By Cocer Peptides 
kwanaki 13 da suka gabata
DUKKANIN LABARI DA BAYANIN KYAUTATAWA DA AKE BAYAR A WANNAN SHAFIN KAWAI DOMIN WATSA BAYANI NE DA MANUFOFIN ILIMI.
Samfuran da aka bayar akan wannan gidan yanar gizon an yi niyya ne kawai don bincike na in vitro. Binciken in vitro (Latin: *a cikin gilashi*, ma'ana a cikin gilashin gilashi) ana gudanar da shi a wajen jikin mutum. Waɗannan samfuran ba magunguna ba ne, Hukumar Abinci da Magunguna ta Amurka (FDA) ba ta amince da su ba, kuma dole ne a yi amfani da su don hanawa, magani, ko warkar da duk wani yanayi na likita, cuta, ko cuta. Doka ta haramta shigar da waɗannan samfuran cikin jikin mutum ko dabba ta kowace hanya.
Bayanan Bayani na GLP-1
GLP-1 labari ne mai glucagon-kamar peptide-1 agonist mai karɓa (GLP-1 RA). Glucagon-kamar peptide-1 (GLP-1) wani hormone ne da jikin ɗan adam ke ɓoye ta halitta wanda ke taka muhimmiyar rawa wajen daidaita glucose na jini. Lokacin da matakan glucose na jini ya tashi, GLP-1 yana ɓoye kuma yana daidaita matakan glucose na jini ta hanyoyi daban-daban. Koyaya, a cikin marasa lafiya na masu ciwon sukari, yawan ɓoyewar GLP-1 baya isa ko tasirin sa bai isa ba. GLP-1 yana ɗaure ga masu karɓar GLP-1, yana kwaikwayon tasirin ilimin lissafin jiki na GLP-1, don haka yana yin tasirin warkewa don metabolism da sarrafa nauyi.
Hoto 1 Jiyya don kiba da tasirin su akan asarar nauyi
Matsayin GLP-1 a cikin Maganin Ciwon sukari
Inganta Sigar Insulin
A ƙarƙashin yanayin ilimin lissafi, lokacin da matakan glucose na jini ya tashi, ƙwayoyin enteroendocrine a cikin hanji suna ɓoye GLP-1. GLP-1 yana ɗaure ga masu karɓar GLP-1 akan saman sel beta na pancreatic, yana kunna jerin hanyoyin sigina don haɓaka haɓakar insulin. GLP-1 kuma yana iya ɗaure musamman ga masu karɓar GLP-1 akan saman sel beta na pancreatic, yana motsa ƙwayar insulin ta hanyar dogaro da glucose. Wannan yana nufin cewa lokacin da matakan glucose na jini ya tashi, GLP-1 yana haɓaka sakin insulin yadda ya kamata don rage matakan glucose na jini; Lokacin da matakan glucose na jini ya kasance cikin kewayon al'ada, tasirin sa akan haɓaka haɓakar insulin yana da rauni, don haka yana rage haɗarin hypoglycemia. Nazarin ya nuna cewa bayan jiyya tare da GLP-1, matakan samar da insulin na marasa lafiya sun inganta sosai, kuma ana iya sarrafa matakan glucose na jini yadda ya kamata.
Hoto na 2: Hanya ta sama mai nauyi-tsakiya tare da ƙarin ƙasa, glucose-centric, da hanyoyin cardiometabolic. Magunguna na tushen Incretin sun riga sun fara aiki a mafi girman mataki.
Ba kamar asirin insulin na al'ada ba, kamar sulfonylureas, waɗanda ke ci gaba da haɓaka haɓakar insulin ba tare da la'akari da matakan glucose na jini ba kuma yana iya haɓaka haɗarin hypoglycemia, GLP-1's glucose-concentration-dependent insulin secretion Properties yana ba shi damar rage matakan glucose na jini yadda ya kamata yayin da yake rage haɗarin hypoglycemia, yana ba da mafi aminci kuma mafi inganci zaɓi na sarrafa glucose na jini don marasa lafiya.
Hana fitar da glucagon
Glucagon hormone ne da ke ɓoye ta ƙwayoyin α pancreatic wanda ke haɓaka matakan glucose na jini, yana aiki sabanin insulin. A cikin masu ciwon sukari, ƙwayar glucagon sau da yawa yakan kasance ba tare da hanawa ba ko da lokacin hawan glucose na jini. GLP-1 yana aiki akan masu karɓar GLP-1 akan ƙwayoyin α pancreatic don hana ɓarna glucagon. Lokacin da ƙwayar glucagon ta ragu, ana hana glycogenolysis na hanta da matakan gluconeogenesis, yana rage samar da glucose na endogenous kuma yana ƙara rage matakan glucose na jini. Masana kimiyya sun tabbatar da cewa a cikin nau'in 2 na marasa lafiya da aka bi da su tare da GLP-1, matakan glucagon na plasma suna raguwa sosai, yadda ya kamata rage yawan glucose na hanta da kuma taka muhimmiyar rawa wajen daidaita matakan glucose na jini.
Jinkirta zubar ciki
GLP-1 yana aiki akan masu karɓar GLP-1 a cikin sashin gastrointestinal don rage yawan zubar ciki. Zubar da ciki da sauri yana sa abinci ya shiga cikin ƙananan hanji cikin sauri, yana haifar da haɓakar matakan glucose na jini cikin sauri. Ta hanyar jinkirta zubar da ciki, abinci ya daɗe a cikin ciki kuma yana shiga cikin ƙananan hanji da sannu a hankali, yana haifar da ƙara yawan shan glucose a hankali da kuma hana haɓakar hauhawar matakan glucose na jini. Wannan tasirin yana taimakawa wajen kiyaye matakan glucose na jini da kwanciyar hankali da kuma rage jujjuyawar glucose na jini. A wasu gwaje-gwajen asibiti, marasa lafiya da aka yi musu magani tare da GLP-1 sun sami raguwa mai yawa a cikin kololuwar glucose na jini na postprandial da ƙananan juzu'i na glucose na jini, haɓaka ingancin sarrafa glucose na jini gaba ɗaya. Bugu da ƙari, jinkirin zubar da ciki na iya haifar da jin daɗin cikawa, yana taimakawa wajen rage cin abinci kuma ta haka yana taimakawa wajen sarrafa glucose na jini da sarrafa nauyi daga wani kusurwa.
Hoto 3: Tsarin GLP-1 don Gudanar da Kiba
Inganta aikin β-Cell
Hyperglycemia na yau da kullun na iya lalata ƙwayoyin β na pancreatic, yana haifar da raguwar aiki a hankali. GLP-1 ba wai kawai rage sukarin jini bane ta hanyar haɓaka siginin insulin amma yana ba da kariya da gyara ƙwayoyin β na pancreatic, ta haka yana haɓaka aikin sel β. Nazarin kimiyya ya nuna cewa GLP-1 na iya kunna wasu hanyoyin siginar siginar ciki don inganta haɓakar β-cell, hana β-cell apoptosis, don haka ƙara lamba da aikin β-cell. A cikin gwaje-gwajen dabbobi da wasu nazarin asibiti, an lura cewa bayan amfani da GLP-1, an haɓaka ƙarfin ɓoye insulin na ƙwayoyin β, kuma an inganta juriya na insulin. Wannan yana da matukar mahimmanci ga dogon lokaci na magani na nau'in metabolism na nau'in 2, saboda yana taimakawa rage ci gaban cutar da rage haɗarin rikice-rikice na ciwon sukari.
Aikace-aikace na GLP-1 a cikin Jiyya na Ciwon sukari
GLP-1 yana da hanyoyin aikace-aikace daban-daban a cikin jiyya na metabolism. Ga sabon kamuwa da cuta na nau'in 2 na marasa lafiya na metabolism, idan matakan glucose na jini ba su da girma sosai kuma babu wata matsala ta musamman ko wasu cututtuka masu tsanani, ana iya la'akari da monotherapy tare da GLP-1. Nazarin asibiti ya nuna cewa wasu sababbin marasa lafiya da aka gano sun sami raguwa sosai a matakan haemoglobin A1c (HbA1c) da asarar nauyi bayan wani lokaci na monotherapy. Misali, a cikin jerin nazarin PIONEER, marasa lafiya da aka yi amfani da su tare da GLP-1 monotherapy na baka sun sami raguwa sosai a matakan HbA1c idan aka kwatanta da rukunin placebo, tare da kyakkyawan aminci da haƙuri. Amfanin monotherapy shi ne cewa yana guje wa haɗarin hulɗar miyagun ƙwayoyi da ke hade da haɗin gwiwa, kuma gudanarwa mai sauƙi yana taimakawa wajen inganta haƙuri ga jiyya.
Hakanan ana iya amfani da GLP-1 tare da wasu magunguna. Lokacin da aka haɗe shi da metformin, wanda shine magani na farko don nau'in 2 na metabolism, yana inganta juriya na insulin kuma yana rage fitowar glucose na hanta. Magungunan biyu suna da ingantattun hanyoyin aiki, suna ba da damar sarrafa glucose na jini mafi inganci. Nazarin ya nuna cewa wannan tsarin haɗin gwiwar yana ƙara rage matakan HbA1c kuma yana haifar da asarar nauyi. Misali, a wasu gwaje-gwajen asibiti, marasa lafiya da aka bi da su tare da metformin waɗanda suka ƙara GLP-1 sun sami raguwa mafi girma a cikin matakan HbA1c idan aka kwatanta da waɗanda suka ci gaba da metformin monotherapy, tare da ƙarin asarar nauyi, ba tare da haɓakar haɗarin hypoglycemia ba. Wannan tsarin ya dace da marasa lafiya waɗanda matakan glucose na jini ba su da isasshen sarrafawa tare da metformin monotherapy.
Ga marasa lafiya da ke da nau'in 2 na metabolism waɗanda ke da matakan glucose na jini kuma suna buƙatar maganin insulin, ƙara GLP-1 zuwa maganin insulin na iya rage adadin insulin. A cikin maganin insulin, marasa lafiya sukan fuskanci al'amura kamar haɓaka nauyi da haɓaka haɗarin hypoglycemia. Lokacin amfani da shi a hade, tasirin GLP-1 na haɓaka ƙwayar insulin da hana ƙwayar glucagon na iya haɓaka amfani da insulin, rage yawan adadin, kuma ta haka ne rage haɗarin hauhawar nauyi da hypoglycemia. Alal misali, a wasu nazarin asibiti, marasa lafiya waɗanda suka ƙara GLP-1 zuwa maganin insulin sun sami raguwar matsakaicin adadin insulin, tare da ƙarin raguwa a cikin matakan HbA1c, asarar nauyi, da raguwa a yawan lokuta na hypoglycemia.
Hakanan za'a iya amfani da GLP-1 tare da sauran magungunan antidiabetic kamar masu hana SGLT2. Masu hana SGLT2 suna rage yawan glucose na jini ta hanyar haɓaka haɓakar glucose a cikin fitsari. Haɗin waɗannan biyun na iya ƙara haɓaka sarrafa glucose na jini ta hanyoyi daban-daban kuma yana iya samun tasirin daidaitawa a cikin sarrafa nauyi.
Matsayin GLP-1 a cikin sarrafa nauyi
Ciwon kai
GLP-1 yana aiki akan masu karɓar GLP-1 a cikin tsarin juyayi na tsakiya, musamman a cikin hypothalamus. Hypothalamus shine yanki mai mahimmanci a cikin jiki don daidaita yanayin ci da kuzari. Bayan ɗaure ga masu karɓar GLP-1 a cikin hypothalamus, GLP-1 na iya daidaita sakin neuropeptides, kamar rage ɓoyewar neuropeptide Y (NPY), wanda shine babban abin motsa jiki mai ƙarfi. Bugu da ƙari, GLP-1 na iya ƙara yawan ayyukan proopiomelanocortin (POMC) neurons, wanda kunnawa ke haifar da siginar satiety. Ta hanyar waɗannan hanyoyin, GLP-1 yana hana ci abinci yadda ya kamata, yana jagorantar marasa lafiya don rage cin abinci. A cikin gwaje-gwajen asibiti, marasa lafiya masu kiba ko masu kiba ta amfani da GLP-1 sun ba da rahoton raguwar ci da rage cin abinci, yana shimfida tushe don asarar nauyi.
Ƙara yawan kuɗin makamashi
Baya ga hana ci abinci, GLP-1 na iya yin tasiri ga metabolism na makamashi, yana ƙara kashe kuzari. Bincike ya nuna cewa GLP-1 na iya ƙara yawan kashe kuzari ta hanyar daidaita ayyukan ƙwayar adipose mai launin ruwan kasa. Brown adipose tissue wani nau'in kitse ne na musamman wanda aikinsa na farko shine cinye makamashi ta hanyar thermogenesis. GLP-1 na iya kunna wasu hanyoyin sigina a cikin ƙwayar adipose mai launin ruwan kasa, haɓaka iskar oxygen da fatty acid da thermogenesis. Bugu da ƙari, GLP-1 na iya yin tasiri ga metabolism na makamashi a cikin kyallen takarda kamar tsoka, ƙara yawan kashe kuzari ko da a lokacin hutawa. Misali, a cikin gwaje-gwajen dabbobi, bayan gudanar da GLP-1, adadin kuzarin dabbobin ya karu, kuma nauyin jikinsu ya ragu ko da lokacin cin abinci ya kasance iri daya, wanda ke nuna cewa GLP-1 yana taka rawa mai kyau wajen sarrafa nauyi ta hanyar kara kashe kuzari.
Regulation na mai metabolism
GLP-1 kuma yana da tasiri na tsari akan metabolism na mai. Yana iya inganta rushewar kitse, rage yawan kitse, da hana ajiyar mai. A cikin hanta, GLP-1 na iya hana ayyukan enzymes irin su fatty acid synthase, ta haka ne rage haɓakar fatty acid. Bugu da ƙari, a cikin ƙwayar adipose, GLP-1 na iya inganta raguwar kitse, ƙara sakin fatty acids kyauta, da sauƙaƙe shigar su cikin mitochondria don rushewar oxidative, don haka rage yawan ajiyar mai. Nazarin asibiti ya nuna cewa bayan wani lokaci na jiyya tare da GLP-1, abubuwan da ke cikin jikin marasa lafiya, musamman abubuwan kitse na visceral, suna raguwa. Wannan ba wai kawai yana taimakawa wajen asarar nauyi ba har ma yana da tasiri mai mahimmanci don inganta ciwo na rayuwa da rage haɗarin cututtukan zuciya.
Aikace-aikacen GLP-1 a cikin Gudanar da Weight
Ga marasa lafiya masu kiba ko kiba tare da cututtuka masu alaƙa
GLP-1 yana da ƙayyadaddun ƙayyadaddun yawan jama'a don sarrafa nauyi. Ga marasa lafiya masu kiba tare da BMI ≥30 kg/m² ko marasa lafiya masu kiba tare da BMI ≥27 kg/m² kuma aƙalla yanayin da ke da alaƙa da nauyi (kamar hauhawar jini, nau'in 2 metabolism, ko hypercholesterolemia), magani ne mai inganci mai sarrafa nauyi. Jerin STEP na gwaje-gwaje na asibiti ya nuna babban hasara mai nauyi a cikin marasa lafiya da aka bi da su. A cikin binciken MATAKI 1, marasa lafiya da aka bi da su sun sami asarar matsakaicin nauyi na kusan 15% sama da makonni 68, yayin da rukunin placebo ya rasa kusan 2.4%. Wadannan sakamakon sun nuna cewa zai iya taimakawa marasa lafiya masu kiba ko kiba tare da yanayin da ke da alaƙa da su cimma mahimmanci da ci gaba da asarar nauyi, inganta sakamakon kiwon lafiya, da kuma rage haɗarin cututtuka masu alaka da kiba.
Haɗe tare da shiga tsakani na rayuwa
A cikin sarrafa nauyi, GLP-1 yawanci ana amfani dashi a hade tare da tsarin rayuwa, gami da rage yawan adadin kuzari da haɓaka ayyukan jiki. Idan asarar nauyi ya dogara ne akan magani kawai ba tare da canza yanayin salon rayuwa mara kyau ba, sau da yawa tasirin ba zai dorewa ba. Haɗuwa da hanyoyi guda biyu yana da tasiri mai tasiri: magani yana hana ci abinci kuma yana ƙara yawan kuzarin makamashi, yayin da kula da abinci ya rage yawan adadin kuzari da kuma ƙara yawan aikin jiki yana kara yawan kuzarin makamashi, wanda zai haifar da asarar nauyi mai mahimmanci da ci gaba. Misali, a wasu ayyuka na asibiti, marasa lafiya waɗanda ke bin tsarin rage cin abinci mai ƙarancin kalori wanda ƙwararrun masana abinci suka haɓaka kuma suna haɓaka lokacin motsa jiki na mako-mako yayin karɓar jiyya suna samun sakamako mafi kyawun asarar nauyi fiye da waɗanda suka dogara kawai kan magunguna ko ayyukan rayuwa. Wannan haɗin gwiwar haɗin gwiwar yana jaddada mahimmancin gudanarwa mai mahimmanci a cikin kula da nauyi, yana taimakawa marasa lafiya su kafa salon rayuwa mai kyau da kuma cimma nasarar sarrafa nauyi na dogon lokaci.
Kammalawa
GLP-1 yana nuna gagarumin yuwuwar a cikin duka jiyya na metabolism da sarrafa nauyi. A cikin jiyya na metabolism, yana sarrafa glucose na jini yadda ya kamata ta hanyoyi da yawa, yana inganta aikin β-cell, kuma ana iya amfani dashi azaman monotherapy ko a hade tare da sauran magungunan antidiabetic. A cikin sarrafa nauyi, yana hana ci, yana ƙara kashe kuzari, kuma yana daidaita metabolism na mai, yana sa ya dace da masu kiba ko masu kiba masu alaƙa da yanayin. Lokacin da aka haɗa shi da tsarin rayuwa, yana haifar da sakamako mafi kyau.
Sources
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Samfura akwai don amfani da bincike kawai:
