1
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
5 Pocket Jean - 30 / Indigo
30
30
32
34
Indigo
Indigo
-
+
$ 404.6 $ 304.6
5 Pocket Jean - 30 / Indigo
30
30
32
34
Indigo
Indigo
-
+
$ 404.6 $ 304.6
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
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28)","#pibtn-icon-font-size":"16px","#continue-text":"Jatka ostoksia","#continue-display":"inline-block","#continue-width":"100px","#continue-height":"42px","#continue-effect-hover":"raise","#continue-font-size":"13px","#continue-font-weight":"400","#continue-font-style":"normal","#continue-text-decoration":"none solid rgb(255, 255, 255)","#continue-color":"rgb(255, 255, 255)","#continue-color-hover":"rgb(255, 255, 255)","#continue-background-color":"rgb(128, 83, 157)","#continue-background-color-hover":"rgb(240, 128, 80)","#continue-border-width":"0px","#continue-border-color":"rgb(0, 0, 0)","#continue-border-color-hover":"rgb(0, 0, 0)","#continue-border-radius":"5px","#checkout-text":"Kassa","#checkout-display":"block","#checkout-width":"100px","#checkout-height":"42px","#checkout-effect-hover":"raise","#checkout-font-size":"13px","#checkout-font-weight":"400","#checkout-font-style":"normal","#checkout-text-decoration":"none solid rgb(255, 255, 255)","#checkout-color":"rgb(255, 255, 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{"#popup-showup-effect":"bounceDownIn","#popup-width":"850px","#popup-font-family":"News_Cycle","#popup-padding":"30px","#popup-background-color":"rgb(255, 255, 255)","#popup-border-width":"0px","#popup-border-color":"rgb(255, 255, 255)","#popup-border-radius":"5px","#product-title-display":"inline","#product-title-font-size":"16px","#product-title-font-weight":"700","#product-title-font-style":"normal","#product-title-text-decoration":"none solid rgb(0, 0, 0)","#product-title-text-align":"left","#product-title-color":"rgb(0, 0, 0)","#success-alert-text":"Product successfully added to your shopping cart","#success-alert-display":"block","#success-alert-font-size":"18px","#success-alert-font-weight":"700","#success-alert-font-style":"normal","#success-alert-text-decoration":"none solid rgb(40, 167, 69)","#success-alert-text-align":"left","#success-alert-color":"rgb(40, 167, 69)","#additional-quantity-text":"Quantity","#additional-subtotal-text":"Subtotal","#additional-total-text":" Total ","#additional-display":"block","#additional-font-size":"14px","#additional-font-weight":"400","#additional-font-style":"normal","#additional-text-decoration":"none solid rgb(0, 0, 0)","#additional-text-align":"left","#additional-color":"rgb(0, 0, 0)","#item-count-text-text":"There are {number} tems in your cart.","#item-count-text-display":"block","#item-count-text-font-size":"18px","#item-count-text-font-weight":"700","#item-count-text-font-style":"normal","#item-count-text-text-decoration":"none solid rgb(0, 0, 0)","#item-count-text-text-align":"left","#item-count-text-color":"rgb(0, 0, 0)","#cart-note-text":"Add a note for admin","#cart-note-display":"block","#cart-note-font-size":"14px","#cart-note-font-weight":"700","#cart-note-font-style":"normal","#cart-note-text-decoration":"none solid rgb(0, 0, 0)","#cart-note-text-align":"left","#cart-note-color":"rgb(0, 0, 0)","#continue-text":"CONTINUE SHOPPING","#continue-display":"inline-flex","#continue-width":"170px","#continue-height":"43px","#continue-font-size":"12px","#continue-font-weight":"400","#continue-font-style":"normal","#continue-text-decoration":"none solid rgb(255, 255, 255)","#continue-color":"rgb(255, 255, 255)","#continue-color-hover":"rgb(228, 228, 228)","#continue-background-color":"rgb(0, 0, 0)","#continue-background-color-hover":"rgb(0, 0, 0)","#continue-border-width":"0px","#continue-border-color":"rgb(0, 0, 0)","#continue-border-color-hover":"rgb(0, 0, 0)","#continue-border-radius":"0px","#checkout-text":"PROCEED TO CHECKOUT","#checkout-display":"inline-flex","#checkout-width":"169px","#checkout-height":"43px","#checkout-font-size":"12px","#checkout-font-weight":"400","#checkout-font-style":"normal","#checkout-text-decoration":"none solid rgb(255, 255, 255)","#checkout-color":"rgb(255, 255, 255)","#checkout-color-hover":"rgb(228, 228, 228)","#checkout-background-color":"rgb(0, 0, 0)","#checkout-background-color-hover":"rgb(0, 0, 0)","#checkout-border-width":"0px","#checkout-border-color":"rgb(0, 0, 0)","#checkout-border-color-hover":"rgb(0, 0, 0)","#checkout-border-radius":"0px","#tocartbtn-text":"GO TO CART","#tocartbtn-display":"none","#tocartbtn-width":"160px","#tocartbtn-height":"41px","#tocartbtn-font-size":"12px","#tocartbtn-font-weight":"400","#tocartbtn-font-style":"normal","#tocartbtn-text-decoration":"none solid rgb(255, 255, 255)","#tocartbtn-color":"rgb(255, 255, 255)","#tocartbtn-color-hover":"rgb(224, 224, 224)","#tocartbtn-background-color":"rgb(0, 0, 0)","#tocartbtn-background-color-hover":"rgb(0, 0, 0)","#tocartbtn-border-width":"0px","#tocartbtn-border-color":"rgb(0, 0, 0)","#tocartbtn-border-color-hover":"rgb(0, 0, 0)","#tocartbtn-border-radius":"0px"}
{"#stickybar-display":"none","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(246, 247, 251)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"130px","#stickybar-buynow-height":"35px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"slide","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(37, 37, 37)","#stickybar-buynow-background-color-hover":"rgb(37, 37, 37)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(255, 255, 255)","#stickybar-buynow-border-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-border-radius":"15px"}
{"#stickybar-display":"flex","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(255, 255, 255)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"130px","#stickybar-buynow-height":"35px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"slide","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(242, 108, 79)","#stickybar-buynow-background-color-hover":"rgb(242, 108, 79)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(255, 255, 255)","#stickybar-buynow-border-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-border-radius":"2px"}
{"#stickybar-action":"goto_checkout","#stickybar-display":"flex","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(255, 255, 255)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"230px","#stickybar-buynow-height":"70px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"slide","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(17, 17, 17)","#stickybar-buynow-background-color-hover":"rgb(17, 17, 17)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(0, 0, 0)","#stickybar-buynow-border-color-hover":"rgb(0, 0, 0)","#stickybar-buynow-border-radius":"0px"}
{"#stickybar-display":"flex","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(242, 108, 79)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(255, 255, 255)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"230px","#stickybar-buynow-height":"70px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"none","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(0, 0, 0)","#stickybar-buynow-background-color-hover":"rgb(0, 0, 0)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(0, 0, 0)","#stickybar-buynow-border-color-hover":"rgb(0, 0, 0)","#stickybar-buynow-border-radius":"0px"}
{"#stickybar-display":"flex","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(255, 255, 255)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"130px","#stickybar-buynow-height":"35px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"none","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 254, 254)","#stickybar-buynow-color":"rgb(255, 254, 254)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(242, 108, 79)","#stickybar-buynow-background-color-hover":"rgb(244, 72, 35)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(255, 255, 255)","#stickybar-buynow-border-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-border-radius":"0px"}
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Rasvamaksa ja tyypin 2 diabetes

Rasvamaksa ja tyypin 2 diabetes

Rasvamaksa on tyypin 2 diabeteksen syy ja seuraus. Rasvamaksa tarkoittaa rasvan runsasta kertymistä maksasolujen sisään. Rasvamaksa kehittyy kun ihminen saa pitkään, kuukausista vuosiin, enemmän energiaa kuin kuluttaa. Ylipaino, varsinkin vyötärölihavuus, on merkittävin rasvamaksan aiheuttaja. Jatkuvan positiivisen energiatasapainon lisäksi rasvamaksan aiheuttaja voi olla alkoholi.

 Normaalitilanteessa ylimääräinen ruoan mukana saatu hiilihydraatti varastoidaan elimistöön glykogeenina. Glykogeeni on pitkäketjuinen hiilihydraatti, jota voidaan varastoida lihaksiin ja maksaan. Maksa pystyy varastoimaan noin 200 grammaa glykogeenia ja lihakset noin 400-700 grammaa riippuen lihasmassasta. Glykogeenivarastot täyttyvät nopeasti, noin 24-48 tunnissa. Kun glykogeenivarastot ovat täynnä, ja elimistö ei kuluta liikaa tarjolla olevaa energiaa, muunnetaan ylimäärä rasvaksi ja varastoidaan ihon alle sekä maksaan ja vatsaonteloon. Rasvaa alkaa kertymään maksaan enemmän ja enemmän, ja lopulta maksan rasvoittuminen johtaa maksassa insuliiniresistenssiin. Sen lisäksi, että maksa varastoi glukoosia (hiilihydraattia) glykogeenina, niin se myös tuottaa glukoosia elimistön käyttöön. Insuliiniresistenssi maksassa kuitenkin aiheuttaa sen, että insuliini ei enää säätele normaalisti maksan glukoosintuotantoa, jolloin verensokeri pomppaa nousuun.

Diabetes(riski) ei ole ainoa rasvamaksan aiheuttama ongelma

Maksalla on yli 500 tehtävää. Maksan vajaatoiminnan merkit huomaa valitettavasti usein vasta, kun maksa on jo vaurioitunut. Kun oireita ilmaantuu niin maksan vajaatoiminta on jo pitkällä.

Maksan tärkeimpiä tehtäviä:

1. Se hajottaa lääkkeitä ja alkoholia
2. Varastoi vitamiineja, energiaa ja rasvaa (joskus liikaakin)
3. Valmistaa proteiineja ja edistää paranemista
4. Erittää sappea ruoansulatuksen käyttöön

Rasvaa varastoituu myös lihaksiin

Sen lisäksi, että rasvaksi muutettu ylimääräinen energia varastoituu ihon alle ja maksaan, varastoituu se myös lihaksiin. Aivan kuten maksassakin, niin myös lihaksissa rasvoittuminen johtaa insuliiniresistenssiin. Suurin osa ruoan mukana saadusta energiasta, eli hiilihydraatista (eli glukoosista), kuljetetaan lihaksien käyttöön, mutta kehittyvä insuliiniresistenssi estää glukoosin virtaamisen lihassoluun ja glukoosi jää verenkiertoon nostaen verensokeria. Insuliiniresistenssi lihaksissa nostaa verensokerin toistuvasti viitearvojen yli. Kun insuliiniresistenssien (maksan ja lihaksien) lisäksi otetaan vielä huomioon haiman insuliinia tuottavien beetasolujen toimintahäiriö, niin tuloksena on tyypin 2 diabetes.
 
 Maksan rasvoittuminen näkyy jo vuosia ennen 2 tyypin diabeteksen kehittymistä hitaana maksa-arvojen (ALAT, ASAT) nousuna, vaikka ne ei vielä ylittäisikään viitearvoja. Vuosien seurannan osoittamasta trendistä voitaisiin kuitenkin ennustaa niin rasvamaksan kuin tyypin 2 diabeteksen kehittyminen.

Videolla lääkärimme Jakob Valdma käy läpi rasvamaksan syyt ja seuraukset:


Haiman beetasolujen toimintahäiriön taustalla samat syyt

Samalla tavalla, kuten rasvaa kertyy maksaan johtaen rasvamaksaan, kertyy ylimääräistä rasvaa myös haimaan. Haiman rasvoittuminen johtaa insuliinia tuottavien beetasolujen rasvoittumiseen johtaen niiden toimintakyvyn romahtamiseen ja insuliiniresistenssiin. Jopa insuliinia tuottavat solut voivat siis olla resistenssejä insuliinille. Yhtälö johtaa beetasolujen tuhoutumiseen pitkällä aikavälillä. 

Pähkinänkuoressa:

Jatkuva positiivinen energiatasapaino, eli energian ylimäärä suhteessa kulutukseen kerryttää rasvaa sisäelimiin, lihaksiin ja ihon alle. Sisäelimien rasvoittuminen alentaa niiden toimintakykyä ja aiheuttaa insuliiniresistenssia. Sisäelinten, kuten maksan ja haiman, toimintakyvyn häiriintyminen johtaa liitännäissairauksiin. Esimerkiksi rasvamaksa aiheuttaa tyypin 2 diabetesta ja toisin päin. Tyypin 2 diabetes aiheuttaa rasvamaksaa, joka entisestään huonontaa diabeteksen hoitotasapainoa.

  Yksinkertaisesti tehokkain keino pysäyttää sairauksien eteneminen ja jopa peruuttaa ne, on saada toistuvasti korkeintaan yhtä paljon energiaa kuin kuluttaa, mutta mielellään vähemmän - erityisesti mikäli on ylipainoa.

Kirjoittanut:

Lempin vastuulääkäri Jakob Valdma


Lähteet:

  • Effect of short-term carbohydrate overfeeding and long-term weight loss on liver fat in overweight humans. 
  • Sevastianova K, Santos A, Kotronen A, Hakkarainen A, Makkonen J, Silander K, Peltonen M, Romeo S, Lundbom J, Lundbom N, Olkkonen VM, Gylling H, Fielding BA, Rissanen A, Yki-Järvinen H 
  • Am J Clin Nutr. 2012 Oct; 96(4):727-34. 
  • Diabet Med. 2013 Mar; 30(3): 267–275. 
  • Banting Memorial Lecture 2012 Reversing the twin cycles of Type 2 diabetes 
  • R Taylor, Diabet Med. 2013 Mar; 30(3): 267–275. Published online 2013 Feb 20. doi: 10.1111/dme.12039