B型インスリン抵抗性の患者のリウマト学的症状
S Amara Ogbonnaya1, Sandra G Williams1, Raphael A Kirou1
1National Institute of Arthritis and Musculoskeletal and Skin Diseases, 9000 Rockville Pike, Building 10 10N311, Bethesda, Maryland, 20894, United States.
Arthritis care & research
|February 18, 2026
まとめ
B型インスリン抵抗性 (TBIR) は,全身性狼症 (SLE) のまれな合併症であり,高いU1RNP自己抗体と関連しています. この生命を脅かす病気の早期発見と治療は極めて重要です.
科学分野:
- エンドクリノロジー エンドクリノロジー
- レウマトロジーの病理学
- 免疫学 免疫学とは
背景:
- B型インスリン抵抗性 (TBIR) は,インスリン受容体を抑制する自己抗体によって引き起こされる自己免疫疾患です.
- これはしばしば重度の高血糖症,体重減少,アカントーシス・ニグリカン症候群を呈し,インスリン治療を強要し,治療なしでは高い死亡率を伴う.
- TBIRは,システミック・ルプス・エリテマトーサス (SLE) と頻繁に関連しています.
研究 の 目的:
- 患者におけるTBIRに関連した臨床および研究室の特徴を特定する.
- TBIRを珍しいが生命を脅かす疾患として認識し,しばしばSLEと関連付けます.
主な方法:
- 国立衛生研究所 (1976年−2024年) で観察されたTBIR患者の38人の逆行図のレビュー.
- 分析には,原発性関節疾患の診断,内分泌学実験室の測定,およびSLEの症状 (低補完血症,サイトペニア,自己抗体) が含まれていた.
主要な成果:
- システミック・ルプス・エリテマトーサス (SLE) は,最も頻繁な基礎診断 (81.5%) であった.
- 患者は主に女性 (89.5%) と黒人/アフリカ系アメリカ人 (84.2%) であり,SLEDAI-2Kの平均スコアは14.
- 高タイトルのU1RNP自己抗体は,患者の50%以上に存在していました. 関連疾患には,頭蓋骨神経神経病 (18.4%),血管内腫 (10.5%),およびウエビチス (5%) が含まれていた.
結論:
- B型インスリン抵抗性 (TBIR) は,SLEの希少だが深刻な合併症である.
- 高タイターのU1RNP自己抗体は,SLE患者におけるTBIRと関連しています.
- TBIRは,他のまれなSLEの症状と同時発症することがあり,患者の総合的な評価の必要性を強調しています.
さらに関連する動画
関連する概念動画
Insulin: Dosing Regimen and Adverse Effects
874
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
874
Diabetes Mellitus: Overview and Type I Subtype
5.6K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
5.6K
Diabetes Mellitus: Type 2 and Gestational
5.1K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
5.1K
Diabetes: Symptoms, Diagnosis, and Complications
2.4K
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
2.4K
Oral Hypoglycemic Agents: Biguanides and Glitazones
702
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
702
Carbohydrate Metabolism
14.5K
Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
14.5K


