Ukuqonda Amanga Akhomayo A1C Izivivinyo Kwabantu abane-Hemoglobin Variants
I-hemoglobin nesifo sikashukela sinomhlobo oqhubekayo. I-glucose iqoqa i-hemoglobin kumaseli akho abomvu egazi bese ihlala khona izinyanga ezintathu. Inani le-glucose elihlanganiswe ne-hemoglobin yakho livivinywa ekuhlolweni kwe-hemoglobin A1c futhi libikwe njengenombolo ye-EAG. Leyo nombolo, kodwa, ithinteka ngaphezu kokushukela kwegazi lakho, futhi ukuqonda amazinga akho kubalulekile ukuqonda imiqondo embalwa.
I-hemoglobin nesifo sikashukela ihlobene kanjani, futhi ukuhlolwa kwakho kwe-A1c kungahle kube nini?
Iyini i-Hemoglobin?
I-Hemoglobin iyi-molecule yamaprotheni emaqenjini akho abomvu egazi abamba i-oxygen emaphashini akho kuzo zonke izingxenye zomzimba wakho. Cishe yonke i-oksijini egazini lakho iqhutshwa ku-hemoglobin, ngakho-ke kubaluleke kakhulu. Iqukethe insimbi futhi yilokho okwenza amaseli obomvu egazi abomvu ngombala. Uma unesifo se-iron esimpofu, kungenxa yokungabi ne-hemoglobin eyanele kumaseli akho abomvu.
I-Hemoglobin Isetshenziswa Kanjani Ukuhlola I-Diabetes?
Uma udla, umzimba wakho wehlisa ama-carbohydrate amakhulu ku-glucose noma ushukela owusebenzisa amandla. Ekugcineni iphela egazini lakho legazi ukuze lithathwe kuzo zonke izingxenye zomzimba wakho. Eminye ushukela ephela egazini lakho legazi ihlangene ne-hemoglobin kumaseli akho abomvu egazi bese ihlala khona izinyanga ezintathu. Amaningi akho amangqamuzana abomvu asetshenziselwa emuva kwezinyanga ezine, ngakho amaseli akho abonisa kuphela umlando wenyanga eyedlule.
Uma usukhuphukile amazinga kashukela egazini lakho, njengoba abantu abaningi abanesifo sikashukela benza, khona-ke lokho kushukela kuzokunamathisela kumaseli akho abomvu egazi. Uma ephakeme uketshezi lweshukela egazini lakho, ushukela oluthe xaxa luhambisana ne-hemoglobin yakho.
I-Hemoglobin A1c Test kanye nesifo sikashukela
Ukuhlolwa kwegazi kwansuku zonke kubaluleke kakhulu ekuphatheni jikelele kwesifo sikashukela.
Kodwa, lezi zivivinyo zinikela kuphela isifinyezo sezinga le-glucose egazini ngesikhathi sokuhlolwa. Ihora elilodwa kamuva, umphumela ungahluka. Isivivinyo esibizwa ngokuthi i- hemoglobin A1c (noma i-glycohemoglobin test) inikeza umbono obude wamazinga e-glucose ngokulinganisa ukuthi i-glucose inamathele kangakanani ku-hemoglobin empilweni yegazi elibomvu, eliyizinyanga ezintathu. Kucatshangwa ukuhlolwa okujwayelekile kwegolide ukuqonda amazinga e-glucose esesikhathi eside egazini futhi kunconywa yi-American Association Diabetes Association. Ibuye isetshenziswe njengendlela yokuhlola ukuhlolwa kwesifo sikashukela.
Ukuhluka kwe-Hemoglobin kuthinta ukuhlolwa kwe-A1C
Ukuhlolwa kwe-A1c akulona iqiniso kubantu abanezinhlobo ezihlukahlukene ze-hemoglobin. Lezi zivivinyo zenzelwe abantu abane-hemoglobin A, uhlobo oluvame kakhulu lwe-hemoglobin. Lezi zinhlobonhlobo ze-hemoglobin zivame kakhulu (zizuzwe njengefa) kubantu abaningi base-Afrika, iMedithera, naseNingizimu-mpumalanga Asia. Kunezinhlobo ezingavamile ze-hemoglobin A. I-hemoglobin evamile yenziwe ngamaketanga amabili noma amabetane amabili B. Uma enye yalezi zingetanga ishoda (isimo esizuzwe njengefa) isimo esiwumphumela sibhekwa njenge- thalassemia .
Izinhlobo ze-hemoglobin zifaka:
- I-Hemoglobin S (etholakala nge-sickle cell trait trait)
- I-Hemoglobin C
- I-Hemoglobin E
- I-Hemoglobin F - Hemoglobin F ibona ngesikhathi sokukhulelwa, ebusweni futhi ngezinye izikhathi ekhulelwe.
- Izinguquko eziningi ezingavamile kakhulu ezifana ne-Hb D noma i-G, i-Hb J, nokuningi
- I-hemoglobin carbamylated (etholakala kubantu abanezinkinga zezinso)
Akuzona zonke izinhlobo ze-hemoglobin eziholela ezinkingeni zezempilo, njengoba zenzelwa isifo se-sickle cell, kodwa zingabangela imiphumela emibi ngokuhlolwa kwe-A1c. Isibonelo, abantu abanesici se-sickle cell - bangabathwali be-sickle cell isifo kepha abanalo izifo zesifo. Kodwa-ke, bayoba nokufundwa okungalungile ekuhlolweni kwe-A1c.
Kubaluleka kwe-Hemoglobin Variants kanye nesifo sikashukela
Uma une-hemoglobin variant, amathuba ukuthi uzothola ukufunda okungamanga kuhlolo lwe-HbA1c ekutshela wena nodokotela wakho ukuthi ushukela wegazi lakho liphakeme kakhulu, ngisho noma lingekho.
Ukuphendula lokhu, imithi yakho yesifo sikashukela noma umthamo we-insulin inganyuka, ukuzama ukuletha isifo sikashukela ngaphansi kokulawula okungcono. Ngeshwa, lokhu kwanda kungabangela ushukela ophansi wegazi (i- hypoglycemia ) engase ibe yingozi kakhulu futhi kuyisimo esiphuthumayo sezokwelapha.
Ukufunda okungamanga kungenza wena nodokotela wakho bakholelwe ukuthi unesifo sikashukela ngisho noma ungenalo. Imithi noma i-insulin ingase iqale, okungathi ngenhla, ingaholela ku-hypoglycemia. Ngomzwelo, ukuxilongwa okungalungile nakho kungabangela ukukhathazeka okukhulu, uma ukholelwa ukuthi unesimo ongasitholi.
Ubani Ongaba ne-Hemoglobin Variant?
Ubani okufanele ahlolwe ukuze abone ukuthi bane-hemoglobin variant? Abantu abangase babe ne-hemoglobin ehlukile kubandakanya labo:
- Ngamagugu ase-Afrika, iMedithera, noma aseNingizimu-mpumalanga Asia
- Unomlando womndeni womuntu onesimo se-hemoglobin
- Uma umangazwa imiphumela yokuhlolwa kwakho kwe-A1c (isibonelo, uma iphezulu futhi ukufundwa kwakho kuhle)
- Uma ukufundwa kwakho kwe-A1c kuphezulu kakhulu
- Uma ukufundwa kwakho kwe-A1c kushintsha kakhulu ngokushintsha kwebhubhu eyenza lezi zivivinyo
Uma une-hemoglobin variant, usengaba nokuhlolwa kwe-HbA1c. Akuzona zonke izivivinyo ezithinteka yi-hemoglobin variants, kanti udokotela wakho uzodinga ukuthi uhlolo lwakho lwenziwe lapho lokhu kucatshangelwa khona.
Zivamile kangakanani i-Hemoglobin Variants?
Esinye isifundo esikhulu sabantu abaningi baseNyakatho Melika, abantu abangamaphesenti angu-3.77 batholakala ukuthi bane-hemoglobin variant. Kulezi, izinhlobo ezihlanganisa:
- I-HbS (i- sickle cell trait ) - amaphesenti angu-2.85
- I-HbSS (i- sickle cell isifo ) - amaphesenti angu-0.03
- Isici se-HbC - amaphesenti angu-0.61
- Isifo se-HbCC - amaphesenti angu-0.01
- HbSC - amaphesenti angu-0.04
- HbE - amaphesenti angu-0.13
- I-HbD noma i-G isilinganiso - amaphesenti angu-0.6
- I -thalasemia ye- HbS B - amaphesenti angu-0.1
- Ukuphikelela HbF - amaphesenti angu-0.01
- HbMontgomery - amaphesenti angu-0.01
I-Alpha thalassemia nayo ikhona ngamaphesenti angu-3,82 alabo abanezinhlobonhlobo ze-hemoglobin.
Ezinye Izinto Okungahle Zinikeze I-Hemoglobin Ye-A1C Yeqiniso
Njengoba izinga lama-A1c le-hemoglobin lixhomeke kumaseli obomvu egazi, noma yini ephazamisa (ilulaza) impilo yamaseli abomvu angabangela imiphumela engavamile. Isibonelo, ukulahleka kwegazi ngenxa yokuhlinzwa noma izikhathi ezinzima zokuya esikhathini noma isimo esifana ne-anemia ye-hemolytic singase sibangele ukufundwa kwamanga okuphansi. Ukwehluleka kwe-iron ukulahlekelwa yi- anemia kungaholela ekufundeni okuphansi, kanti ukwelashwa kwe-iron esikhundleni kungabangela amazinga aphezulu. Uma ngabe uphethwe igazi, amazinga akho angase abe nokungalungile. Amazinga we-Hemoglobin A1c angase kube nzima ukuhumusha kubantu abanokuhluleka kwezinso ngenxa yezizathu eziningana.
Ngaphansi kwe-Hemoglobin Variants ne-Hemoglobin A1C Izinga
I-hemoglobin level A1c ibaluleke kakhulu ekunqumeni izinga lesilinganiso seshukela legazi esikhathini eside. Ngeshwa, ukuhlukahluka kwe-hemoglobin kungenza lokhu kuhlolwa kungalungile, ngaleyo ndlela kuncishiswe ukunemba.
Uma amazinga akho e-A1c engabonakali ahambisana nokuhlola kwakho kwe-glucose kwansuku zonke, ikakhulukazi uma ungumuntu wase-Afrika, iMedithera, noma i-Southeast Asian heritage, khuluma nodokotela wakho mayelana nokuhlolwa kwegazi okulula ukubona ukuthi une-hemoglobin variant. Ukwazi ukuthi unomqondo ohlukile, udokotela angase aqiniseke ukuthi igazi lihlolwe ebhodini elisebenzisa izinqubo ezingathinteki kulezi zihlukahluka.
> Imithombo:
> Little, R., La'ulu, S., Hanson, S., Rohlfing, C., no R. Schmidt. Imiphumela yezinguquko ezingu-40 ezihlukile ze-Hb ezilinganisweni ze-HbA1c ngezindlela eziyisishiyagalombili. Journal of Diabetes Isayensi Nezobuchwepheshe . 2015. 9 (4): 849-56.
> Lorenzo-Medina, M., De la-Iglesia, S., Ropero, P., Noqueira-Salqueiro, P., noJ. Santana-Benitiz. Imiphumela ye-Hemoglobin Variants kwi-Hemoglobin A1C Imilinganiselo Elinganiselwe Ukusebenzisa Ukusebenza Okuphezulu Kokusebenza Kwe-Liquid Chromatography. Journal of Diabetes Isayensi Nezobuchwepheshe . 2014. 8 (6): 1168-1176.
> I-Hemoglobin Variants ingase ibangele ukuhluka okuphawulekayo ku-Hemoglobin A1c njengoba kulinganiswa yi-High-Performance Liquid Chromatography nezindlela ze-enzymatic kwiziguli zesifo sikashukela. Ama-Annal of Clinical Biochemistry . 2016 Aug 5. (Epub ngaphambi kokuphrinta).