Nealkoholna masna bolest jetra i šećerna bolest

master's thesis

• Title (english): Non-alcoholic fatty liver disease and diabetes
• Author: Viktoria Škurla
• Mentor: Ivica Grgurević (mentor)
• Committee member: Lucija Virović Jukić (predsjednik povjerenstva)
• Committee member: Ivančica Delaš (član povjerenstva)
• Committee member: Ivica Grgurević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2020-09-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Nealkoholna masna bolest jetre (NAFLD) jedna je od najčešćih jetrenih bolesti, te među prva tri uzroka transplantacije jetre. Glavno obilježje NAFLD je nakupljanje masti u jetri. Poremećaj uključuje nealkoholnu masnu jetru (NAFL) i nealkoholni steatohepatitis (NASH). NAFL karakterizira nakupljanje masti u jetri, dok NASH uz steatozu prati upala i oštećenja stanica jetre.
Najteža komplikacija NAFLD-a je razvoj ciroze jetre i hepatocelularnog karcinoma (HCC), koji su ujedno i razlozi za transplantaciju jetre. Šećerna bolest i NAFLD su međusobno uzročno povezani pri čemu prisutnost dijabetesa u bolesnika s NAFLD uzrokuje teže oblike bolesti. Osim dijabetesa, razvoju masne jetre pogoduju prekomjerena tjelesna masa, arterijska hipertenzija i dislipidemija (smanjena koncentracija lipoproteina velike gustoće (HDL) i/ili povećana koncentracija triacilglicerola)
koji zajedno čine metabolički sindrom (MetS) kao najvažniji uzrok kardiovaskularnog morbiditeta danas. NAFLD je najčešće asimptomatska bolest te se većinom otkrije tek u poodmaklom stadiju. Prezentira se najčešće umorom i nelagodom pod desnim
rebrenim lukom. Puno češće u prvi plan izbijaju pridruženi komorbiditeti poput šećerne bolesti, kardiovaskularnih bolesti, pa čak i ekstrahepatalni tumori. Zbog toga se NAFLD smatra dijelom multisustavne bolesti kojoj je u podlozi MetS. Za dijagnostiku NAFLD koristimo neinvazivne i invazivne metode. Neinvazivne metode su biokemijski pokazatelji i slikovna dijagnostika, a
invazivna metoda je biopsija jetre. Biopsija jetre je još uvijek jedina metoda kojom se pouzdano postavlja dijagnoza NASH-a. Za liječenje NAFLD-a ključna je promjena stila života. Dijeta i tjelesna aktivnost nužne su za gubitak tjelesne mase i smanjenje jetrene steatoze. Mnogi lijekovi su u fazi istraživanja, a ključno je adekvatno regulirati postojeće metaboličke poremećaje.

Abstract (english)

Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of liver disease, and one of the first three causes for liver transplantation. Main characteristic of NAFLD is excessive hepatic fat accumulation. NAFLD includes two conditions, non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH). NAFL is characterized with liver steatosis, while NASH includes steatosis, inflammation and liver damage. The most severe NAFLD outcomes are liver
cirrhosis and hepatocellular carcinoma (HCC), which are also most common indications for liver tranplantation. Diabetes and NAFLD are intertwined. Diabetes causes severe form of NAFLD. In addition to diabetes, the development of fatty liver is favored by obesity, arterial hypertension and dyslipidemia (decreased concentration of high density lipoproteins (HDL) and/or elevated triglycerides) which represent metabolic syndrome (MetS) as one of the most important cause of cardiovascular morbidity. Usually, NAFLD is asymptomatic and is mostly detected at an advanced stage. It mostly presents with fatigue and right upper abdominal discomfort. Much more often, associated comorbidities such as diabetes, cardiovascular disease, and even extrahepatic tumors stand out. Therefore, NAFLD is considered as part of the multisystem disease underlying MetS. We use non-invasive and invasive methods to diagnose NAFLD. Non-invasive methods include biochemical parameters and imaging methods, and invasive methods include liver biopsy. Liver biopsy is still the only method that can reliably diagnose NASH. Lifestyle change is the key to treating NAFLD. Diet and physical activity are necessary for weight loss and reduction of hepatic steatosis. Many drugs are in the research phase, and it is crucial to adequately regulate existing metabolic disorders.

• Keywords: NAFLD; diabetes mellitus tip 2; steatoza; NASH
• Keywords (english): NAFLD; diabetes mellitus type 2; steatosis; NASH
• Language: croatian
• URN:NBN: urn:nbn:hr:105:356302
• 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: 2021-03-22 13:53:33