Povezanost čimbenika rasta fibroblasta 23 i gubitka koštane mase u kandidata za transplantaciju jetre

doctoral thesis

• Title (english): Association between fibroblast growth factor 23 and bone loss in liver transplant candidates
• Author: Andrija Jurina
• Mentor: Mario Starešinić (mentor)
• Mentor: Marijana Vučić Lovrenčić (komentor)
• Committee member: Zlatko Giljević (predsjednik povjerenstva)
• Committee member: Anna Mrzljak (član povjerenstva)
• Committee member: Vesna Kušec (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-07-03, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Orthopedics
• Universal decimal classification (UDC): 617 - Surgery. Orthopaedics. Ophthalmology

Abstract

Uvod: Jetrena osteodistrofija (engl. hepatic osteodistrophy, HO) je koštano-mineralni poremećaj u kandidata za ortotopnu transplantaciju jetre (OTJ) koju obilježava gubitak koštane mase i sklonost prijelomima. Čimbenik rasta fibroblasta 23 (engl. fibroblast growth factor 23, FGF23) regulira metabolizam fosfata i vitamina D, a povećane koncentracije se povezuju s gubitkom koštane mase i osteoporotskim prijelomima. Cilj ovog istraživanja je bio ispitati povezanost gubitka koštane mase i koncentracije intaktnog FGF23-a (engl. intact FGF23, iFGF23) u kandidata za OTJ.
Ispitanici i metode: U istraživanje su uključeni odrasli kandidati za OTJ. Gubitak koštane mase (osteopenija ili osteoporoza) je dijagnosticiran s pomoću denzitometrije kosti X-zrakama dvostruke prodornosti (DXA), a prijelomi kralježnice standardnim radiološkim snimkama. Izmjerene su koncentracije parametara koštano-mineralnog metabolizma, upale, inzulinske rezistencije, iFGF23 i aktivnost koštane alkalne fosfataze (BALP) u krvi. Ispitanici su podijeljeni u skupinu bez i s gubitkom koštane mase.
Rezultati: U istraživanje je uključeno 90 ispitanika (40 u skupini bez, a 50 u skupini s gubitkom koštane mase). Pojavnost gubitka koštane mase iznosila je 55,6%, a prijeloma kralježnice 48,9%. Nije bilo razlike statistički značajne razlike u parametrima koštano-mineralnog metabolizma, upale, inzulinske rezistencije te iFGF23-a između promatranih skupina. Aktivnost BALP-a bila je povećana u ispitanika s gubitkom koštane mase. Ženski spol i veća aktivnost BALP-a nezavisni su čimbenici rizika gubitka koštane mase, a starija životna dob prijeloma. Aktivnost BALP-a značajno je negativno korelirala s nalazom DXA.
Zaključci: Pojavnost gubitka koštane mase i osteoporotskih prijeloma kralježnice u kandidata za OTJ je veća nego u zdravoj populaciji. Koncentracija iFGF23-a nije povezana s gubitkom koštane mase.

Abstract (english)

Introduction: Hepatic osteodystrophy (HO) is a bone-mineral disorder in orthotopic liver transplantation (OLT) candidates that leads to bone loss and tendency to fractures. Fibroblast growth factor 23 (FGF23) regulates phosphate and vitamin D metabolism, and is associated with bone loss and fragility fractures. The aim of this study was to examine the relationship between bone loss and the concentration of intact FGF23 (iFGF23) in OLT candidates.
Patients and methods: Adult OLT candidates were included in the study. Bone loss (osteopenia or osteoporosis) was diagnosed using dual-energy X-ray absorptiometry (DXA), and spinal fractures by standard radiological imaging. Parameters of bone-mineral metabolism, inflammation, insulin resistance, iFGF23 and bone alkaline phosphatase (BALP) activity were measured in blood. Patients were divided into groups with and without bone loss.
Results: Ninety (90) patients were included in the study (40 in the group without and 50 in the group with bone loss). The bone loss prevalence was 55.6% and vertebral fractures 48.9%. No significant differences in parameters of bone-mineral metabolism, inflammation, insuline resistance and iFGF23 were found between groups. Group with bone loss had higher BALP activity. Female gender and higher values of bone alkaline phosphatase were independent risk factors for bone loss, while older age was for fractures. BALP activity significantly negatively correlated with DXA results.
Conclusions: Prevalence of bone loss and osteoporotic fractures among OLT candidates is higher than in healthy population. No association exists between iFGF23 concentration and bone loss.

• Keywords: Osteoporotični prijelomi; Prijelomi kralježnice; Transplantacija jetre; Faktor rasta fibroblasta-23; Inzulinska rezistencija; Osteoporoza; Bolesti kostiju
• Keywords (english): Osteoporotic Fractures; Spinal Fractures; Liver Transplantation; Fibroblast Growth Factor-23; Insulin Resistance; Osteoporosis; Bone Diseases
• Language: croatian
• URN:NBN: urn:nbn:hr:105:564008
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 73 str.
• File origin: Born digital
• Access conditions: Embargoed access; Embargo expiration date: 2026-07-03
• Created on: 2024-07-23 08:08:41