肥胖和糖尿病课件.pptVIP

* Insulin resistance leads to hyperinsulinemia,which is followed by beta cell exhaustion * 对于正常情况，胰岛素激活POMC厌食神经元PI3激酶，导致神经元的静默和MOMC的转录，释放a-MSH,减少摄食和增加能量消耗。胰岛素也激活VMH的SF-1表达的神经元，激活钾离子通道，减少放电频率，通过谷氨酸投射调节ARC的POMC神经元。肥胖病人，POMC胰岛素抵抗了，进一步刺激摄食和体重增加，胰岛素浓度升高，导致VMH神经元兴奋，超极化，减少了对ARC POMC神经元的兴奋性投入。 * 白内障 心脏瓣膜病 palpoitations心悸 安非太酮 * Pramlintide普兰林肽 Glucosidase:α-葡糖苷酶 二甲双胍 Meglitinides抑制腺嘌呤核甘三磷酸敏感性鉀通道而促使胰島素分泌，具有insulinotropic作用，在藥理學分類上屬於胰島素分泌刺激劑。氯茴苯酸类 thiazolidinediones噻唑烷二酮类 TZD类药物 TDs通过激活核受体过氧化物酶体增殖物激活受体 γ(PPAR γ)显著增加胰岛素敏感性 * 曲格列酮噻唑烷二酮类药物，可改善胰岛素[1]?抵抗，增加人体组织对胰岛素的敏感性，增强胰岛素的作用阿卡波糖 二甲双胍metformin * sulfonyfurea磺脲类药物 Model of insulin resistance Treatment flow diagram for obese Appetite suppressant agents Drugs on food intake Treatment of Hyperglycaemia Diabetes prevention trials Acknowledgement * A study published in Lancet shows that almost 30% of people globally are either obese or overweight, for a total of 2.1 billion people. May 30, 2014 A study published in Lancet shows that almost 30% of people globally are either obese or overweight, for a total of 2.1 billion people. The researchers conducted what they called the most comprehensive assessment of obesity to date using data covering 188 nations from 1980 to 2013. During the 33 years studied, the researchers found that rates of being obese or overweight increased 28% in adults and 47% in children. During that span, the number of overweight and obese people rose from 857 million in 1980 to 2.1 billion in 2013. The richest country, the United States, was home to the largest proportion of the world’s obese population—13%—even though it claims less than 5% of its people. The biggest obesity rises among women came in Egypt, Saudi Arabia, Oman, Honduras, and Bahrain. Among men, it was in New Zealand, Bahrain, Kuwait, Saudi Arabia, and the United States. In addition, the researchers found that nations in the Middle East and North Africa, Central America, and the Pacific and Caribbean islands reached staggeringly high obes