病理学内分泌系统疾病.ppt

* * The most frequent pattern of involvement is * * The most frequent pattern of involvement is * * Polydipsia The classic clinical pictures inculde The hyperglycemia exceeds the renal threshold for reabsorption, and glycosuria ensues. The glycosuria induces an osmotic diuresis and thus polyuria, causing a profound loss of water and electrolytes The obligatory renal water loss combined with the hyperosmolarity resulting from the increased levels of blood glucose tends to deplete intracellular water, triggering the osmoreceptors of the thirst centers of the brain. In this manner, intense thirst (polydipsia) appears. With a deficiency of insulin，the scales swing from insulin-promoted anabolism to catabolism of proteins and fats. Proteolysis follows (resulting in weight loss and muscle weakness), and the gluconeogenic amino acids are removed by the liver and used as building blocks for glucose. The catabolism of proteins and fats tends to induce a negative energy balance, which in turn leads to increasing appetite (polyphagia), thus completing the classic triad of diabetes: polyuria, polydipsia, polyphagia and weight loss. The combination of polyphagia and weight loss is paradoxical and should always raise the suspicion of diabetes. * * The classic clinical pictures inculde The hyperglycemia exceeds the renal threshold for reabsorption, and glycosuria ensues. The glycosuria induces an osmotic diuresis and thus polyuria, causing a profound loss of water and electrolytes The obligatory renal water loss combined with the hyperosmolarity resulting from the increased levels of blood glucose tends to deplete intracellular water, triggering the osmoreceptors of the thirst centers of the brain. In this manner, intense thirst (polydipsia) appears. With a deficiency of insulin，the scales swing from insulin-promoted anabolism to catabolism of proteins and fats. Proteolysis follows (resulting in weight loss and muscle weakness), and the gluconeogenic amino acids are r