Dijabetička dislipidemija

master's thesis

• Title (english): Diabetic dyslipidemia
• Author: Iva Bilješko
• Mentor: Tomislav Bulum (mentor)
• Committee member: Lea Smirčić-Duvnjak (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Tomislav Bulum (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Šećerna bolest tipa 2 je kronična bolest koja ukoliko nije zadovoljavajuće regulirana rezultira razvojem kroničnih komplikacija na raznim organima i značajno povećava rizik kardiovaskularne bolesti. Šećerna bolest tipa 2 predstavlja izniman javnozdravstveni problem jer bolesnici u većini slučajeva nemaju jasne simptome, otkivaju se prekasno uz komplikacije te opterećuju zdravstveni sustav. Temeljni patofiziološki čimbenik razvoja šećerne bolesti tipa 2 je inzulinska rezistencija koja je povezana s razvojem metaboličkog sindroma te karakteristične dijabetičke dislipidemije koja značajno doprinosi povišenom kardiovaskularnom riziku. Dijabetičku dislipidemiju karakterizira povišena razina VLDL-kolesterola i triglicerida uz sniženu razinu HDL-kolesterola. Značajne promjene se događaju i na razini LDL kolesterola koji često nije značajno povišen ali dominira prevaga malih gustih LDL čestica koje su značajno aterogenije od normalnih LDL-čestica. Male guste LDL čestice su osjetljivije na oksidaciju, lakše ulaze u arterijsku stijenku od velikih čestica te se duže zadržavaju u cirkulaciji. U novim smjernicama u liječenju dijabetičke dislipidemije dodatno je snižena ciljna vrijednost LDL-kolesterola kao glavnog terapijskog cilja, osobito u bolesnika sa šećernom bolešću i komorbiditetima. Temelj liječenja dijabetičke dislipidemije predstavlja pridržavanje dijabetičke dijete te tjelesna aktivnost. Većina bolesnika zahtijevaju i farmakološko liječenje kod kojeg prednost imaju visokopotentni statini (atorvastatin, rosuvastatin) sa ili bez ezetimiba, fibrati u slučaju hipertrigliceridemije te u slučaju potrebe PCSK-9 inhibitore.

Abstract (english)

Diabetes type 2 is a chronic disease, which unless regulated results in development of chronic complications for different organs and increases cardiovascular risk. It also represents an exceptional public health issue due to lack of clear symptoms in the majority of patients. It is discovered too late with secondary complications which bur-den the health care system. Essential pathophysiological factor in diabetes type 2 de-velopment is the insulin resistance which leads to development of metabolic syn-drome, as well as specific dyslipidemia in diabetes. It contributes significantly to the increased cardiovascular risk. Dyslipidemia in diabetes is characterised with higher levels of VLDL-cholesterol and triglyceride with lower level of HDL-cholesterol. Signi-ficant changes are happening at the LDL-cholesterol level which hasn't increased but there is a dominating level of small and thick LDL-particles. They are vastly more at-herogenic than normal LDL-particles. Small and thick LDL-particles are more sensi-tive to oxidation and easier to enter in the endothelium than bigger particles, which are contained longer in circulation. New guidelines for dyslipidemia in diabetes are showing that lowering LDL-cholesterol values is the main therapy goal, especially with patients with diabetes and comorbidities. Dyslipidemia in diabetes treatment is based on diabetic diet and physical activity. Majority of patients also demand phar-macological treatment which is based on high potent statins (atorvastatin, rosuvasta-tin) with or without ezetimibe, fibrates in case of hypertriglyceridemia, and if needed PCSK-9 inhibitors.

• Keywords: inzulinska rezistencija; dijabetička dislipidemija; šečerna bolest; kardiovaskularni rizik
• Keywords (english): insulin resistance; dyslipidemia in diabetes; diabetes; cardiovascular risk
• Language: croatian
• URN:NBN: urn:nbn:hr:105:024792
• 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: 2023-01-03 11:59:43