ʻana o ka mea i ka hoʻomohala ʻana i ka maʻi mellitus maʻi diabetes, metabolic syndrome, na alaʻi cardiovascular, a me ka holo ʻana o nā aʻolo o ke kino (atea, nā pēpē).

ʻO ke aʻo ʻana i ka pale ʻana i ka insulin he analike ʻana i kēia mau kuhikuhi:

Hoʻokomo ʻia ka Insulin e nā ʻāpana pancreatic (nā kekena beta o nā mokupuni o Langerhans). Lawe ʻo ia i nā hana nui ma ke kino. Akā ʻo nā hana nui a ka insulin:

• huka glucose i nā cell cell,
• hoʻoponopono o nā lipid me ka metabolism,
• ka hoʻōho maʻamau o nā pae koko koko, etc.

Ma lalo o ka mana o kekahi mau kumu, kūkulu ke kanaka i ka kūʻē i ka insulin a i kāna hana kūikawā paha. Me ka hoʻomohala o ka pale ʻana o nā pūnao a me nā ʻolua e kū i ka insulin, ke piʻi nei ke koʻokoʻo o ke koko, e alakaʻi ana i ka piʻi o ka glucose. Ma muli o kēia, hiki i ka hoʻomohala ʻana o ke ʻano type type 2, metabolic syndrome, a me ka momona. Ma muli o ke ʻano o ka hopena o ka metabolic ke alakaʻi i ka hōʻeha ʻana a me ka puʻe. Eia naʻe, aia ka manaʻo o ka "kūlohelohe o ka pale kino physiological", hiki iā ia ke ulu me ka nui o ka pono o ka ikaika ma ke kino (i ka wā hāpai ʻana, ka hoʻoikaika kino kino).

Kākau: i ka manawa pinepine, ua ʻike ʻia ka pale ʻana o ka insulin i ka poʻe momona. Inā piʻi ke koʻikoʻi o ke kino ma mua o 35%, a laila ua hoʻemi ʻia ka naʻau o insulin e 40%.

Hōʻike ka HOMA-IR i kahi kuhikuhi no ka ʻike i ka hopena i ka pale ʻana i ka insulin.

Hoʻomaopopo ka noiʻi ʻana i ka ratio o ka basal (wikiwiki) ka glucose a me ka pae o ka insulin. ʻO ka hoʻonui nui aʻe o ka kuhikuhi HOMA-IR kuhikuhi i ka hoʻonui nui o ka glucose wikiwiki a i ʻole insulin. He mākaʻi maʻalahi kēia o ka maʻi maʻi.

Eia kekahi, hiki ke hoʻohana ʻia kēia ʻatikala i nā hihia i hiki ke hoʻomohala i ka hōʻemi ʻana i ka wahine i ka wahine me ka polycystic ovary syndrome, gestational diabetes mellitus, kidney renal failed, maʻi hepatitis B a me C, a me ka steatosis ate.

Nā hōʻailona no ka hoʻoili

• Ka ʻike ʻana i ka kūleʻa o ka insulin, kāna loiloi ma dinamics,
• ʻO ka wānana o ka hopena o ka hoʻomohala ʻana i ka maʻi mellitus a me ka hōʻoia o ka maʻi i ke kaʻe ʻana o kona mau hōʻike maʻi,
• ʻĀpae maʻi hoʻomanawanui iki
• ʻO ka nānā ʻana i nā pilikia o ka puʻuwai cardiovascular - ka maʻi puʻuwai coronary, atherosclerosis, hōʻemi puʻuwai, a,.
• Ke nānā nei i ke kūlana o nā mea maʻi me ka momona nui,
• ʻO nā hōʻike paʻakikī no nā maʻi o ka ʻōnaehana endocrine, nā maʻi metabolic,
• ʻO ka hoʻonaninani o ka polycystic ovary syndrome (ovarian dysfunction ma ke kua o ka endocrine pathologies),
• ʻO ka nānā a me ka mālama ʻana i nā maʻi me ka hepatitis B a i ʻole C i ke ʻano maʻi,
• ʻO ka hana ʻana o ke kīkī o ka puhaka o ka palaka ʻole, ke aloha ʻole (a me ke ʻano kaulike)
• ʻO ka koho ʻana i ka hopena o ka ulu ʻana o ka hypertension a me nā ʻano ʻē aʻe e pili ana me ke koko kiʻekiʻe,
• ʻO ka maʻi maʻi o ka maʻi gestational i nā wahine hāpai,
• ʻO ka hopohopo ākea o nā maʻi maʻi maʻi, ka koho ʻoi ʻana i ka maʻi conservative.

Ke hoʻokaʻawale i nā hopena o ka loiloi no ka pale ʻana i ka insulin e hiki i nā mea lapaʻau: lapaʻau, pediatrician, lapaʻau, diagnostician function, endocrinologist, cardiologist, gynecologist, kanaka lapaʻau.

Nā ʻikepili waiwai

• Ua wehewehe ʻia nā palena ʻāpana no ka glucose:
  • 3.9 - 5.5 mmol / L (70-99 mg / dl) - maʻamau,
  • 5.6 - 6.9 mmol / L (100-125 mg / dl) - prediabetes,
  • oi aku ma mua o 7 mmol / l (maemae mellitus).
• ʻO ka pae o 2.6 - 24.9 mcED no 1 ml ka mea i manaʻo i ke ʻano o ka insulin.
• ʻO NOMA-IR insulin pale kū'ē (coefficient) no nā pākeke (20 a 60 makahiki paha) me ka ʻole o ka maʻi maʻi: 0 - 2.7.

Ma ke ʻano o ka hōʻike ʻana, ʻike ʻia nā hōʻailona: ʻo ke kaona o ka glucose a me ka insulin i loko o ke koko, a me ka hoʻoliʻi kūlohelohe o insulin. Hoʻopili ʻia kēia hope e ka ʻano hoʻohālike:

NOMA-IR = "glucose i kūʻai i ka glucose (mmol no kēlā" 1 l) * ka nui o ka insulin (μED i ka 1 ml) / 22.5

Kahi ʻia kēia ʻōlapa e noi kūʻokoʻa loa i ka hihia o ke koko wikiwiki.

Nā mea hōʻike i ka hopena

• ʻO ka manawa hoʻohuihui koko ʻole ʻole no ka hōʻike,
• Haki i nā rula o ka hoʻomākaukau no ka aʻo,
• Ke lawe nei i kekahi mau lāʻau lapaʻau
• Kahawai
• Hemolysis (i ka hana o ka luku maoli ʻana i nā ʻāpana koko ʻulaʻula, e hoʻokuʻu ʻia nā huila e hoʻopau iā insulin).
• ʻO ka mālama Biotin (hōʻike no ka pale ʻana i ka insulin e lawe ʻia ma mua o 8 mau hola ma hope o ka hoʻolauna ʻana i kahi lāʻau kiʻekiʻe o ka lāʻau lapaʻau),
• Inine hoʻōla.

Hoʻonui nā kumukūʻai

• Ke hoʻomau nei o ka pale kū'ē (kū'ē, kūhiʻi) i ka insulin,
• ʻO ka hoʻonui pinepine ʻia o ka maʻi maʻi
• ʻO ka maʻi maʻi gestational
• ʻO ka maʻi Cardiovascular
• Ka hana ʻo ka metabolic (kūleʻa o ke kalapona, ka momona a me ka hoʻoliemina o ka keʻokeʻo),
• Hōʻailona o ka polycystic ovary
• Loaʻa o nā ʻano ʻano like ʻole,
• ʻO nā maʻi o ka ʻōpū (pono, viral hepatitis, steatosis, cirrhosis and others),
• Hoʻopau ʻole nā ​​hopena hanaliki
• ʻO ka hōʻeha ʻana o nā ena o ka ʻoihana endocrine (gland glandal, pituitary, thyroid a pancreas, etc.),
• Nā ʻōhua kino
• ʻO nā kaʻina loina Oncological, etc.

Hōʻike ka hōʻike HOMA-IR haʻahaʻa i ka hemahema o ka pale ʻana i ka insulin a ua manaʻo ʻia he mea maʻamau.

Hoʻomākaukau ʻai

Kaomi noiʻi biomaterial: koko venous.

Ke ʻano laikini lāʻau biomaterial: venipuncture o ka ulnar uaua.

Ke koi ʻia ʻana o ka pā: paʻa ma kahi ʻōpū ʻole!

• ʻAʻole pono nā keiki ma lalo o ka makahiki 1 i ka minuke 30-40 mau minuke ma mua o ka hoʻopaʻa ʻana.
• ʻAʻole ʻai nā keiki nona 1 a hiki i 5 mau makahiki no 2-3 mau hola ma mua o ke aʻo ʻana.

Nā koi haʻawina hou

• I ka lā o ke kaʻina (ma mua o ka hoʻopunipuni ʻana) hiki ʻoe ke inu i ka wai maʻamau me ka ʻole o ka hau a me ka paʻakai.
• Ma ka pō o ke ho'āʻo, pono i nā momona, ka ʻalī, nā palaoa a me nā pōpono, nā mea ʻala, a me nā meaʻai i poki ʻia i ka meaʻai. Ua pāpā ʻia i ka inu ʻana i ka ikehu, inu i ka ʻona, inu i ka wai ʻona.
• I ka lā, e kaawale i kekahi ukana (kino a me / a psycho-naʻau) paha. 30 mau minuke ma mua o ka hāʻawi ʻana i ke koko, kekahi haunaele, jog, hoʻokiʻekiʻe ʻana, a me nā mea hou aku.
• ʻO kahi hola ma mua o ka hoʻokolokolo kū ʻana o ka insulin, pono ʻoe e pale i ka ulaula (me ka uahi o ka uila).
• Pono nā papa āpau o nā lāʻau lapaʻau a i ʻole ka hoʻohui ʻana, pono e hōʻike ʻia nā huaora i ke kauka i mua.

Ua kuhikuhi paha ʻoe iā ʻoe: