生理学 内分泌(5学时).ppt

胰岛素对糖代谢的影响 脑组织 1）脑组织对葡萄糖的摄取和利用不受胰岛素影响 2）仅利用葡萄糖供能 胰岛素对脂肪代谢的影响 胰岛素促进脂肪的合成，抑制脂肪的分解 1）因增强对葡萄糖的利用，因而对脂肪的利用减少 2）增加葡萄糖向脂肪细胞的转运，促进脂肪的合成 3）抑制脂肪酶的活性 缺乏胰岛素时，因大量代谢脂肪，使血浆胆固醇和磷脂水平升高?动脉粥样硬化 ?酮症酸中毒 酮体（Ketone bodies）:β-羟基丁酸（β-hydroxybutyric acid）, 丙酮（acetone),乙酰乙酸（acetoacetic acid） 胰岛素对蛋白质代谢的影响 1）加强细胞对氨基酸的摄取 2）增强转录，翻译 3）降低对蛋白质的分解代谢 4）降低糖异生，减少对氨基酸的利用 胰岛素与生长激素对促生长的协同效应 胰岛素分泌的调节 胰岛素分泌调节 ⒈ 血糖↑→胰岛素↑ ⒉ 精氨酸、赖氨酸↑→胰岛素↑ ⒊ 促胃液素、促胰液素、胆囊收缩素、抑胃肽 →胰岛素↑ 生长素、皮质醇、甲状腺激素、胰高血糖素 →胰岛素↑ 生长抑素→胰岛素↓ ⒋ 神经调节：迷走神经使胰岛素分泌↑， 交感?抑制?兴奋 二、胰高血糖素 （一）生理作用： 促糖异生和分解，使血糖升高； 促脂肪和蛋白质分解，异生为糖。 （二） 分泌调节 ⒈ 血糖水平 ⒉ 胰岛素：直接，间接 3、神经调节：交感促进，迷走抑制 胰岛A、B、D细胞相关： D细胞分泌生长抑素抑制A、B分泌（旁分泌）；A分泌物刺激B分泌（旁分泌）；B分泌胰岛素抑制A分泌。 a)若A、B、D细胞均↓或功能↓，出现类胰腺切除的糖尿病； b)若B细胞↓产生单纯性的糖尿病，胰岛素可治疗； c)若D细胞瘤，抑制A、B也可出现糖尿病。 * Synthesis process: Prepro-pro-active form Ca2+ and/or cAMP signal pathway required for exocytosis Peptide hormones are water soluble, allowing them to enter the circulatory system easily and be carried to their target tissues. Most of the hormones in the body are polypeptides and proteins. These hormones range in size from small peptides with as few as 3 amino acids (thyrotropin-releasing hormone) to proteins with almost 200 amino acids (growth hormone and prolactin). In general, polypeptides with 100 or more amino acids are called proteins, and those with fewer than 100 amino acids are referred to as peptides. Protein and peptide hormones are synthesized on the rough end of the endoplasmic reticulum of the different endocrine cells, in the same fashion as most other proteins (Figure 74–2). They are usually synthesized first as larger proteins that are not biologically active (preprohormones) and are cleaved to form smaller prohormones in the endoplasmic reticulum. These are then transferred to the Golgi apparatus for packaging into secretory vesicles. In this process, enzymes in the vesicles cleave the prohormones to produce smaller, biologically active h