Nealkoholna masna bolest jetre

master's thesis

• Title (english): Nonalcoholic fatty liver disease
• Author: Andrea Pavić
• Mentor: Lucija Virović Jukić (mentor)
• Committee member: Maja Hrabak Paar (predsjednik povjerenstva)
• Committee member: Ivančica Delaš (član povjerenstva)
• Committee member: Lucija Virović Jukić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Nealkoholna masna bolest jetre definirana je pretjeranim nakupljanjem masti u jetri, koje se dokazuje histološki ili slikovnim metodama, uz odsustvo drugih uzroka steatoze. Uključuje dva entiteta: nealkoholnu masnu jetru i nealkoholni steatohepatitis s mogućnošću progresije prema fibrozi i cirozi. Procijenjena globalna prevalencija bolesti je oko 25% i dalje je u porastu. Patogeneza bolesti je složena, a najčešće je objašnjavana teorijom „dvostrukog udarca“, od kojih je prvi nakupljanje masti, a drugi oštećenje hepatocita i upala. Dodatni mehanizmi su uključeni u razvoj fibroze. Nealkoholna masna bolest jetre usko je vezana uz inzulinsku rezistenciju, a značajni su u patogenezi i razlitiči proupalni citokini i adipokini. Klinička slika je nespecifična, a u dijagnostici se koriste laboratorijski nalazi, slikovne metode i biopsija jetre, koja je još uvijek zlatni standard za potvrdu dijagnoze i procjenu uznapredovalosti bolesti. Liječenje treba biti individualno, a učinak u liječenju pokazuju gubitak na tjelesnoj masi i povećanje tjelesne aktivnosti, farmakološka terapija pioglitazonom i vitaminom E, te operativni zahvati usmjereni redukciji tjelesne mase. Nealkoholna masna bolest jetre može dovesti i do smrtnih ishoda uzrokovanih samom bolešću jetre, ali češće su uzrok smrti pridružene kardiovaskularne bolesti.

Abstract (english)

Nonalcoholic fatty liver disease is defined as the presence of hepatic fat accumulation, proven by histological analysis or imaging techniques, in the absence of other causes of steatosis, and includes two entities: nonalcoholic fatty liver and nonalcoholic steatohepatitis with possible progression to fibrosis and cirrhosis. The estimated global prevalence of the disease is around 25% and it is increasing. The pathogenesis of the disease is complex, and is usually explained
by the "two hits" hypothesis, the first of which is fat accumulation and the other damage to hepatocytes and inflammation. Additional mechanisms are involved in the development of fibrosis. Nonalcoholic fatty liver is associated with insulin resistance, but other different cytokines and adipokines are also involved in the pathogenesis of the disease. Clinical feature is nonspecific, and in diagnosing laboratory findings, imaging techniques, and liver biopsy are used. Liver biopsy still remains the gold standard for diagnosis and assessment of disease progression. The treatment should be tailored individually, and the effect can be achieved by body mass reduction, increase in physical activity, pharmacologic therapies with pioglitazone and vitamin E, and bariatric surgery. Nonalcoholic fatty liver disease can lead to death, caused by the liver disease alone, but more frequently causes of death are associated with cardiovascular diseases.

• Keywords: nealkoholna masna bolest jetre; inzulinska rezistencija; steatoza; nealkoholni hepatitis; ciroza
• Keywords (english): nonalcoholic fatty liver disease; insulin resistance; steatosis; nonalcoholic hepatitis; cirrhosis
• Language: croatian
• URN:NBN: urn:nbn:hr:105:158214
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-03-14 08:04:48