Promjene količine masnoga i krtoga tkiva u bolesnika s kroničnom opstruktivnom bolešću i metaboličko značenje humoralnih čimbenika

doctoral thesis

• Title (english): Proportion of body fat and lean mass in patients with chronic obstructive disease and metabolic role of humoral factors
• Author: Marta Koršić; VIAF: 305589739
• Mentor: Vesna Kušec (mentor)
• Committee member: nije dostupno (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2015-09-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences
• Universal decimal classification (UDC): 61 - Medical sciences

Abstract

Uvod: Kronična opstruktivna plućna bolest (KOPB) čini vrlo kompleksnu sistemsku bolest.
Debljina i kaheksija su dvije krajnosti metaboličkog poremećaja koje su karakteristične za
KOPB, a povezuju se sa sistemskom upalom.
Masno tkivo stvara i oslobađa proupalne i protuupalne čimbenike uključujući IL-6, TNF-α,
leptin, adiponektin koji imaju važnu ulogu u regulaciji sastava tijela.
Ispitanici i metode: Cilj ovog istraživanja bio je ispitati postojanje razlika u sastavu tijela (udio
masnog i krtog tkiva) kod bolesnika s KOPB-om ovisno o težini bolesti i povezanost s
koncentracijom humoralnih čimbenike upale (TNF-α, IL-6), adipokina (adiponektin, leptin),
statusa D vitamina (25-OH D) i koštanog sustava. Ispitivanje je uključilo 108 ispitanika s KOPBom
oba spola kojima je udio masnog, krtog tkiva i koštane mase određivan DEXA metodom.
Rezultati: U trećine bolesnika s KOPB-om nađena je prekomjerna tjelesna težina i pretilost s
posljedičnim učinkom na osobitosti sastava tijela (udjeli masnog i krtog tkiva) uz bolju koštanu
masu. Hipovitaminoza D je prisutna u skoro svih bolesnika. U bolesnika oba spola s blažim
stadijem KOPB-a također je bila očuvana krta tjelesna masa, a u muškaraca ujedno i koštana
masa bila bolja. Leptin pozitivno korelira s tjelesnom masom i parametrima raspodjele masnog
tkiva, te nekim denzitometrijskim parametrima koštane mase u oba spola. U muškaraca je blaži
oblik bolesti povezan s boljim koštanim statusom, a u žena s većom krtom masom. Samo u
muškaraca postoji negativna korelacija adiponektina s BMI i indeksima masnog tkiva, te
koštanim statusom kuka. Učestalost osteoporoze i osteopenije je uglavnom podudaran u oba
spola, ali je učestalost smanjene koštane mase za područje slabinske kralježnice znatno veća u
žena nego u muškaraca u ovom istraživanju.
Zaključak: KOPB je stanje koje zahvaća osim pluća, većinu organskih sustava s ozbiljnim i
teškim posljedicama po mišićni i koštani sustav, a uslijed upalnog stanja pluća i sustavne upale.
Poznavanje i razumijevanje povezanosti osnovne bolesti i promijenjenog sastava tijela ovih
bolesnika je od velike važnosti za medicinsku skrb i prognozu ovih bolesnika.

Abstract (english)

Introduction: Chronic obstructive pulmonary disease (COPD) is a very complex systemic
disease. Obesity and cachexia are the two extremes of metabolic disorders that are characteristic
for COPD and associated with systemic inflammation. Adipose tissue produces and releases a
proinflammatory and anti-inflammatory factors, including IL-6, TNF-α, leptin, adiponectin,
which play an important role in the regulation of body composition.
The aim of this study was to investigate differences in body composition (ratio of fat and lean
mass) in patients with COPD depending on the severity of the disease and correlation with the
concentration of humoral factors of inflammation (TNF-α, IL-6), adipokines (adiponectin, leptin),
the status of vitamin D (25-OH D) and skeletal system.
In the study 108 patients with COPD were included. The proportion of fat, lean mass and bone
mineral density were determined by DEXA.
Results: Thirty percent of COPD patients were found to be overweight and obese with a
consequential effects on the characteristics of body composition (fat and lean tissues) and
increased bone mass density. Hypovitaminosis D is present in almost all patients. Patients of both
sexes with mild-stage COPD preserved lean body mass, while in men bone mass was also better.
Leptin is positively correlated with body mass, parameters of body fat distribution and some
densitometric parameters of bone mass in both sexes. In men a milder form of the disease is
associated with better bone status and in women with the better lean mass. Only in men there is a
negative correlation of adiponectin with BMI and indexes of body fat and hip bone status. The
incidence of osteoporosis and osteopenia is generally identical in both sexes, but the prevalence
of reduced bone mass in the lumbar spine area is significantly higher in women than in men.
Conclusion: COPD is a condition that affects lungs and also other organ systems with serious
effects on muscular and skeletal system due to systemic inflammatory conditions. Knowing and
understanding the relations of the underlying disease and altered body composition of these
patients is of great importance to medical care and prognosis of these patients.

• Keywords: medicina
• Keywords (english): medicine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:450068
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
• Type of resource: Text
• Extent: 117 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-05-05 07:34:51