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memory for pool. in /usr/local/www/apache22/data/sapphire/dev/Log.php on line 2 Warning: include_once(): Unable to allocate memory for pool. in /usr/local/www/apache22/data/sapphire/core/Core.php on line 70 Warning: require_once(): Unable to allocate memory for pool. in /usr/local/www/apache22/data/sapphire/thirdparty/Zend/Log.php on line 124 Warning: require_once(): Unable to allocate memory for pool. in /usr/local/www/apache22/data/sapphire/thirdparty/Zend/Log/Exception.php on line 23 İnsülin Direnci

İnsülin Direnci

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Diğer Adları: HOMA-IR

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İnsülin pankreasta beta hücreleri tarafından üretilen bir hormondur. Glukozu enerji üretimi için gerekli olduğu vücut hücreleri içine taşımaya yardımcı olmak için her öğünden sonra normal olarak küçük miktarlarda salınmaktadır.  İnsüline direnç özellikle kas ve yağ (adipoz) dokularının insülinin etkilerine karşı yanıt verme kabiliyetindeki azalmayı ifade etmektedir. Hücrelerin yaşamak için glukoza ihtiyacı olduğundan vücut ilave miktarlarda hormon üreterek insüline karşı oluşan direnci telafi etmeye çalışır. Bu durum kanda aşırı insülin birikimine (hiperinsülinemi) ve insüline duyarlı bazı dokuların aşırı derecede uyarılmasına yol açar. Zamanla bu süreç  kan şekeriyle insülin arasındaki ilişkide dengesizliğe ve vücutta sağlıksız bir dalgalanma etkisine neden olabilir.

Hiperinsülinemi ve insüline direnç, trigliseritlerin  ve sdLDL‘lerin ( küçük yoğun lipoproteinler) düzeylerini artırıp  HDL (yüksek yoğunluklu lipoprotein, “iyi” kolesterol) düzeylerini azaltarak kandaki  vücut lipitlerinin oranını olumsuz etkileyebilmektedir. Hastanın kan pıhtısı geliştirme riskini de artırabilmekte, iltihabi değişikliklere ve kan basıncının yükselmesine yol açabilen daha fazla sodyum tutulumuna neden olabilmektedir.

İnsüline direnç bir hastalık veya spesifik bir tanı olmamakla birlikte kalp-damar hastalığı (KDH)hipertansiyon, polikistik over sendromu (PKOS), tip 2 diyabet, obezite ve alkole bağlı olmayan yağlı karaciğer hastalığı gibi klinik durumlarla ilişkilendirilmiştir. Bazı araştırmacılar insüline direnç ile bazı kanser türleri arasında bir bağıntı olabildiğine de inanmaktadır. Ancak bu bağıntıların mekanizmaları iyice anlaşılmamıştır. Bu rahatsızlıkları olan birçok kişide insüline direncin mevcut olmadığı ve benzer şekilde insüline direnci olan birçok kişinin de hiçbir  zaman bu hastalıklara yakalanmayacağı önemli bir husustur. Bunlar yalnızca ortaya çıkmış olan bağlantı kalıplarıdır. Sıklıkla birlikte görülmekte ve insüline direncin gelişmelerine katkıda bulunabildiği ve var olduğunda o hastalıkları ağırlaştırabildiği düşünülür.

Metabolik sendrom ve insüline direnç sıklıkla birbirlerinin yerine kullanılan iki terim olup artmış insülin direnci ve artmış insülin üretimi ile ilişkili anormallikleri tanımlamak için kullanılır. Bu değişikliklerin ilerde oluşacak hastalığın risk faktörleri olduğu kabul edilir.  Metabolik sendrom esasen insüline direncin bir altgrubu olup lipit düzeylerinde değişiklikler ve kan şekeri metabolizmaları bozulmaya başlayan obez ve hareketsiz yaşam tarzı süren kişileri tanımlamaya odaklanır.  Bu tanımlamanın amacı bu kişilerle birlikte çalışarak sağlıklarına karşı oluşan riskleri yaşam tarzı değişiklikleri ile azaltmaktır.

İnsüline direncin nedeni tam olarak anlaşılmamıştır. Kısmen etnik köken gibi genetik faktörlere kısmen yaşam tarzına bağlı olduğu düşünülür. İnsüline direnç gösteren hastaların çoğunda herhangi bir hastalık belirtisi yoktur. Bu sürecin vücutlarında oluştuğunun farkında değillerdir. Olguların çoğunda vücut birçok yıl fazladan insülin üretimi gereksinmesiyle başa çıkabilir. Vücudun insülin üretimi gereksinmeye yetişemezse veya yetişemediğinde hiperglisemi oluşacaktır. Kan şekeri düzeyleri yeterince yüksek düzeylere ulaştığında diyabet mevcut demektir. Yüksek kan şekeri düzeyleri böbrekler dahil birçok organda kan damarlarına zarar verebilmektedir. Bu yüksek kan şekeri düzeyleriyle ilişkili insüline direnç, tip 2 diyabet geliştirme için bir risk faktörüdür. Lipitlerdeki değişiklikler atardamarların içinde yağlı plak birikimlerine neden olabilmekte, kalp-damar hastalığı ve inmelere yol açabilmektedir.

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